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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
Q

how do identify azoles?

A

end in azole

26
Q

what do azoles treat?

A

systemic and superficial fungal infections

27
Q

Azoles have a drug drug interaction with

A

CYP450 pathway

28
Q

Itraconazole Adverse Effects

A

(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
Q

Itraconazole administration consideration

A
  • give with cola soda b/c need acidic enrivo

- give 1 hr before getting drugs that raise gastric pH

30
Q

which drugs needs an acidic enviro to be absorbed?

A

Itraconazole

31
Q

Fluconazole treats

A

(Diflucan)

systemic fungal infections

32
Q

Fluconazole Adverse Effects

A

GI (N/V/D)

Steven Johnson Syndrome (rare)

33
Q

superficial mycoses are caused by 2 groups of organisms

A
  1. candida

2. dermatophytic infection

34
Q

candida effects what part of body?

A
  • mucous membrane, moist skin

chronic: nails, hair, scalp

35
Q

dermatophytic infections effect

A

-skin, hair nails

36
Q

dermatophytic infections =

A

RINGWORM

37
Q

clotrimazole treats

A

(mycelex) superficial infections

38
Q

nystatin treats

A

(mycostatin)

-superficial infections

39
Q

what the heck is a helminth?

A

treats parasitic worms

40
Q

most common site of parasitic worm infection =

A

intestines

-caused by poor sanitation

41
Q

Parasitic worm infections can subside…

A

on own when adult worm dies

42
Q

Mebendazole treats

A

intestinal round worm and mixed parasites

43
Q

mebendazole fxn

A

prevents uptake of glucose by susceptible worms causing a slow death

44
Q

mebendazole absorption

A

poorly absorbed so results in less side effects

45
Q

clearance of parasitic worms can take ___ days and cause

A

up to 3 days

-cause abd pain and diarrhea if large infection

46
Q

what the heck is an ectoparasite?

A

parasite that lives on the surface of the host

47
Q

pediculosis- what is it?

A

LICE infestation

48
Q

what part of lice infestation do we see?

A

nits aka eggs

49
Q

how is lice transmitted?

A

head to head contact

50
Q

What are scabies

A

mites burrow into the skin to lay eggs

51
Q

how is scabies transmitted?

A

direct contact, linen, towels, clothes, furniture

***treat items + person!

52
Q

common burrows for scabies

A

wrists, elbows, web oof fingers, gentials

53
Q

itching with scabies is worse at

A

bedtime

54
Q

how do you treat lice?

A

Nix - 1% permethrin formula

55
Q

How do you treat scabies?

A

Elimite - 5% permethrin formula

56
Q

what does permethrin do?

A

highly toxic to ADULT MITES and LICE - not so much the ova

-causes paralysis of insect

57
Q

Permethrin Adverse Effects

A
  • exacerbation of itching
  • edema
  • erythema
  • burning/stinging/numbness
58
Q

how long can scabies itching last?

A

1-2 weeks

59
Q

besides meds, what else do you do to treat lice?

A

remove nits with a fine tooth comb

Pharmacotherapeutics (20 decks)

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