GI Infection Pharm

Question 1

What is the treatment for Clostridioides difficlie?

(drug and its class)

Answer 1

• oral vancomycin (glycopeptide _{-> poorly absorbed so vancomycin is normally only given IV because of this, C. diff infection is in the GI tract so this is actually beneficial)}
• fidaxomicin (macrolide) second choice

Question 2

What is the treatment for Campylobacter jejuni?

(drug and its class)

Answer 2

• ciproflocacin (fluoroqinolone)
• azithromycin (macrolide) second choice

Question 3

What is the treatment for Salmonella spp.?

(drug and its class)

Answer 3

• ciprofloxacin (fluoroquinalone; topoisomerase)
• azithromycin (macrolide; 23S) second choice

Question 4

What is the treatment for Shigella spp.?

(drug and its class)

Answer 4

• ciprofloxacin (fluoroquinalone)
• azithromycin (macrolide) second choice

Question 5

What drug class is most commonly used to treat helminth infections?

(MOA and specific drugs)

Answer 5

Benzimidazoles** (microutbule** polymeriztion inhibitor, binds β-tubulin:

• albendazole**
• mebendazole
• thiabenazole (toxicities so only used in cutaneous infections)

Question 6

What miscellaneous drugs are used to treat helminth infections?

Answer 6

• ivermectin (glutamate-gated Cl^- channels -> hyperpolarizes; paralyzes worm); threadworm/Strongyloides
• nitazoxanide (pyruvate:ferrodoxin oxidoreductase/PFOR; anaerobic metabolism)
• praziquantel (inreases permiability -> loss of Ca²⁺); schistosoma and adult taenia
• pyrantel pamoate

Question 7

What is the treatment of choice for amebiasis (Entomaeba histolytica)?

Answer 7

-metronidazole and paromomycin

Question 8

What is the treatment of choice for hookworms (Ancylostoma spp. and Necator americanus)?

Answer 8

-albendazole > mebendazole

Question 9

What is the treatment of choice for roundworms (Ascaris lumbricoides)?

Answer 9

-albendazole > mebendazole

Question 10

What is the treatment of choice for giardiasis (Giardia spp.)?

Answer 10

-metronidazole

Question 11

What is the treatment of choice for adult tapeworm (Diphyllobothrium latum and Taenia spp.)?

Answer 11

-praziquantel

Question 12

What is the treatment of choice for larval tapeworms (Echinococcus granulosus)?

Answer 12

-albendazole and praziquantel

Question 13

What is the treatment of choice for larval tapeworms (Taenia solium cysticercosis)?

Answer 13

-albendazole

Question 14

What is the treatment of choice for pinworms (Enterobius vermicularis)?

Answer 14

-mebendazole > albendazole

Question 15

What is the treatment of choice for schistosomiasis (Schistosoma spp.)?

Answer 15

• praziquantel
• add streoids for neuro disease

Question 16

What is the treatment of choice for threadworm (Strongyloides stercoralis)?

Answer 16

-ivermectin

only one where ivermectin is first choice

Question 17

What is the treatment of choice for whipworm (Trichuris trichiura)?

Answer 17

-mebendazole > albendazole

(mebendazole is shown to be more effective here and therefore given over albendazole which is normally preferred because it can be given in a one time dose)

Question 18

What is the treatment of choice for trichinellosis (Trichinella spp.)?

Answer 18

• albendazole
• add steroids for severe disease

Question 19

What is the treatment of choice for Cryptosporidium spp.?

Answer 19

-nitazoxanide

Question 20

What is the treatment of choice for Cyclospora cayetanensis?

Answer 20

• trimethoprim-sulfamethoxazole (TMP-SMZ)
• ciprofloxacin (for sulfa allergies)

Question 21

What is paromomycin and what is its MOA?

Answer 21

aminoglycoside

targets 30S ribosomal subunit

Question 22

What is metronidazole and what is its MOA?

Answer 22

(Flagyl)

anti-bacterial/protazoal

interupts ETC -> nitro-radicals that damage DNA