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GI Pharm > GI Infection pharm > Flashcards

GI Infection pharm Flashcards

1
Q

C Diff treatment

A

vancomycin (preferred for severe infection)
methronidazole
fidaxomicin
supportive care

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2
Q

C Diff treatment (Vancomycin)

A

Preferred for severe CDI
A glycopeptide that inhibits cell wall synthesis (D-ALA_
oral vancomycin not absorbed systemically (IV has no effect)
Adverse effect is red man syndrome

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3
Q

C Diff treatment (metronidazole)

A 
used for mild CDI 
a nitroimidazole with toxic intermediates incorporated into bacterial DNA
reduced by reacting with ferredoxin 
Oral and IV have wide distribution including BBB
Avoid alcohol
metallic taste
nausa 
peripheral neuropathy 
also kills flagellated pathogens
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4
Q

C diff treatment ( fidaxomicin

A 
treats recurring CDI 
spares anaerobic colonic flora 
bacterial protein synthesis inhibitor, binds RNA pol
given orally 
limited GI side effects
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5
Q

H pylori treatments

A

bismuth subslicylate
metronidazole
tetracycline (protein synthesis inhibitor)
omeprazole

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6
Q

entamoeba histolytica treatment

A

binucleated trophozoite, tetra nucleated cyst
pathogenic if RBCs in cytoplasm
metronidazole (drug of choice for extraluminal)
- eradicates intestinal and extraintestinal infection
tinidazole (better tolerated than metronidazole)
paromomycin (luminal amebicide)
lodoquinol (luminal amebicide)
must include amebicide to ensure eradication

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7
Q

lodoquinol

A

E histolytica treatment

  • 90% retained and excreted unchanged
  • contraindicated in its with intolerance to iodine
  • neurotoxicity with prolonged exposure
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8
Q

Paromomycin

A
  • protein synthesis inhibitor
  • no absorption
  • no effect extraintestinally
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9
Q

G lamblia tx

A

supportive with fluid
tinidazole (first line)
metronidazole
nitazoxanide

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10
Q

Nitazoxanide

A

G lamblia tx
inhibits pyruvate-ferredoxin oxidoreductase enzyme
- disrupts metabolism
prodrug - active met is tizoxanide

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11
Q

tinidazole

A

similar to metronidazole but better tolerated

tx for G lamblia and E histolytica

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12
Q

cryptosporidium parvum

A 
contaminated water, day care, travelers 
oocysts with 4 motile sporozoites
life cycle in intestinal epithelial cells 
self limiting 
life threatening in immunocompromised
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13
Q

cryptosporidium tx

A

antidiarrheal (loperamide)
nitazoxanide
paromomycin

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14
Q

nematode tx

A 
albendazole
mebendazole
ivermectin
thiabendazole
pyrantel pamoate
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15
Q

albendazole and mebendazole

A

broad spectrum
inhibits microtubule synthesis, paralyzes worm
prodrug
wide distribution
few adverse effects
contraindicated in pregnancy and cirrhosis

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16
Q

thiabendazole

A

inhibits microtubule synthesis and paralyzes worm
more toxic than albendazole and mebendazole
can cause liver failure and stevens johnson syndrome
contraindicated in pregnancy, hepatic or renal disease

17
Q

ivermectin

A

increases GABA transmission in nematode causing paralysis

contraindicated in pregnancy and when pt is taking barbituates, benzos, or valproic acid

18
Q

pyrantel pamoate

A

neuromuscular blocking agent, causes Ach release and inhibition of AchE
paralyzes worm
poorly absorbed from GI tract, with half being recovered unchanged in feces
no adverse effects
contraindicated in liver dysfuncitons

19
Q

Necator americanus and Ancylostoma duodenale tx

A

albendazole (primary)

mebendazole or pyrantel pamoate (secondary)

20
Q

Ascaris lumbricoides tx

A

albendazole or mebendazole (primary)

ivermectin (alternate)

21
Q

Strongyloides stercoralis tx

A

ivermectin (primary)

albendazole (secondary)

22
Q

T. tichiura tx

A

mebendazole (primary)

albendazole or ivermectin (secondary)

23
Q

E. vermicularis tx

A

albendazole, mebendazole or pyrantel pamoate (all primary)

24
Q

Schistosoma tx

A

praziquantel
-increases cell membrane permeability to Ca resulting in paralysis
- as worm dies, immune response may mount causing fever, pruritus, rash
contraindicated in pregnancy

25
Q

cestode tx

A

praziquantel
niclosamide
albendazole

26
Q

cestodes

A 
Taenia solium (pig)
Taenia saginata (Cow)
Diphyllobothrium latum (freshwater fish)
echinococcus granulosus (Dog and sheep, form Hydatid cyst)
27
Q

Niclosamide

A

not effective against hydatid cysts or cysticercosis (t.solium)
inhibits ox phos
contraindicated in pregnancy, kids under 2 or with alcohol consumption

GI Pharm (6 decks)

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