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14 Cards in this Set
- Front
- Back
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DOC for amebiasis
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Metronidazole
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Giardiasis
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Metronidazole or furazolidone
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Trichomoniasis
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Metronidazole (treat both partners)
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Pneumocystics
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TMP-SMX (back ups are atavaquone or pentamidine IV)
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Toxoplasmosis
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Pyremethamine and sulfadiazine
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Leishmaniasis
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Stibogluconate (antimonial)
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Trypanosomiasis
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Nifurtimox (Chagas)
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Amphoterecin B
(a) mechanism of action (b) spectrum/clinical use (c) mechanism of resistance (d) toxicity/notes |
(a) binds ergosterol, causing formation of artificial pores altering membrane permeability
(b) For systemic fungemial ;Wide antifungal spectrum (asp, cocci, blasto, histo, candida, crypto, mucor, sporothrix); intrathecal for fungal meningitis (does not cross BBB) (c) very uncommon; decrease or structurally altered ergosterol (d) cytokine storm (fevers/chills/hypotension); nephrotoxicity limits dosing; reversible anemia (secondary to epo decr); arrhythmias, IV phlebitis |
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Flucytosine
(a) mechanism of action (b) spectrum/clinical use (c) mechanism of resistance (d) toxicity/notes |
(a) permease allows entry, deaminated to 5-FU, converted to FdUMP (thymidylate synth inhibitor)
(b) Crypto, Candida albicans (systemic) in combo w/ampB (c) rapid if used as a single agent; decreased activity of fungal permease and deaminases (d) reversible bone marrow suppression; alopecia; n/v/d; typically combined w/AmpB or fluconazole |
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Azoles: fluconazole, itraconazole, voriconazole, ketoconazole
(a) mechanism of action (b) spectrum/clinical use (c) mechanism of resistance (d) toxicity/notes |
(a) inhibit synthesis of ergosterol leading to altered membrane permeability
(b) Systemic mycoses; Fluc: cryptococcal meningitis in AIDS and candidal infx of all types Keto: blasto, cocci, histo, candida; hypercortisolism Clotri and Micon: topical (c) decreased sensitivity of target enzyme (d) v/d; skin rash; rare hepatotoxicity; gynecomastia (hormone synth inhibition); decr p450 inhibition |
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Echinocandin (caspofungin)
(a) mechanism of action (b) spectrum/clinical use (c) mechanism of resistance (d) toxicity/notes |
(a) inhibit synth of beta 1,2 glucan, a component of fungal cell walls
(b) candida and invasive aspergillus (c) none (d) not very toxic, headache, infusion related rxns (flushing) |
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Griseofulvin
(a) mechanism of action (b) spectrum/clinical use (c) mechanism of resistance (d) toxicity/notes |
(a) uptake by energy dependent transporters; interferes w/microtubule formation in dermatophytes (disrupts mitosis); may inhibit polymerization of nucleic acids
(b) oral treatment of superifical infections; dermatophytes of hair and scalp; accumulates in keratin (c) decreased transport/uptake (d) confusion and vertigo; headache; blurred vision; nausea/vomiting; incre P450; GI irritation; disulfiram like rxn ; teratogenic, carcinogenic; incr warfarin metabolism |
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Terbinafine
(a) mechanism of action (b) spectrum/clinical use (c) mechanism of resistance (d) toxicity/notes |
(a) inhibits squalene epoxidase (for sterol biosynth)
(b) accumulates in keratin used in onyhomycosis (c) n/a (d) GI irritation, rash, headache, taste disturbance |
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Nystatin
(a) mechanism of action (b) spectrum/clinical use (c) mechanism of resistance (d) toxicity/notes |
(a) disrupts membrane by binding ergosterol; too toxic for systemic use
(b) candida esp oral; topical for diaper rash or vaginal candidiasis (c) same as amphotericine (d) contact dermatitis, S-J syndrome |
