Antimicrobials V Flashcards
nystatin
bind ergosterol - form pores
nystatin clinical use
topical only - too toxic for systemic
diaper rash or vaginal candidiasis
oral candidiasis
swish and swallow nystatin
flucytosine
inhibit DNA and RNA biosynthesis
-convert to 5-FU by cytosine deaminase
adverse flucytosine
bone marrow suppression
clinical use flucytosine
crypto meningitis
-in combo with amphotericin B
clotrimazole
azole
fluconazole
azole
itraconazole
azole
ketoconazole
azole
miconazole
azole
voriconazole
azole
azole
inhibit fungal sterol (ergosterol) synthesis
inhibit P450 enzyme that converts lanosterol > ergosterol
other tx for blastomyces
itraconazole
other tx of coccidioides
itraconazole
other tx of histoplasma
itraconazole
chronic suppression of cryptococcal meningitis in AIDS patients
fluconazole
topical fungal infection tx
clotrimazole
miconazole
adverse azole
testosterone synthesis inhibition - gynecomastia
liver dysfxn - inhibit P450
terbinafine
inhibit fungal enzyme squalene epoxidase
stop conversion squalene > squalene epoxide
-precursor in synthesis of ergosterol
tx of onychomycosis
fungal infection under finger/toe nails
terbinafine
adverse terbinafine
GI upset
HA
hepatotoxic
taste disturbance
anidulafungin
echinocandin
caspofugin
echinocandin
micafungin
echinocandin
echinocandin
inhibit cell wal lsynthesisi - inhibit synthesis of beta-glucan
ergosterol
in cell MEMBRANE
amphotericin B and nystatin poke hole
cell wall of fungi
inhibited by echinocandin
-caspofungin, micafungin, anidulafungin
griseofulvin
interfere microtubule fxn
-disrupt mitosis
deposit in keratin containing tissues
ora tx for dermatophytes
griseofulvin
tinea, ringworm, etc.
tx toxoplasmosis
pyrimethamine
tx trypanosoma brucei
suramin
melarsoprol
tx t. cruzi
nifurtimox
tx leishmaniasis
sodium stibogluconate
permethrin
block Na channel - neurotoxic
malathion
acetylcholinesterae inhibitor
lindane
inhibit GABA - neurotoxic
tx for scabies
permerthrin
malathion
lindane
lice
pediculus
pthirus
tx - permethrin, malathion, lindane
chloroquine
block detoxification of heme into hemozoin
-heme accumulate - toxic to plasmodia
tx of plasmodium infections
chloroquine
adverse chloroquine
retinopathy
pruritis - dark skinned individuals
plasmodium falciprum
high resistance
-so tx with chloroquine doesn’t work
resistance to chloroquine
membrane pump - decrease intracellular concentration of drug
tx of p. falciprum
artemether/lumefantrine
atovaquone/proguanil
tx life-threatening malaria
quinidine or artesunate
mebendazole
anti-helminth tx
pyrantel pamoate
anti-helminth tx
ivermectin
anti-helminth tx
diethylcarbamazine
anti-helminth tx
praziquantel
anti-helminth tx