GI Infections Pharm Flashcards
Antiobiotics that cause C. diff (4)
Fluoroquinolones
Clindamycin
Broad specturm cephalosporins
Broad spectrum penicillins
C. diff Treatment
Drugs (3), Indications and Distributions
Vancomycin
Severe infection
Oral dose, stays in GI tract
Metronidazole
Mild Infection
IV/Oral dose, goes systemic
Fidaxomicin
Recurrent infection
Metronidazole Adverse Effects (2)
Metallic taste in mouth
Disulfiram-like effect (vomiting if taken with alcohol)
Invading Entamoeba histolytica
Complications (2) Diagnosis and Treatment (4)
Liver abscesses Pulmonary abscesses (deadly)
Visualize amoeba with ingested RBC in cytoplasm
Treat with Invading and Luminal Amebicides:
Metronidazole
Tinidazole
Paromomycin or Iodoquinol
Asymptomatic Entamoeba histolytica
Diagnosis and Treatment (2)
Amoeba visualized without RBC in cytoplasm
Luminal amebicides:
Paromomycin*
Iodoquinol
Iodoquinol Adverse Effects (3)
Iodine allergies
Mild GI/CNS issues
Rash
Giardia lamblia Clinical Description (2), Appearance and Treatment (3)
Causes steatorrhea without blood
Coats small intestine without invading
Kite shaped trophozoid
Tinidazole*
Metronidazole
Nitazoxanide
Nitazoxanide
MOA (2) and Adverse Effects (4)
Prodrug that inhibits pyruvate-ferrodoxin oxidoreductase
Flatulence
Yellow eyes
Bright yellow urine
Enlarged salivary glands
Cryptospiridium parvum Clinical Features (2) and Treatment (3)
Severe, life threateneing diarrhea (3-17 L/day)
Seen in immunocompromised patients
Nitazoxanide
Paromomycin
Loperamide
Necator americanus/Ancylostoma duodenale (Hook)
Key Life Cycle Features (2), Presentation (5) and Treatment (3)
Penetrates feet
Eggs excreted in feces (stool analysis to diagnose)
Diarrhea Abdominal pain Weight loss Anemia Penetration site itching
Albendazole**
Mebendazole
Pyrantel pamoate
Ascaris lumbricoides
Key Life Cycle Features (2), Presentation (2) and Treatment (3)
Infects via egg consumption
Excreted in feces (stool analysis to diagnose)
Abdominal cramping
Malnutrition
Albendazole**
Mebendazole**
Ivermectin
Strongyloides stercoralis
Key Life Cycle Features (5) and Unique Clinical Feature
Worms penetrate skin Eggs hatch in GI (eggs not in feces) Larvae autoinfect Larvae infect perianal area Larvae excreted in feces
Immunosuppression via prednisone for asthma can lead to severe autoinfection
Strongyloides stercoralis
Presentation (5), Diagnosis (2) and Treatment (2)
Vomiting Bloating Diarrhea Anemia Weight Loss
Larvae in feces
Enterotest (eggs on ingested string)
Ivermectin**
Albendazole
Trichuris trichiura
Key Life Cycle Features (6), Presentation (2) and Treatment (3)
Infection via football shaped egg ingestion No larvae No invasion No lung involvement No eosinophilia No autoinfection
Abdominal pain
Diarrhea
Mebendazole**
Albendazole
Ivermectin
Enterobius vermicularis
Key Life Cycle Features (2) Clinical Features (2) and Treatment (3)
Infection via egg ingestion
Female lays eggs in perianal area at night
Severe perianal itching
No eosinophilia
Diagnose with scotch tape test
Albendazole**
Mebendazole**
Pyrantel Pamoate**
Albendazole and Mebendazole
Description (2) and MOA (2)
Broad spectrum prodrugs
Paralyze worms by inhibiting microtubule synthesis
Thiabendazole
MOA and Adverse Effects (4)
Inhibit microtubule synthesis
Liver toxicity
Dizziness
Anorexia
N/V
Ivermectin
MOA (2)
Paralyzes worms by increasing GABA signaling in peripheral nerves
Pyrantel Pamoate
MOA (2)
Paralyzes worms by increasing acetycholine and decreasing acetylcholinesterase to blockade NMJ
Schistosomas (blood flukes)
Key Life Cycle Features (5) Presentation (3) and Treatment
Invade any exposed skin
Eggs hatch in water
Adult worms do molecular mimicry to avoid immunity
Japonicum/Mansoni release eggs into feces
Haemotobium release eggs into urine
Dermatitis
Katayama Fever (fever, hives bronchospasm)
Chronic fibrosis
Praziquantel
Praziquantel
MOA and Adverse Effects: Immediate (4) and Late (3)
Paralyze worms via increased Calcium permeability
Immediate: Headache, Dizzy, Drowsy, Lassitude
Late: Low grade fever, Pruritis, Skin rash
*Immediate are from drug and late are from immmune reaction to dead worms
Taenia solium and Taenia saginata
Key Life Cycle Features (2), Animal Hosts (2)
Presentation (2)
Animal eats from field contaminated by human feces
Human eats undercooked meat and ingests eggs
Taenia solium found in pork
Taenia saginata found in beef
Weight loss
Malnutrition
Diphyllobothrium latum
Infectious Route, Diagnosis (2) and Presentation
Ingesting larvae in raw freshwater fish
Proglottids and eggs in feces
Vitamin B12 deficiency (pernicious anemia)
Echinococcus granulosus
Life Cycle Features (3)
Humans ingest eggs from dog feces
Eggs hatch in intestines
Larva form hydatid cysts in muscle
Cestodes (Tape worms)
Examples (4) and Treatment (3)
Taenia solium
Taenia saginata
Diphyllobothrium latum
Echinococcus granulosus
Praziquantel**
Albendazole**
Niclosamide
Niclosamide
MOA (2) and Issues (3)
Kills parasite by uncoupling Oxidative Phosphorylation
Side effects
Long therapy duration
Lack of availability
