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Pharm > antifungal therpay > Flashcards

antifungal therpay Flashcards

1
Q

amphotericin B mechaims

A

binds ergosterol (unique to fungi); forms membrane pores that allows leakage of electrolytes (esp K+); leading to funal cell lysis

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2
Q

use of amphotericin B

A

serious , systemic mycoses
Cryptococcus (amphotericin B w/wo flucytosine for cryptococcal meningits)
Blastomyces, coccidiodes, histoplasma, canddia, mucor
intrathecally for fungal meningits
supplement K+ and Mg2+ bc of altered renal tubule permeability

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3
Q

SE of amphotericin B

A

fevers / chills , hypotension, neprhotoxcity (decrease GFR, toxic effects on tubular eptihelium), arrhtymias, anemia, IV thrombophelbitis
hydration decrease neprhotoxicity
liposomal amphotericin decrese toxiicty

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4
Q

anemia in amphotericiin B due to

A

suppression of renal EPO synthesis

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5
Q

SE of amphotericin B to electorylyest

A

hypomagensiumeia, hypokalmeia

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6
Q

mechainms of nystatin

A

same as amphtoericin b;

topical use only as too toxic for systemic use

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7
Q

use of nystatin

A

swish and swallow for oral candidais (thrush); topical for diaper rash or vaginal candiasisis

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8
Q

flucytosine mechanism

A

inhibits dna and rna biosyntehsis by conversion to 5 fluorouracil by cytosine deaminase

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9
Q

use of flucytosine

A

systemic fugnal infectsion (esp meniginits caused by cryptococcus) in combo w amphotericin B

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10
Q

SE of flucytosine b

A

bone marrow suppression

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11
Q

azoles

A

clotrimazole, fluconazole, itraconazole, ketoconazlole, miconazole, voriconazole, isavuconazole

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12
Q

mechanism of azoles

A

inhibit fungal sterol (ergosterol ) synthesis by inhibiting cytochrome p450 enzyme (14ademethylase) that converts lanosteorl to ergosterol

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13
Q

use of azoles

A

local and less serious systemic mycoses;

flucaconazole for chronic suppression of cryptococcal meningits in AIDS patietns and candidal infectsion of all types

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14
Q

which azole for blastomyces, coccidiodes, histoplasmoa

A

itraconazole

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15
Q

which for topical funal infections

A

clotrimazole; micoconazole

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16
Q

whic azole for aspergillus and some candida

A

voriconazole

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17
Q

which azole for serious asperigllus and mucorales infectiosn

A

isavucoconazole

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18
Q

SE of azoles

A

testosterone syntehsis inhibition (gynecomastia, esp with ketoconazole, liver dysfunction (inbhitis cytocohrome p450``

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19
Q

terbinafine mechanism

A

inhibits fugnal enzyme squalene epoxidase (thus inhibits ysntehsis of ergosterol

20
Q

use of terbinafine

A

dermatophytoes (esp onychomycosis 0 infection of finger or toe nails)

21
Q

se of terbinafine

A

Gi upset headaches hepatotocity, taste distrubance

22
Q

echinocandins

A

anidulafungin, caspofungin, micafungin

23
Q

mehcanism of echinocandins

A

inhibit cell wall syntehsis by inhibitng syntehssi of B glucan (1, 3 B D glucan)

24
Q

use of ehcinocandins

A

invasive aspergillosis, candida

25
Q

SE of enchinocandins

A

Gi upset, flushing (by histamine release)

26
Q

griseofulvin mechansim

A

inteferes w microtubule function; disrupts mitosis; depostis in keratin containin tissues (nails) ; p450 inducer

27
Q

use of griseofulvin

A

oral treatment of supericial infections; inhibits growth of dermatophytes (tinea, ringworm)

28
Q

se of griseofulvin

A

teratogenic, carcinogenic, confusion, headaches, disulfiram like reaction; increase cytcohome p450 and warfarin metabolism

29
Q

antiprotozona therpay

A

t

30
Q

pyrimethamine used for

A

toxoplasmosis
and malaria
inhibits parasitic DHFR

31
Q

suramin and melarssoprol use

A

trypansoma brucei

32
Q

nifurtimox use

A

T. cruzi

33
Q

sodium stibogluconate use

A

leishmaniasis

34
Q

anti mite/louse therpay treats

A

sarcopetes scabeie,

lice (pediculus, phtrius)

35
Q

Treat PML (Pesty Mites and LIce) with PML bc they NAG you

A 
Treat PML (Pesty Mites and LIce) with PML bc they NAG you
'
Pesty Mites Lice
Permethrin Malthion, lindane
Na, Ache, Gaba
36
Q

permethrin mechainsm

A

neuronal membrane depolarizioant via Na+ channels

37
Q

malathion mechainsm

A

ache inhibtor

38
Q

lindane mechanism

A

blocks Gaba channles - neurotoxicity

39
Q

chloroquine mechanism

A

blocks detoxification of heme into hemozoin. heme accumualtes and is toxic to plasmodia

40
Q

use of chloroquine

A

treamtent of plasmodial species other than p. falciparium (frequency of resistance in P. falciparum is too high)

41
Q

african species are chlorioqine resisatn so use

A

atovaquone - proguanil or artemisisns

42
Q

Resistance to chloroquine

A

membrane pump that decrease intracellular concentration of drug
treat p . falciparum w artemether/lumefantrine or atovaquone/proguanil

43
Q

for life threatemning malaria use

A

quinidien in US (quinine lesewhere) or artesunate

44
Q

se of chloroquine

A

retinopathy, pruirtus (esp in dark skinned indivudlas)

45
Q

antihelminthic therpay

A 
mebendazole (microtubule inhibitor) 
pyrantel pamoate
ivermectin
diethylcarbamazine
praziquantel

Pharm (13 decks)

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