drugs for GI infections I Flashcards
What are the fluoroquinolones
Ciprofloxacin
Levofloxacin
what are the antiprotozoals
metronidazole
what other antibiotics are available for GI infections
vancomycin, bactrim (trimethoprim-sulfamethoxazole
definition of diarrhea
acure, persisten chronic
> 3 unformed stools/day
acute 30 days
what viruses cause diarrhea
noro and rota
what bacteria cause diarrhea
salmonella, campylobacter, shigella, EHEC, vibrio, yersinia, EAEC, ETEC
what protozoa can cause diarrhea
cryptosporidium, giardia, cyclospora, entamoeba, others
what pathogens can cause dysentery
shigella, salmonella, campylobacter, EHEC, yersinia and C difficile
what do you test for with bloody diarrhea and no fever or HUS
shiga toxin and EHEC
bloody diarrhea with recent immigration from tropical Africa, Asia or Latin Aerica
entamoeba histolytica
what bloody diarrhea is assoc with shellfish
vibrio
general approach to Tx of infectious diarrhea
prevention dehydration
Tx protocol for mild-moderate dehydration
oral rehydration therapy, superior to administratino of IV fluids
necesary compounds in oral rehydration therapy
carbs (glucose), Na, K, cl and water
Indiscriminant se of antimicrobials leads to increased risk of
antimicrobial Resistance, prolonged shedding of certain pathogens, Salmonella, C difficile
Side effects
superinfection after destruction of normal flora
what is rec antibiotic for mild to moderate travelers diarrhea
loperamide of bismuth subsalicylate alone
if travelers diarrhea is associated with fever or bloody stools, self tx with what antibiotics for how long
any of the floxacins for 3 days
what drug is used to tx noninvasive strains of E coli
rifaximin
what is Tx for quinolone R campylobacter
azithromycin
what antibiiotic use is assoc with C difficile
clindamycin, ampicilin, cephalosporins, fluoroquinolones, PPIs
hish risk groups C diff
elderly, debilitated, cancer, surgical
Tx options for C diff
metronidazole (PO or IV), vancomycin PO, fidazomicin
Vancomycin is preffered for when in C diff
severe infection
otherwise use metronidazole
how is vanco administered
PO
Tx campylobacteriosis
erythromcyin
if Diarrhea lasts longer than 7-10 days, most likley?
parasitic, giardia
Tx giardia
metronidazole
when is antibiotic Tx not recommended for diarrhea
EHEC, salmonella
why do not use antibiotics with salmonella
increase fecal shedding of pathogens and associated with prolonged carriage and relapse, does not reduce diarrhea
MOA idoquinol antiprotozoal
unknown, only effective on luminal organisms
therapeutic use idoquinol
adjunt to metronisazole in amebiasis
Adverse effects idoquinol
diarrhea, anorexia, nausea, comiting, abdominal pain, HA, rash, pruritis
may increase protein bound serum iodine
use caution in those with optic neuropathy, renal or thyroid disease or nonamebic hepatic disease
MOA nitazoxanide
inhibits pyruvate-ferredoxin oxidoreductase pathway
therapeutic use nitazoxanide
cryptosporidium
alternative to metronidazole in giardia
MOA paromomycin
interferes with bacterial protein synthesis by binding 30S ribosomal subunits
only luminal organisms
therapeutic use paromomycin
Tx acute and chronic intestinal amebiasis
off label cryptosporidium
adverse effects paromomycin
occasional abdominal distress and diarrea
may accumulate with renal insufficiency
MOA albendazole
antihelminthic
though to inhibit microtubule synthesis
wha tincreases absorption albendazole
fatty meals for tissue parasites
empty stomach for intraluminal parasites
therapeutic use albendazole
hydatid disease
cysticercosis
pinworm and hookworm infections: ascariasis, trichuriasis, strongyloides
therapeutic use rifaximin
prevention hepatic encephalopathy
travelers diarrhea from EHEC
off label IBS and refractory C difficile
MOA fidaxomicin
inhibits RNA polymerase resulting in inhibition protein synthesis causing cell death
PK of fidaxomicin
GI tract, undergoes intestinal hydrolysis to a less active metabolie
therapeutic use fidaxomicin
C difficile infection
adverse effects fidaxomicin
nausea, abdominal pain, vomiting
HS reacitons have been reported
