myco/fungi/scabies/helmninth Flashcards by Becky Koscik

prophylaxis for mycobacterium tuberculosis

isoniazid

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treatment of mycobacterium tuberculosis

RIPE
rifampin
isoniazid
pyrazinamide
ethambutol

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prophylaxis of mycobacterium avium-intracellulare

azithromycin

rifabutin

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treatment for mycobacterium avium-intracellulare

azithromycin or clarithyromycin and ehtambutol

can add rifabutin or ciprofloxacin

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azithromycin/clathrithromycin and ethambutol and can add rifabutin or ciprofloxacin for?

treatment for mycobacterium avium-intracellulare

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treatment fo mycobacterium leprae - tuberculoid form

long term with dapson and rimapine

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treatment of mycobacterium leprae - lepromatous form

dapsone, rifampin, clofazimine

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treat ? with this: dapson, rifampine, clofazimine

mycobacterium leprae

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what is the MOA of rifampin and rifabutin

inhibit DNA dependent RNA polymerase

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what antimycobacterial drugs inhibit DNA dependent RNA polymerase

rifampin and rifabutin

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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

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toxo of rifampin and rifabutin

minor hepatotoxicity and increases P450

orang body fluids

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which rifamycin is preferred in HIV patients and why

rifabutin bc stimulates cytochrome P450 less

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what is the mechanism of resistance of rifampin and rifabutin

mutationed reduces drug binding to RNA polymerase

monotherapy - increased resistance

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what are rifampins FOUR Rs?

RNA polymerase inhibitor
ramps up microsomal cytP450
red/orange body fluids
rapid resistance if used alone

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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

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what is isoniazid used for

m TB

ONLY antimycobacterial that can be used on its own

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what are the toxicities of isoniazid

neurotoxicity - can prevent with B6

hepatotoxicity

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what is the mechanism of resistance of isoniazid

mutations that lead to underexpression of KatG

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how can you decrease the neurotoxicity of isoniazid

give em B6

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what is the MOA of pyrazinamde

unknown

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what is the cxl use of pyrazinamide

M Tb

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what are the a/se of pyrazinamde

hyperuricemia

hepatotoxcity

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what is the MOA of ethambutol

decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

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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 ```