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164 Cards in this Set
- Front
- Back
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fungi are -- cells
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eukaryotic
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fugi have -- cell wall containing ---
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rigid
chitin |
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cell membrane of fungi composed of --
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ergosterol
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fungi have different ----
distinct ---- |
ribosome
nuclear membrane |
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fungi are resistant to ---
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antibiotics
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fungi are -- cells
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eukaryotic
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fugi have -- cell wall containing ---
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rigid
chitin |
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cell membrane of fungi composed of --
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ergosterol
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fungi have different ----
distinct ---- |
ribosome
nuclear membrane |
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fungi are resistant to ---
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antibiotics
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predisposing factors for fungal infections to develop:
loss of ---- --- deficiency --- abnormalities suppression of ----- organism ---, ---- environment |
barriers
immunodeficiency metabolic competing warm, moist |
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fungal infections most often involve the ---,but can be --- adn very difficult to tx
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skin
systemic |
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overview of drugs to tx fungal infections
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polyenes
flucytosine imidazole triazoles echinocadins griseofulvin allyamines |
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polyenes work by altering --- integrity and ------
also inhibit --- ---- |
membrane
permeability ergosterol synthesis |
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azoles inhibit --- ------
decreased ----- |
innosterol demethylase
ergosterol |
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allyamines: inhibit --- ----
decreased ---- |
squalene epoxidase
ergosterol |
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enchinocandins inhibit --- in cell wall formation
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D-glucans
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which antifungal inhibit cell wall
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echinocandins
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which anitfungal inhibit cell membrane
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polyenes
azoles allylamines |
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cell division inhibition due to
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griseofulvin
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griseofulvin inhibits
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microtubules
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nucleic acid synthesis inhibition due to
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flucytosine
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flucytosine converted to 5- ---- then to 5- -----
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flurouracil
fluorouradine |
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flucytosine inhibits --- synthase
inhibits --- synthesis |
thymidylate
dna |
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ampotericin b forms channels in --- membranes to allow -- and -- to leak out/in of cells
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ergosterol
K Mg out |
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ampotericin b causes -- damage to membrane
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oxidative
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iv ampohtericin
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amphotericin b deoxycholate
c-amb (fungizone) |
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lipid formulations of amp b
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amp b lipid complex
amp b colloidal suspension liposomal amp b |
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amphotericin b txs
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crytococcus
blatomyces histoplasma candida coccidioides aepergillus |
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how long should u infuse amphotericin b for
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4 hrs
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what limits tx of amphotericin b
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se
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ae of amphotericin:
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fever
chills |
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why fever and chills w/ amp b
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due to IL-1 and TNF
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what do u pretreat w/ amp b
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apap
antihistamine corticosteroids |
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ae of amp b
--- abnormalities ---tension --ia decreased ---- |
electrolyte
hypotension uremia decreased filtration |
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which med ahs a life dose
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amp b
(3-5 g) |
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amp b can cause -- ---damage
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renal tubule
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how to prevent renal tubule damage w/ amp b
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hydrate w/ ns
to decrease amount in tubules |
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route of nystatin
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topical
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nystatin used for --- ---
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oral candidiasis
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t/f
nystatin not absorbed |
t
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nystatin is -- toxic
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nephro
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nystatin very similar to ---
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amp b
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5 flurocytosine converted to ---- by cytosine deaminase
why doesn't it affect human cells |
5-flurouridine
humans lack cytosine deaminase |
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5-flurocytosine inhibits ----- syntase
this inhibits -- adn --- synthesis |
thymidylate
dna rna |
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indicatiosn for 5-flurocytocine:
used w/ amp b for --- used w/ ----- in chrombobastomycosis |
cryptococcal meningitis
itraconazole |
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ae of 5-flurocystosine:
---- suppression ---toxicity ---- disturbances ----- |
bone marrow
hepatotoxicity gi disturbances rash |
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imidazoles and triazoles
inhibit ---- involved in conversion of ---- to ----- |
14-alpha-demethylase
lanosterol ergosterol |
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indications for imidazoles and triazoles
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aspergillis
athletes food ringworm jock itch onychomycosis: nails |
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ketoconazole route
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oral
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t/f
ketoconazole should not be taken w/ meals |
f
take w/ meals |
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t/f
ketoconazel enters the cns |
f
doesn't (rarely used) |
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ae ketoconazole
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n/v
anorexia |
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ketoconazole inihibits cyp ------
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3A4
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itraconazole: --- active
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orally
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itraconazole has a --- spectrum
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wider
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itraconazole --- metabolite
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active
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itraconazole useful in
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blastomycosis
histoplasmosis onchyomycosis febrile neutopenic patients not responding to abx |
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itraconazole subrate for and inhibitor of cyp ----
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3A4
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t/f
ok to give itraconazole during pregnancy |
teratogenic
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posaconazole is a imidazole/triazole
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triazole
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posaconazole structurally r/t
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itraconazole
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which is more potent against 14 alpha demethylase
posaconazole or itraconazole |
posaconazole
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posaconazole route
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oral
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posaconazole mainly eliminated in --- unchaged
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feces
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posaconazole
high/low protein binding |
high
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t/f
posaconazole given w/ food |
t
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posaconazole effective against
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aspergillis
candida zygomycetes refractory fungal infections |
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only azole effective against zygomycetes
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posaconazole
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ae of posaconazole
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qt prolongation
fever diarrhea hypokalemia thrombocytopenia |
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imidazoles and triazoles cause
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qt prolongation
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which zole has the best oral absorption
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fluconazole
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t/f
fluconazole penetrates the cns |
t
so can be used in crytococcal meningitis, preventative in AIDS |
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what's used for oral and vaginal candidiasis
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fluconazole
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fluconazole excreted in the ---
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urine
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how many dose of fluconazole given for vaginal candidiasis
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single
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fluconazole inhibits cyp --- and cyp -----
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3A4
2A4 |
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fluconazole can cause:
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n/v
teratogenic in animals |
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which has less se voriconazole or amphoterin
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voriconazole
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voriconazole route
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oral
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voriconazole effective against
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systemic aspergillis
candida |
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voriconazole effects
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vision
liver and renal fx teratogenic in animals |
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what's starting to replace amp
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voriconazole
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class of caspofungins
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echinocandins
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route of caspofungin
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iv
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caspofungin inhibit -- --- formation
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cell wall
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caspofungin used for
---- candidiasis systemic ----- not responding to itraconazole or amp ---- --- pt not responding to abx |
espohageal
aspergillis febrile neutropenic |
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griseofulvin interupts --- ----, stops cell division in -----
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mitotic spindles
dermatophytes |
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griseofulvin deposited in ---- precursor cells in ---, --- and -----
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mitotic spindles
skin hair nails |
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what body parts will griseofulvin tx
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skin
hair nails |
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tx --- infections w/ griseofulvin for 1 month
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scalp
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tx -- infections w/ griseofulvin for 6-9 months
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fingernails
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tx ----- infections w/ griseofulvin for up to 12 months
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toenails
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griseofulvin is --- soluable
effective agains numerous ------ not candida (fungistatic) |
lipid
dermatophytes |
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what will increase absorption of griseofulvin
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high fat meals
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ae of griseofulvin
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ha
mental confusion fatigue blurred vision induces microsomal enzymes cyp 3a4 |
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two drugs of allylamines
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naftifine
terbinafine |
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allylamines inhibit ---synthesis
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ergosterol
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which allylamines is used topically?
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naftifine
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which allylamines is used orally
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terbinafine
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allylamines are used for ----- --- infectins
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superficial dermatophyte
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tx --- infections w/ allylamines for 6-12 weeks
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fingernail
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tx --- infections w/ allylamines for up to 12 months
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toenail
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tolnafate effective against ---- ----
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cutaneous mycoses
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t/f
tolnalfate effective against candidda |
f
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tolnafate used against
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tinea pedia
tinea cruris tinea corporis NOT tinea unguium |
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t/f tolnafate used for fingernail infection
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f
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stategies for prevention of protozoa
control --- supplying ---- improved ---- and ---- --- ---tx |
vector
parasite hygiene sanitation vaccination chemotx: prophylaxis |
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tx of leishmaniasis
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Na stibogluconate
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leishmaniasis is spread by
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sandflies
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tx of trypanosomiasis
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melarsoprol
nifurtimox |
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tx of amoebiasis
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iodoquinol
metronidazole |
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tx of giardiasis
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metronidazole
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tx of trichomonaisis
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metronidazole
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metronidazole used to tx:
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amebiasis
giardiasis trichomoniasis |
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griseofulvin is fungi----
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static
(why's it's ineffective against candida) |
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metronidazole is converted by a --- enzyme to a free ------ which attacks the dna of the protozoa
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protozal
nitroradicals |
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ae of metronidazole
--- discomfort --- like rxn --- taste avoid taking in --- trimester |
gi
disulfiram metallic 1st |
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what do you give for metronidazole resistant organisms
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tinidazole
has similar ae |
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malaria:
--- to liver -- to plasma |
sporozoite
merozoites |
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malaria enters -----
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rbc
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malaria
--- rupture ------ |
schizonts
rbc |
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what's associated w/ rupture of rbc
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fever
chills |
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t/f
malaria passed back to mosquito |
t
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what prevents growth of malaria in rbc
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pyrimethamine
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what clears malaria protozoa from the blood
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chloroquine
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what med used in late hepatic stage
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primaquine
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what med is used in rbc stage
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quinine
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which med used as prophylaxis in malaria
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atovaquone
proguanil |
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what meds used in mild to mod attacks of malaria
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atovaquone
proguanil |
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how long will it take for chloriquine to clear blood of protozoa
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about 72 hrs
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t/f
chloriquine clears protozoa from the liver |
f
only the blood so malaria not completely gone |
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pyrimethamine inhibits --- ----- reductase
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protozoal dihydrofolate
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pyrimethamine prevents formations of --- in blood cells
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schizonts
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ae of pyrimethamine
---- ---- deficiency ---penia -----penia w/ sulfa drugs: ---- ------ |
folic acid
leukopenia thrombocytopenia exfoliative dermatitis steven-johnson's syndrome |
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t/f
chlorquine is used as tx only |
f
tx and prophylaxis |
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chlorquine is effective against ---- ----- protozoa
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blood borne
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resistance developing for chlorquine against
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p falciparium
most virulent form |
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ae of chlorquine
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itching
vomiting ha retinopathy caridac depression ototoxicity |
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what used for chlorquine resistance
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mefloquine
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ae of mefloquine
neuro--- syndrome w/ mental ----- ---- anxiety seizures coma ---penia ---penia |
psychiatiric
confusion hallucinations anxiety seizures coma leuko thrombo |
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t/f
worry about resistance for mefloquine |
t
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what effective in late hepatic stage of malaria
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primaquine
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primaquine used in combo w/
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chlorquine
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ae of primaquine
-- disturbances --- in glucose-6-phosphate deficiency |
gi disturbances
hemolysis |
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quinine used in --- stage of malaria
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ethrocytic
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quinine used in --- attacks or --- ---
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mild
resistante |
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what can be used in place of quinine
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quinidine
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ae of quinine
--- depression -- tension --- and --- disturbances blood ---- |
cardiac
hypotension visual/auditory blood dyscrasias |
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atovaquone inhibits --- fx
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mitochondrial
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atovaquone used in combo w/ --- to prevent resistnace
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proguanil
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atovaquone inhibits -- stages of malaria
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liver
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ae of atovaquone
---- pain ---- --- |
abd pain
n/v |
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doxycycline used as --- in malaria
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prophylactic
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when is doxycycline given for malaria
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1-2 days before
during 4 weeks after return |
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doxycycline used in combo w/ quinine for -- resistant plasmodium falciparium
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chloroquine
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pneumocystitis jiovicii is -- in nature
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fungal
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t/f
most kids have pneumocystitis jiovicii |
t
asymptomatic or mild infection by age 4 |
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who's prone to getting pneumocystitis jiovicii
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malnourished
premature infants immunocompromised |
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tx for pneumocystitis jiovicii and is a prophylactic in AIDS patients
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trimethoprim-sulfamthoxazole
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what's used in pts unresponsive to trimethoprim-sulfamthoxazole
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trimetrexate
|
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why give leucovorin w/ trimetrexate
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cuz trimetrexate also blocks production of folic acid
needed as a rescue |
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what used as prophylaxis in pneumocystitis jiovicii
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atovaquone
dapsone |
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leucovorin is the active form of
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folic acid
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