Block 3- 6/10 Flashcards
1
Q
metronidazole acts on what organisms
A
protozoa and anaerobic bacteria
2
Q
is metronidazole luminal, systemic, or mixed acting
A
mixed
3
Q
what are 3 adverse effects of metronidazole
A
peripheral neuropathy
seizures
disulfiram like reaction
4
Q
what drug can be used for E. histolytica, H. pylori, B. fragilis, and C. diff
A
metronidazole
5
Q
what is the main drug used for giardia
A
metronidazole
6
Q
what is the main difference between metronidazole and tinidazole
A
tinidazole is longer acting with less severe effects than metronidazole
7
Q
what are the 2 main adverse effects of iodoquinol
A
nausea/vomiting
optic neuritis
8
Q
what can iodoquinol be used to treat
A
giardia
9
Q
what is the mechanism of action of nitazoxanide
A
inhibits pyruvate ferredoxin oxidoreductase for electron transport
10
Q
chloroquine, when used with metronidazole and paromomycin or iodoquinol, can be used to treat __
A
amoebic liver disease
11
Q
what is the mechanism of action of ementine
A
blocks AA chain elongation
12
Q
what is the main adverse effect of ementine
A
cardiotoxicity
13
Q
what are the 3 main uses of ementine
A
severe intestinal amebiasis
severe hepatic amebiasis
severe extraintestinal amebiasis
14
Q
ementine should be avoided in patients with __ and __
A
heart arrythmias
heart failure
15
Q
what is the drug of choice for asymptomatic protozoal cyst carriers
A
paromomycin or iodoquinol
16
Q
what is the drug of choice for mild-severe intestinal amoebiasis
A
metronidazole or tinidazole with paromomycin or iodoquinol
17
Q
what is the drug of choice for amebic liver abscess
A
metronidazole or tinidazole with chloroquine and paromomycin
18
Q
in early E. african T. brucei infection, what is the drug of choice
A
pentamidine or suramin
19
Q
what is an adverse reaction of pentamidine
A
renal dysfunction
20
Q
what is the drug of choice for late stage E. african T. brucei infection
A
melarsoprol
21
Q
what is an adverse effect of melarsoprol
A
fatal reactive encephalopathy
22
Q
what drug is used for either early or late infection of W. african T. brucei
A
Flexinidazole
23
Q
what drug is used in late stage W. african T. brucei infection
A
melarsoprol
24
Q
what is the drug of choice for T. cruzi infection
A
nifurtimox or benznidazole
25
what is the mechanism of action of nifurtimox or benznidazole
formation of free radicals and inhibition of trypanothione reductase and DNA synthesis
26
what are the 2 main toxic effects of nifurtimox and benznidazole
abdominal pain/nausea/vomiting
neurological reactions (paresthesia, polyneuritis, seizures)
27
what are the 3 classifications of antifungals
antibiotics
antimetabolites
azoles
28
amphotericin B is what class of antifungal
antibiotic
29
what is the mechanism of action of amphotericin B
binds to ergosterol, creates pores, causes leakage of cell contents
30
is amphotericin B fungicidal or fungistatic
fungicidal
31
what is the main toxicity of amphotericin B
nephrotoxicity
32
what can be done to decrease the nephrotoxicity of amphotericin B
liposomal preparation
give normal saline prior to administration
slow IV infusion
33
__ can occur with prolonged use of amphotericin B
anemia
34
what is the effect of IV infusion of amphotericin B
release of histamine
35
amphotericin B is the drug of choice for what infections
coccidiomycosis
blastomyces
histoplasmosis
36
amphotericin B is an anti__
fungal
37
flucytosine is what class of antifungal
antimetabolite
38
flucytosine is an anti__
metabolite
39
what is the mechanism of action of flucytosine
inhibition of thymidylate synthase, inhibiting DNA synthesis
40
is flucytosine able to cross the BBB
yes
41
is flucytosine fungistatic or fungicidal
fungistatic
42
what is the main adverse effect of flucytosine
it has a narrow therapeutic range
43
flucytosine is often combined with __ to allow for pore producing, enhancing the ability for 5-fluorouracil to get into fungal cells
amphotericin B
44
what is the mechanism of action for ketoconazole
inhibits demethylase-->leakage of cell contents
45
ketaconazole is an anti__
fungal
46
drug resistance to ketoconazole can develop due to the gene __ in C. albicans
ERG11
47
is ketoconazole better absorbed on an empty or full stomach
empty
48
what are the 2 main adverse effects of ketoconazole
disulfiram like reaction
blockage of androgen receptors (gynecomastia, decreased libido, impotence, menstrual irregularity)
49
ketoconazole should not be combined with what drug
amphotericin B
50
what is the mechanism of all azole drugs for fungal infections
inhibition of demethylase-->leakage of cell contents
51
what are the 2 main advantages to fluconazole usage
CSF permeability
wide therapeutic index
52
what is used to treat cryptococcal meningitis
fluconazole
53
what drug is used to prevent candidemia in ICU patients
fluconazole
54
is itraconazole a broad or narrow spectrum drug
broad
55
what are the 2 main adverse effects of fluconazole
hepatotoxicity
should be avoided in pregnancy
56
itraconazole is the drug of choice for what infections
histoplasmosis
blastomycosis
sporothichosis
57
what is the main adverse effect of voriconazole
visual disturbances
58
what is voriconazole used to treat
invasive aspergillosis
59
what is the main adverse effect of posaconazole
hyperaldosteronism-->hypertension and hypokalemia
60
what is the main use of posaconazole
prophylactic for fungal infection in chemotherapy
61
echinocandins are anti__
fungal
62
echinocandins have the suffix -___
fungin
63
what is the mechanism of action of echinocandins
inhibition of glucan synthesis-->fungal cell lysis
64
how can resistance be developed against echinocandins
AA changes in Fks subunit of glucan synthase
65
are echinocandins fungistatic or fungicidal
fungicidal
66
what fungal drug class is relatively free of any drug-drug interactions
echinocandins (capsofungin, micafungin)
67
what are 3 main uses of capsofungin
disseminated and mucocutaneous candida infections
empirical treatment in febrile neutropenia and stem cell transplants
salvage therapy in invasive aspergillosis
68
echinocandins such as capsofungin should be avoided in patients with __
liver disease
69
what are the 2 main superficial fungal infection drugs
griseofulvin
terbinafine
70
what is the mechanism of actions of griseofulvin
prevention of infection of new hair/skin/hairs by preventing microtubule formation-->inhibition of mitosis
71
what superficial fungal infection drug requires prolonged therapy
griseofulvin
72
what is an adverse effect of griseofulvin
disulfiram like reaction
73
what is the mechanism of action of terbinafine
inhibition of squalene epoxidase and ergosterol synthesis
-->accumulation of toxic squalene
74
what are the 2 main adverse effects of terbinafine
GI distress
hepatotoxicity
75
griseofulvin is an anti__
fungal
76
terbinafine is an anti__
fungal
77
what is terbinafine used for
dermatophytosis
78
what drug is used for onychomycosis of nails
terbinafine
79
albendazole is an anti__
helminthic
80
what is the mechanism of action of albendazole
inhibition of assembly of tubulin /microtubules
inhibition of glucose uptake
81
what is the distribution of albendazole
to bile and CSF
82
what are the main adverse effects of albendazole
at high dose-->hepatitis and hematologic toxicity
avoid in pregnancy
83
what are the uses of albendazole
ascariasis (roundworm)
pinworm (enterobius vermicularis)
hookworm (nector americanus and ancyclostoma duodenal)
whipworm (trichuris trichuria)
hydatid cyst
cysticerosis
neurocysticerosis
prophylaxis for filariasis
84
pyrantel palmoate is an anti__
helmintic
85
what is the mechanism of action of pyrantel palmoate
enhances ACh release and inhibits AChE
inhibits neuromuscular transmission
86
what is pyrantel palmoate used for
roundworm
87
what are the main adverse effects of piperazine citrate
urticaria
bronchospasm
muscle incoordination
88
piperazine citrate should be avoided in patients with __
seizure disorder
hepatic dysfunction
renal dysfunction
pregnancy
89
ivermectin is an anti__
helminth
90
what is the mechanism of action of ivermectin
enhances glutamate mediated transmission of Cl- influx
91
what is ivermectin used for
onchocerciasis
strongyloidasis
92
what are the adverse effects of ivermectin
Mazotti like reaction
avoid in pregnancy and meningitis
93
what is the Mazotti like reaction caused by ivermectin
allergic reaction to dying microfilariae leads to fever, HA, weakness, lymphadenitis, lymphedema, edt
94
diethylcarbamazine (DEC) is commonly combined with what other drug
albendazole
95
diethylcarbamazine (DEC) is an anti__
helminth
96
what is the mechanism of action of diethylcarbamazine (DEC)
immobilize microfilariae
modify surface area proteins and displace them from tissue
97
what is diethylcarbamazine (DEC) used for
lymphatic filariasis
tropical eosinophilis
98
what is diethylcarbamazine (DEC) used for
lymphatic filariasis
tropical eosinophilia
99
praziquantel is an anti__
helminth
100
what is the mechanism of action of praziquantel
increases calcium permeability in trematodes and cestodes
101
what is praziquantel used for
flukes
cestodes (tapeworms)
102
praziquantel should be avoided in patients with __
pregnancy
103
sodium stibogluconate is an anti__
helminth
104
what is the mechanism of action of sodium stibogluconate
inhibition of glycolysis
105
what is sodium stibogluconate used for
cutaneous, visceral, and mucocutaneous leishmania
106
what are the adverse effects of sodium stibogluconate
cardiac arrythmias
renal, hepatic, and cardiac toxicity
GI effects
107
what drug is used specifically for visceral leishmania
amphotericin B
108
what drug is used in combination with amphotericin B for specifically cutaneous leishmania
paromomycin
109
what is the first choice of drug for P. falciparum infection
chloroquine
110
what drug is used for chloroquine resistant P. falciparum
quinine or mefloquine
111
what drug is used for multidrug resistant P. falciparum
artemisinin
112
what drug is used for severe, complicated multidrug resistant P. falciparum
artemisinin
113
what drug is used for P. malariae
chloroquine
114
what drug is used for clinical cure of P. ovale and vivax
chloroquine
115
what drug is used for chloroquine resistant P. vivax and ovale
mefloquine
116
what drug is used for radial (blood and tissue) cure of P. vivax and ovale
primaquine and tafenoquine
117
what drug is used for malaria in the pregant
melfloquine
118
__ is the main drug choice for malaria but if the area is resistant, __ is used
main= chloroquine
chloroquine resistant= mefloquine
119
what malaria drug can be used for both prophylaxis and treatment
atovaquone-proguanil
120
what is the mechanism of action of chloroquine
inhibits heme polymerase-->accumulation of heme which is toxic to parasites at the erythrocytic stage
121
chloroquine has a high affinity for __ and __
RBC
melanin
122
what malaria drug is able to cross the placenta
chloroquine
123
what are the adverse effects of chloroquine
cinchonism (vertigo and tinnitus)
pruritus
visual disturbances
EKG changes
discoloration of nail beds and mucous membranes
124
chronic use of chloroquine can lead to __
retinopathy
125
__ along with artesunate is the drug of choice for severe P. falciparum infection
quinine
126
what are the adverse effects of quinine
cinchonism (tinnitus and vertigo)
hypoglycemia
hypotension
127
what are the toxic effects of mefloquine
hallucinations
seizures
128
mefloquine should be avoided in patients with what pre-existing conditions
seizures
cardiac conduction defects
psychiatric disorders
129
what is the mechanism of action of pyrimethamine sulfadoxine
pyrimethamine inhibits DHFR
sulfadoxine inhibits dihydrofolate synthase
130
what is the adverse effect of pyrimethamine +sulfadoxine (FANSIDAR)
megaloblastic anemia
131
what is the main adverse effect of artemisinin
delayed hemolysis
