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step 1 microbiology > antifungals/antiprotozans/antihelminths > Flashcards

antifungals/antiprotozans/antihelminths Flashcards

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Biology 101 flashcards
1
Q

lanosterol synthesis inhibition

A

terbinafine

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2
Q

cell wall synthesis inhibition

A

echinocandins (anidulafungin, caspofungin, micafungin)

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3
Q

cell membrane integrity inhibition

A

polyenes (Amphotericin B, Nystatin)

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4
Q

nucleic acid synthesis inhibition

A

flucytosine

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5
Q

ergosterol synthesis inhibition

A

-conazoles

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6
Q

Amphotericin B MOA

A

binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes

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7
Q

Amphotericin B use

A

serious, systemic mycoses

intrathecally for fungal meningitis

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8
Q

Amphotericin B coadmin

A

Supplemental K and Mg bc of altered renal tubule permeability

Hydration: dec nephrotoxicity

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9
Q

Amphotericin B ADR

A

Fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis,

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10
Q

which type of Amphotericin B decreases toxicity?

A

liposomal amphotericin

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11
Q

Nystatin MOA

A

same as Amphotericin B; ONLY topical due to extreme systemic toxicity

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12
Q

Nystatin use

A

swish and swallow for oral candidiasis

topical for diaper rash/vaginal

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13
Q

Flucytosine MOA

A

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

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14
Q

Flucytosine use

A

systemic fungal infections (esp. meningitis by Cryptococcus) in combo with Amphotericin B

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15
Q

Flucytosine ADR

A

bone marrow suppression

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16
Q

Conazoles MOA

A

inhibit fungal sterol synthesis by inhibiting p450 enzyme that converts lanosterol to ergosterol

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17
Q

conazoles use

A

local and less serious systemic mycoses

18
Q

fluconazole use

A

chronic suppression of cryptococcol AIDS pt and candida infections of all types

19
Q

itraconazole use

A

blastomyces, coccidioides, histoplasma

20
Q

clotrimazole, miconazole use

A

tropical fungal infections

21
Q

conazole ADR

A

testosterone synthesis inhibition (gynecomastia w/ ketoconazole); liver dysfunction (inhibits p450)

22
Q

terbinafine MOA

A

inhibits the fungal enzyme squalene epoxidase

23
Q

terbinafine use

A

dermatophytoses (esp. onchomycosis)

24
Q

terbinafine ADR

A

GI upset, HA, hepatotoxicity, taste disturbance

25
Q

Echinocandins MOA

A

inhibit cell wall synthesis by inhibiting synthesis of B-glucan

26
Q

Echinocandin use

A

invasive aspergillosis, Candida

27
Q

Echinocandin ADR

A

GI upset, flushing (induces histamine)

28
Q

Griseofulvin MOA

A

interferes w/ microtubule function, disrupts mitosis.

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

29
Q

Griseofulvin use

A

oral tx of superficial infections; inhibits growth of dermatophytes

30
Q

Griseofulvin ADR

A

teratogenic, carcinogenic, confusion, HA, p450 inducer –> inc warfarin metabolism

31
Q

Antiprotozoan therapy

A

pyrimethamine (toxo); suramin and melarsoprol (Trypanosoma brucei); nifurtimox (T cruzi); sodium stibogluconate (leishmaniasis)

32
Q

Anti-mite/louse therapy

A

Permethrin, malathion, lindane

33
Q

Permethrin MOA

A

blocks Na channels –> neurotoxicity

34
Q

Malathion MOA

A

AChE inhibitor

35
Q

Lindane MOA

A

blocks GABA channels –> neurotoxicity

36
Q

Chloroquine MOA

A

blocks detox of heme into hemozoin. heme accumulates and is toxic to plasmodia

37
Q

Chloroquine use

A

Tx of plasmodium species other than P. falciparum

38
Q

Chloroquine ADR

A

retinopathy, pruritus (in dark skinned individuals)

39
Q

Chloroquine resistance

A

due to membrane pump dec. intracellular concentration of drug

40
Q

P. falciparum treatment

A

artemether/lumefantrine OR atovaquone/proguanil

41
Q

life-threatening malaria tx

A

Quinidine (US), quinine (outside US), or artesunate

42
Q

antihelminthic therapy

A

mebendazole (microtubule inhibitor), pyrantel pamoate, ivermectin, diethylcarbamazine, praziquantel

step 1 microbiology (7 decks)

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