Antimicrobial III Flashcards
types of fungal infections (locations)
superficial, pulmonary, CNS, systemic
parental med for fungal mengitis
amphotericin B
superficial anti-fungal agent Dr. Dodge <3
Fluconazole
What are some toxicities of amphotericin B?
renal, fever/chills, anemia, hypotension crisis, thrombophlebitis
This form of ampho B is less toxic, particularly renal
Lipsomal
This is used with ampho B, you can use a lower does of ampho B however it is more limited to crytopcoccus and candida
flucytosine
T/F: Azoles are tetratogenic
T
What are other risks for azoles?
drug interactions, decrease steroid hormone production
Great tx for fungal meningitis, least potent azole, oral/IV, vaginal yeast infections, hepatic toxicity is rare
fluconazole
This is a strong inhibitor of gonadal and adrenal steroids and CANNOT be given with ampho B
Ketoconazole
This is a derivative of ketoconazole; indicated in candida septicemia and invasive aspergillosis
Voriconazole
This type of herpes results in severe infections in immunocompromised pt
herpes simplex
Two popular anti-human herpes virus agents
acyclovir, valacyclovir
CMV complications in immunocompromised pt
retinitis, encephalitis
Anti-CMV agent
ganciclovir
Anti-hepatitis agents
interferon alfa-2a, ribavirin, ledipasvir+sofosbuvir
Interferon toxicities
neuropsychiatric, flu-like sx, marrow suppression, hepatic toxicity
New standard of care for Hep C Tx
ledipasvir + Sofosbuvir
Prophylactic agents against influenza A need in first 24-48 hrs
amantadine, rimantadine
Anti-flu agents that are neuraminidase inhibitors start within 48 hrs
zanamivir, oseltamivir
This NI is dangerous in pt with severe asthma or COPD
zanamivir
What are the 5 classes of HIV meds?
- nucleoside/tide reverse transcriptase inhibitors NRTIs
- nonnucleoside RT inhibitors (NNRTIs)
- protease inhibitors
- fusion inhibitors
- integrase inhibitor
NRTI agent
Zidovudine
NRTI toxicities
bone marrow tox, drug interactions
NNRTIs agent
efavirenz
NNRTI toxicity
epidermal reactions- TEN, SJS
Protease inhibitor agent
saquinavir
Protease inhibitor toxicity
drug interactions, hyperglycemia and hyperlipidemia
When do you initiate HIV therapy?
at time of first dx
Key HIV tx strategy (HAART)
highly active anti-retroviral therapy
T/F people can be genetically immune to HIV
True
5 common medical protozoa
entamoeba histolytica, giardia lambia, toxoplasmosis gondii, trichomonas vaginalis, plasmodium species
amebic colitis (dysentery) is treated with ____.
metronidazole
T/F giardiasis is not responsive to metronidazole
F
This protozoan in cats can pass ova of this via there poop and pee.
Toxoplasmosis gondii
T/F if you are NOT immunocompromised Toxoplasmosis gondii can affect you.
F
IF a pregnant women is exposed to Toxoplasmosis gondii, what can happen
there can be significant levels in the blood stream and it can effect the fetus causing congenital malformations -CNS
Tx for Toxoplasmosis gondii involves ___
plasmodium inhibitor, broad spectrum ABX (more than one agent)
Least common vaginal infection
trichomonas vaginalis
Tx of trichomonas vaginalis
single dose (2g) of metronidazole
Issue with metronidazole
disulfiram (antabuse)- like reaction possible
Metronidazole indications
protozoal, anaerobic infections, bacterial vaginosis
lethal malaria bug
plasmodium falciparum
what drugs are used to tx malaria
Chloroquine (depending), artemisinin
Most concerning side effects of Chloroquine?
QT (ekg) changes, retinal toxicity, visual disturbances, hemolysis in G6PD deficient individuals
What is the current standard tx for P. falciparum infections?
Artemisinin based combo therapy
Good drug useful for pinworms?
albendazone