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Pharmacotherapeutics > Antifungal, Antihelmintic, Ectoparasitic > Flashcards

Antifungal, Antihelmintic, Ectoparasitic Flashcards

Thanks Kol!

1
Q

2 broad classifications for antifungal treatments

A

superficial infection and systemic infections

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2
Q

Where do superficial infections occur?

how are they treated?

A

scalp, nails, mucous membrane (oral vaginal)

-generally treated with topical drugs

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3
Q

which is more common- superficial or systemic fungal infections?

A

superficial

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4
Q

where do systemic fungal infections occur?

how do you treat systemic fungal infections?

A

internal organs: lung, brain, GI

-treat with IV or pill

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5
Q

which is more difficult to treat and requires more treatment time: systemic or superficial fungal infections?

A

systemic fungal infections

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6
Q

who is at risk for systemic fungal infections?

A

immunocompromised, transplants, HIV

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7
Q

3 systemic antifungal drugs to know

A
  1. Fluconazole (diflucan)
  2. Itraconazole (sporanox)
  3. Amphotericin B
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8
Q

How many categories of anitfungal drugs out there?

A

4

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9
Q

Amphotericin B- systemic or superficial antifungal

A

systemic antifungal

-broad spectrum

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10
Q

amphotericin B fxn

A

works by binding to ergosteroids in fungal cell membrane

  • increase permeability
  • cell leaks out cat ions like Potassium
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11
Q

amphotericin route

A

IV ONLY

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12
Q

Amphotericin Adverse effects

A
  • nephrotoxicity
  • electrolyte imbalance (K and Mg need replacing)
  • anemia with long term use (monitor CBC)
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13
Q

total infusion time for 1 dose of amphotericin B

A

18 hours!

  • 12 hours electrolyte
  • 4 hours ampho
  • 2 hours normal saline
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14
Q

Amphotericin Admin issues (3 general)

A

-phlebitis, fever, chills

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15
Q

Why use central line with amphotericin B?

A

avoid thrombophlebitis

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16
Q

how to decrease risk of nephrotoxicity with amphotericin B

A

give 500-1000 mL SALINE 1 hour before infusion of ampho

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17
Q

What do you premedicate with for Amphotericin B?

A

TYLENOL and BENADRYL to prevent infusion rxn of stimulating pro-inflammatory cytokines causing fever/chills/nause/headache

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18
Q

IV tubing and Amphotericin B

A
  • IV tubing not compatible with normal saline!!

- –> change IV tubing to set up with D5

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19
Q

saline + aphotericin B=

A

precipitate

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20
Q

Amphotericin infusion rate

A

4 hours

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21
Q

Amphotericin B and Rigors- treat with….

A

merperidine (demerol) or dantrolene to stop shaking chills

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22
Q

2 post admin things to be done with Amphotericin B

A
  • 500-1000 ml NORMAL SALINE over 1 hr

- Replace potassium and Magnesium

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23
Q

Amphotericin KCL replacement infusion rate

A

40 meq over 2 hours X 4 bags = 8 hours

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24
Q

Amphotericin infusion of replacement Mg

A

infuse over 2-4 hours

25
how do identify azoles?
end in azole
26
what do azoles treat?
systemic and superficial fungal infections
27
Azoles have a drug drug interaction with
CYP450 pathway
28
Itraconazole Adverse Effects
(sporanox) - N/V/D - can't give to someone with heart failure b/c makes worse - Liver injury (N/V, RUQ pain, jaundice, fatigue, pale stool)
29
Itraconazole administration consideration
- give with cola soda b/c need acidic enrivo | - give 1 hr before getting drugs that raise gastric pH
30
which drugs needs an acidic enviro to be absorbed?
Itraconazole
31
Fluconazole treats
(Diflucan) | systemic fungal infections
32
Fluconazole Adverse Effects
GI (N/V/D) | Steven Johnson Syndrome (rare)
33
superficial mycoses are caused by 2 groups of organisms
1. candida | 2. dermatophytic infection
34
candida effects what part of body?
- mucous membrane, moist skin | chronic: nails, hair, scalp
35
dermatophytic infections effect
-skin, hair nails
36
dermatophytic infections =
RINGWORM
37
clotrimazole treats
(mycelex) superficial infections
38
nystatin treats
(mycostatin) | -superficial infections
39
what the heck is a helminth?
treats parasitic worms
40
most common site of parasitic worm infection =
intestines | -caused by poor sanitation
41
Parasitic worm infections can subside...
on own when adult worm dies
42
Mebendazole treats
intestinal round worm and mixed parasites
43
mebendazole fxn
prevents uptake of glucose by susceptible worms causing a slow death
44
mebendazole absorption
poorly absorbed so results in less side effects
45
clearance of parasitic worms can take ___ days and cause
up to 3 days | -cause abd pain and diarrhea if large infection
46
what the heck is an ectoparasite?
parasite that lives on the surface of the host
47
pediculosis- what is it?
LICE infestation
48
what part of lice infestation do we see?
nits aka eggs
49
how is lice transmitted?
head to head contact
50
What are scabies
mites burrow into the skin to lay eggs
51
how is scabies transmitted?
direct contact, linen, towels, clothes, furniture | ***treat items + person!
52
common burrows for scabies
wrists, elbows, web oof fingers, gentials
53
itching with scabies is worse at
bedtime
54
how do you treat lice?
Nix - 1% permethrin formula
55
How do you treat scabies?
Elimite - 5% permethrin formula
56
what does permethrin do?
highly toxic to ADULT MITES and LICE - not so much the ova | -causes paralysis of insect
57
Permethrin Adverse Effects
- exacerbation of itching - edema - erythema - burning/stinging/numbness
58
how long can scabies itching last?
1-2 weeks
59
besides meds, what else do you do to treat lice?
remove nits with a fine tooth comb

Pharmacotherapeutics (20 decks)

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