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Pharmacology > Antifungals and antiparasites > Flashcards

Antifungals and antiparasites Flashcards

1
Q

mechanism amphotericin B

A

binds ergosterol –> forms membrane pores

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2
Q

clinical use amphotericin B

A 
serious systemic mycoses:
  cryptococcus
  blastomyces
  coccidioides
  histoplasma
  candida
  mucor
fungal meningitis (intrathecally)
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3
Q

what should you supplement when giving amphotericin B

A

K and Mg

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4
Q

why do you supplement K and Mg when giving amphotericin B

A

altered renal tubule permeability

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5
Q

side effects amphotericin B

A
  1. fever/chills (shake and bake)
  2. hypotension
    3, nephrotoxicity
  3. anemia
  4. IV phlebitis
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6
Q

how to reduce nephrotoxicity from amphotericin B

A

hydration

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7
Q

how to reduce amphotericin B toxicity

A

liposomal amphotericin B

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8
Q

nystatin mechanism

A

binds ergosterol –> membrane pores (same as amphotericin B)

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9
Q

how is nystatin administered?

A

topical

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10
Q

clinical use nystatin

A

oral candidiasis

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11
Q

treatment of typical oral candidiasis

A

nystatin

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12
Q

azoles mechanism

A

inhibit fungal ergosterol synthesis by inhibiting cytochrome P-450 that converts lanosterol to ergosterol (lanosterol 14-alpha desmolase)

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13
Q

clinical use fluconazole

A

cryptococcal meningitis and candidiasis in AIDS pts

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14
Q

treatment of candidiasis in AIDS pts

A

fluconazole

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15
Q

clinical use itraconazole

A

blastomyces
coccidioides
histoplasma

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16
Q

clinical use clotrimazole and miconazole

A

topical fungal infections

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17
Q

treatment of topical fungal infections (i.e. tinea circinata)

A

clotrimazole or miconazole cream

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18
Q

side effects azoles (2)

A
  1. testosterone synthesis inhibition (gynecomastia)

2. liver dysfunction (inhibits cytochrome P-450)

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19
Q

flucytosine mechanism

A

inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase

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20
Q

clinical use flucytosine

A

systemic fungal infections (i.e. cryptococcus meningitis) in combo with amphotericin B

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21
Q

side effects flucytosine

A

bone marrow suppression

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22
Q

can you use flucytosine in pts with HIV?

A

NO!! (bone marrow suppression)

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23
Q

what are 3 echinocandins?

A
  1. caspofungin
  2. micafungin
  3. anidulafungin
24
Q

mechanism echinocandins

A

inhibit cell wall synthesis by inhibiting synthesis of beta-glucan

25
Q

clinical use echinocandins

A

invasive aspergillosis, candida

26
Q

side effects echinocandins

A
  1. GI upset

2. flushing (histamine release)

27
Q

terbinafine mechanism

A

inhibits squalene epoxidase

28
Q

clinical use terbinafine

A

dermatophytoses (especially onychomycosis)

29
Q

treatment of onychomycosis

A

terbinafine

30
Q

side effects terbinafine

A
  1. GI upset
  2. headache
  3. hepatotoxicity
  4. taste disturbance
31
Q

griseofulvin mechanism

A

interferes with microtubule function –> disrupts mitosis

deposits in keratin-containing tissues (i.e. nails)

32
Q

clinical use griseofulvin

A

oral tx of superficial infections

inhibits growth of dermatophytes (tinea, ringworm)

33
Q

side effects griseofulvin

A
  1. teratogen
  2. carcinogen
  3. confusion, headaches
  4. increases P-450 metabolism
34
Q

treatment for toxoplasmosis

A

pyrimethamine and sulfadiazine (same as TMP-SMX)

35
Q

what is pyrimethamine for

A

toxoplasmosis (use with sulfadiazine)

36
Q

treatment for trypanosoma brucei

A

suramin (blood)

melarsoprol (CNS)

37
Q

what is suramin for?

A

trypanosoma brucei

38
Q

what is melarsoprol for?

A

trypanosoma brucei

39
Q

treatment for trypanosoma cruzi

A

benznidazole or

nifurtimox

40
Q

what is benznidazole for?

A

T. cruzi

41
Q

what is nifurtimox for?

A

T. cruzi

42
Q

treatment for leishmaniasis

A

amphotericin B

sodium stibogluconate

43
Q

what is sodium stibogluconate for?

A

leishmaniasis

44
Q

chloroquine mechanism

A

blocks detoxification of heme into hemozoin –> heme accumulates, toxic to plasmodia

45
Q

clinical use chloroquine

A

plasmodia (other than P. falciparum –> resistant)

46
Q

mechanism of resistance to chloroquine

A

membrane pump –> decreases intracellular concentration of drug

47
Q

treatment of P. falciparum

A

artemether/lumefantrine or

atovaquone/proguanil

48
Q

life-threatening malaria treatment

A

quinidine or artesunate

49
Q

side effects chloroquine (2)

A
  1. retinopathy

2. pruritis

50
Q

what is mebendazole?

A

antihelminthic – immobilizes

51
Q

what is pyrantel pamoate?

A

antihelminthic – immobilizes

52
Q

what is ivermectin?

A

antihelminthic – immobilizes

53
Q

what is diethylcarbamazine?

A

antihelminthic – immobilizes

54
Q

what is praziquantel?

A

antihelminthic – immobilizes

55
Q

treatment for flukes (trematodes) i.e. schistosoma

A

praziquantel

Pharmacology (8 decks)

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