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SG - Pharm 4 > Fungal & Protozoa > Flashcards

Fungal & Protozoa Flashcards

1
Q
  • Histoplasmosis
  • Coccidioidomycosis
  • Cryptococcoisis
  • Blastomycosis
  • Paracoccidioidomycosis
  • Sporotrichosis
A

Systemic mycoses caused by pathogenic fungi

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2
Q
  • Candida albicans
  • Aspergillus species
  • Trichosporon
  • Candida glabrate
  • Fusarium
  • Alternaria
  • Mucor.
A

Opportunistic fungi

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3
Q

MOA:

  • Selectively toxic to fungi
  • Interacts w/ or inhibits the synthesis of ergosterol
  • A sterol unique to fungal cell membranes
A

Antifungal agents

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4
Q

What are the 2 targets for antifungal drugs?

A
  • cell membrane
  • cell wall
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5
Q

Susceptibility Activity of which drugs?

  • Candidemia
  • Aspergillus
  • Blastomyces
  • Cryptococcus
  • Coccidioides
  • Histoplasma
  • Mucormycosis
A
  • Amphotericin B
  • Azoles
    • Ketoconazole
    • Fluconazole* (prototype)
    • Itraconazole
    • Posaconazole
    • Voriconazole
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6
Q

Which drug?

  • Binds to ergosterol in fungal cell membranes forming “leaky pores”
  • Tx Candidemia
  • Nephrotoxicity is dose-limitng, additive w/ other nephrotoxic drugs
  • Infusion rxns (Chills, fever, muscle spasms, hypotension)
A

Amphotericin B

“Amphoterrible”

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7
Q

Which drug?

  • Interferes w/ DNA & RNA synthesis selectively in fungi
  • Tx Cryptococcus and chromoblastomycosis infections
  • Toxcities: renal excretions & myelosuppression
A

Flucytosine

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8
Q

MOA of Azoles as antifungals

  • Ketoconazole
  • Fluconazole
  • Itraconazole
  • Posaconazole
  • Voriconazole
A

Inhibit fungal P450 dependent enzymes blocking ergosterol synthesis

  • Resistance can occur w/ long-term use
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9
Q

What are the 3 clinical applications of Azoles

A
  • Aspergillosis
  • Blastomycosis
  • Mucormycosis
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10
Q
  • Azoles have various topical & oral forms for ____.
  • Oral & parenteral forms for _____
A
  • dermatophytoses
  • mycoses
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11
Q
  • Most azoles undergo ____ metabolism.
  • ______ eliminated in urine unchanged.
A
  • hepatic
  • Fluconazole
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12
Q
  • ______ is rarely used in systemic fungal infections owing to its inhibition of hepatic and adrenal P450s
  • Other azoles are less toxic, but may cause which 2 sxs?
  • _____ causes visual disturbances & class D for pregnancy risk
A
  • Ketoconazole
  • GI upsets & rash
  • Voriconazole
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13
Q

Which drug?

  • Inhibits epoxidation of squalene
  • Tx for mucocutaneous fungal infections (accumulates in keratin)
  • Oral: long duration of action (weeks)
  • Toxicities: GI upsets / HA
A

Terbinafine

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14
Q
  • What is the 1st line tx for Aspergillus species?
  • What is the 1st line tx for:
    • Balstomyces
    • Candida
    • Cryptococcus
    • Coccidioides immitis
    • Histoplasma
    • Mucoraceae
    • Sporothrix
A
  • Voriconazole
  • Amphotericin B (if this is not an option choose an Azole)
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15
Q

Which 3 antifungals cause Nephrotoxicity?

A
  • Amphotericin B
  • IV Itraconazole
  • IV Voriconazole
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16
Q

Which 4 antifungals cause abdominal discomfort?

A
  • Fluconazole
  • Itraconazole
  • Voriconazole
  • Posaconazole
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17
Q

Which antifungals cause increased hepatic transaminases?

A

All 6:

  • Amphotericin B
  • Fluconazole
  • Itraconazole
  • Voriconazole
  • Posaconazole
  • Echinoconazole
18
Q

Which antifungals cause Rash & photosensitivity?

A
  • Fluconazole
  • Itraconazole
  • Voriconazole (Vori-Malignancy)
  • Posaconazole
  • Echinoconazole

(All except Amphotericin B)

19
Q

Which 2 antifungals cause Infusion related reactions/Histamine release?

A
  • Amphotericin B
  • Echinoconazole
20
Q

Which antifungal causes CNS & visual disturbances?

A
  • Voriconazole
21
Q

Which antifungals cause Cardiomyopathy?

A
  • Fluconazole
  • Itraconazole
  • Voriconazole
  • Posaconazole
  • Echinoconazole?

NOT ampho

22
Q

The treatment for ____ actually made the condition worsen. Go to CDC website to find out what to give patients for tx.

A

Malaria

23
Q

What tx?

  • Used to tx infections caused by protozoa (single cell organisms that belong to type of parasites)
  • Occur throughout the world
  • Major cause of morbidity and mortality in some regions such as ____ & South-East Asia.
A

Antiprotazoal Treatments

24
Q

What are the 3 diseases caused by protazoa?

A
  • Malaria
  • Giardia
  • Trichomoniasis
25
Q

What is special about the treatment of malaria?

A

They are used to both TREAT and PREVENT malaria

26
Q

What are the 4 antimalarial drugs?

A
  • Mefloquine
  • Chloroquine
  • Atovaquone-proguanil (Malarone)
  • Doxycycline
  • Pimaquine
27
Q

What is the MOA of antimalarial drugs?

A

Kill / inhibit growth of protozoa by affecting different stage of parasitic life cycle

28
Q

Prevention of Malaria

  • Choice of drugs is based on what?
A

Destinations visiting

29
Q

Which Tx of Malaria?

  • Treatment & chemoprophylaxis of infections w/ sensitive parasites
A

Chloroquine

30
Q

Which tx of Malaria?

  • Chemoprophlaxis & tx of infections w/ P falciparum
A
  • Mefloquine
  • Atovaquone-proguanil (Malarone)
31
Q

Which tx of Malaria?

  • Radical cure and terminal prophylaxis of infections w/ Plasmodium vivax and Plasmodium ovale; alternative for malaria chemoprophylaxis
A

Primaquine

32
Q

Which tx of malaria?

  • Treatment (with quinine) of infections w/ P falciparum; chemoprophylaxis
A

Doxycycline

33
Q
  • GI upset, so give w/ Cola
  • Photosensitivity
  • Can give to children if duration is <21 days
A

Doxycycline

34
Q

Which Malaria drug?

  • Dyspepsia
  • Insomnia
  • Vivid dreams*
  • Use w/ caution in pts w/ epilepsy, szs, depression, or other mental health problems, severe heart or liver problems
A

Mefloquine

35
Q

Which Antimalarial tx?

  • Convulsions
  • Visual disturbances
  • Depigmentation or loss of hair
  • Use w/ caution in pts w/ neurological disorders (myasthenia gravis), glucose-6-phosphate dehydrogenase deficiency (which helps RBCs function), liver & renal problems
A

Chloroquine

36
Q

Which antimalarial tx?

  • Insomnia & “abnormal” dreams
  • Depression*
  • Should not be given to pregnant or breastfeeding women
  • Not recommended for pts w/ severe kidney problems
A

Atovaquone-proguanil (Malarone)

37
Q

Which antimalarial tx?

  • N/V/D
  • Causes yellow teeth and teeth disfigurement if taken during development
  • Should not be given to pregnant/breastfeeding women & children under 8 yrs
  • Avoid taking w/ antacids, milk , Ca, or Mg salts
  • Photosensitivity may occur
  • Avoid prolonged sunligh exposure and use appropriate sunscreen
A

Doxycylcine

38
Q

What is the tx for Giardia lamblia?

A
  • Metronidazole
39
Q

Tx for Leishmaniasis

  • Cutaneous is spread by what?
A

Sodium stibogluconate

  • Sandflies
40
Q

Protozoa tx for pregnancy

A

Spiramycin (daiy until delivery)

41
Q

Protozoa tx for Trichomonas vaginalis

A

Metronidazole

SG - Pharm 4 (16 decks)

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