myco/fungi/scabies/helmninth Flashcards
prophylaxis for mycobacterium tuberculosis
isoniazid
treatment of mycobacterium tuberculosis
RIPE rifampin isoniazid pyrazinamide ethambutol
prophylaxis of mycobacterium avium-intracellulare
azithromycin
rifabutin
treatment for mycobacterium avium-intracellulare
azithromycin or clarithyromycin and ehtambutol
can add rifabutin or ciprofloxacin
azithromycin/clathrithromycin and ethambutol and can add rifabutin or ciprofloxacin for?
treatment for mycobacterium avium-intracellulare
treatment fo mycobacterium leprae - tuberculoid form
long term with dapson and rimapine
treatment of mycobacterium leprae - lepromatous form
dapsone, rifampin, clofazimine
treat ? with this: dapson, rifampine, clofazimine
mycobacterium leprae
what is the MOA of rifampin and rifabutin
inhibit DNA dependent RNA polymerase
what antimycobacterial drugs inhibit DNA dependent RNA polymerase
rifampin and rifabutin
what is the clinical use of rifampin and rifabutin?
m TB
delay resistance to dapson @ M leprae
meningococcal prolylaxis and chemoprophylaxis in contacts of children with HIB
toxo of rifampin and rifabutin
minor hepatotoxicity and increases P450
orang body fluids
which rifamycin is preferred in HIV patients and why
rifabutin bc stimulates cytochrome P450 less
what is the mechanism of resistance of rifampin and rifabutin
mutationed reduces drug binding to RNA polymerase
monotherapy - increased resistance
what are rifampins FOUR Rs?
RNA polymerase inhibitor
ramps up microsomal cytP450
red/orange body fluids
rapid resistance if used alone
what is the MOA of isoniazid
decreases synthesis of mycolic acids
bacterial catalase peroxidase encoded by KatG is needed to activate to its active metabolie
what is isoniazid used for
m TB
ONLY antimycobacterial that can be used on its own
what are the toxicities of isoniazid
neurotoxicity - can prevent with B6
hepatotoxicity
what is the mechanism of resistance of isoniazid
mutations that lead to underexpression of KatG
how can you decrease the neurotoxicity of isoniazid
give em B6
what is the MOA of pyrazinamde
unknown
what is the cxl use of pyrazinamide
M Tb
what are the a/se of pyrazinamde
hyperuricemia
hepatotoxcity
what is the MOA of ethambutol
decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase
what is cilinical sue of ethambutol
m TB and with azithromycin/clarithromycin for MAC (Can add rifabutin or ciprofloxacin)
a/se of ethambutol please
optic neurpathy - red gree colour blindness
what is the MOA of amphotericin B
binds ergosterol to form membrane pores that allow electrolytes through
clinical use of amphotericin B
serious systemic mycoses
treat Cryptococcus meningitis!
amphotericin B and flucytosine
treat systemic blastomyces, cocciodies, histoplasma, candida please
amphotericin B
treat serious mucor!
amphotericin B
what do you need to supplement treatment of amphotericin B with
potassium and magnesium - altered renal tubule permeability
what are the toxicities fo amphotericn B
FEVER and CHILLES (shake and bake) hypotension nephrotoxicity arrhythmias anaemia IV phlebitis
how to decrease nephrotoxicity in amphotericin B
hydrate
what form of amphotericin can decrease toxicities?
liposomal
toxos: nephrotoxicity, hypotension, arrhythmias, fever, chills, IV phlebitis
what is the MOA of nystatin
same as amphotericin B
binds to ergosterol and makes pores in membrane so electrolytes leak
what is the clinical use of nystatin
topical only bc too toxic for systemic use
swish and swallow for oral candidiates
topical at diaper rash and vaginal candidaisis
treat diaper rash @ the munchkins!
nystatin
treat vaginal candidiasis @ the ladies!
nystatin
treat oral candidiasis @ the immunocompromised
nystatin
what is the MOA of flucytosine
DNA and RNA biosynthesis inhibition
converted to 5-FU by cytosine deaminase
what is the use of flucoytosine
cryptococcal systemic/meningitis with amphotericin B
what is the toxo of flucytosine
bone marrow suppression
list the azoles
clotrimazole fluconazole itraconazole ketoconazole miconazole voriconazole
what is the moa of the azoles
inhibit funcal sterol/ergosterol synthesis by inhibiting the cytochrome _450 enzyme that converts lansterol to ergosterol
what are azoles used for
less serious systemic and local mycoses
treat: chronic suppression of cyroptococcal meningitis in AIDS patients
fluconazole
treat: candida infection of all types
fluconazole
treat: blacstomyces, cocciodiosis, histoplasmosis non serious systemic
itraconazole
treat topical funcal infections
clotrimazole
miconazole
what is fluconazole used for
chronic suppression fo cryptococcal meningitis in ADIs patients
candida infetino of all types
what is itraconazole used for
balstomyces, cocciodiosos, histplamsoms - not so serious infections
what are clotrimazole and miconazole used for
treatment of topical fungal infections
what is the moa of terbinafine
inhibits the funcal enzyme squalene epoxidase
used of terbinafine
dermatophytoses - especially onychomycosis
whats the toxo of terbinafine
gi upset
headaches
hepatotoxicity
taste disturbance
what are the toxo fo azoles
testosterone synthesis inhibition - gynecomastia especially @ ketoconazole
liver dysfunction - inhibits cytochrome P450
list the echinocandins
anidulaFUNGIN
caspoFUNGIN
micaGUNFIN
what is the MOA of anidulafungin, caspofungin, micafungin
echinocandins: inhibit cell wall synthesis by inhibiting synthesis of beta glucan
what is the clinical use fo echinocandins
invasive aspergillosis candida
treat invasive aspergillus!
echinocandin!!
anidulaFUNGIN
caspoFUNGIN
micaFUNGIN
what are the a/se of anidulafungin, caspofungin, micafungin
gi upset
flushing
HISTAMINE RELEASE
@ echinocandins
what is the MOA of griseofulvin
interferes with microtubule founction - fustuprs mitosis
deposts in keratine containing tissues
what are your options of dematophyte infections
terbinafine and girseofulvin
cxl use of griseofulvin please
oral reatment of superficial infections
inhibits growth of fermatophyts - tinea and ringworm
what is the toxicity of griseofulvin
teratogenic carcinogenic confusion heaaches increases cytP450 and warfarin metabolism
toxoplasmosis thearphy please
pyrimethamine
treatment of trypansoma brucei pelase
seramin and melarsoprol
treatment of T cruzi
nifurtimox
treatment of leishmaniasis
sodium stibogluconate
list the drugs used for mite/louse treatment
permethrin
malathion
lindane
what is the use and moa of permethrin
scabies and lice
blocks Na channels - neurotoxicity
what is the use and moa of malathion
scabies and lice
inhibit acetylcholinesterase
what is the use and moa of lindane
blocks GABA channels - neurotoxicity
scabies and lice
permethrin
malathion
lindane
?
scabies and lice
function of chloroquine
inhibits the conversion of heme into hemozoin - heme accumulates and is toxic to the plasmodia
what is chloroquine used for
plasmodia EXCEPT falciparum
how is falciparum resistant to chloroquine?
membrane pump that decreases intracellular drug concentration
how do you treat plasmodium falciparum
artemether/lumefantrine
OR
atovaqone/proguanil
what ot use for life threatening malaria?
quinidine or artesunate
what toxos to worry about with chloroquine
retinopathy
prurutis esp at dark skinned individuals
list the antihelmninthic therapies
mebendazole pyrantel pamoate ivermectin diethylcarbamazine praziqantel
