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Pharmocology - step > myco/fungi/scabies/helmninth > Flashcards

myco/fungi/scabies/helmninth Flashcards

1
Q

prophylaxis for mycobacterium tuberculosis

A

isoniazid

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2
Q

treatment of mycobacterium tuberculosis

A 
RIPE
rifampin
isoniazid
pyrazinamide
ethambutol
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3
Q

prophylaxis of mycobacterium avium-intracellulare

A

azithromycin

rifabutin

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4
Q

treatment for mycobacterium avium-intracellulare

A

azithromycin or clarithyromycin and ehtambutol

can add rifabutin or ciprofloxacin

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5
Q

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

A

treatment for mycobacterium avium-intracellulare

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6
Q

treatment fo mycobacterium leprae - tuberculoid form

A

long term with dapson and rimapine

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7
Q

treatment of mycobacterium leprae - lepromatous form

A

dapsone, rifampin, clofazimine

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8
Q

treat ? with this: dapson, rifampine, clofazimine

A

mycobacterium leprae

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9
Q

what is the MOA of rifampin and rifabutin

A

inhibit DNA dependent RNA polymerase

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10
Q

what antimycobacterial drugs inhibit DNA dependent RNA polymerase

A

rifampin and rifabutin

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11
Q

what is the clinical use of rifampin and rifabutin?

A

m TB
delay resistance to dapson @ M leprae
meningococcal prolylaxis and chemoprophylaxis in contacts of children with HIB

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12
Q

toxo of rifampin and rifabutin

A

minor hepatotoxicity and increases P450

orang body fluids

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13
Q

which rifamycin is preferred in HIV patients and why

A

rifabutin bc stimulates cytochrome P450 less

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14
Q

what is the mechanism of resistance of rifampin and rifabutin

A

mutationed reduces drug binding to RNA polymerase

monotherapy - increased resistance

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15
Q

what are rifampins FOUR Rs?

A

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

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16
Q

what is the MOA of isoniazid

A

decreases synthesis of mycolic acids

bacterial catalase peroxidase encoded by KatG is needed to activate to its active metabolie

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17
Q

what is isoniazid used for

A

m TB

ONLY antimycobacterial that can be used on its own

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18
Q

what are the toxicities of isoniazid

A

neurotoxicity - can prevent with B6

hepatotoxicity

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19
Q

what is the mechanism of resistance of isoniazid

A

mutations that lead to underexpression of KatG

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20
Q

how can you decrease the neurotoxicity of isoniazid

A

give em B6

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21
Q

what is the MOA of pyrazinamde

A

unknown

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22
Q

what is the cxl use of pyrazinamide

A

M Tb

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23
Q

what are the a/se of pyrazinamde

A

hyperuricemia

hepatotoxcity

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24
Q

what is the MOA of ethambutol

A

decreases carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase

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25
Q

what is cilinical sue of ethambutol

A

m TB and with azithromycin/clarithromycin for MAC (Can add rifabutin or ciprofloxacin)

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26
Q

a/se of ethambutol please

A

optic neurpathy - red gree colour blindness

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27
Q

what is the MOA of amphotericin B

A

binds ergosterol to form membrane pores that allow electrolytes through

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28
Q

clinical use of amphotericin B

A

serious systemic mycoses

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29
Q

treat Cryptococcus meningitis!

A

amphotericin B and flucytosine

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30
Q

treat systemic blastomyces, cocciodies, histoplasma, candida please

A

amphotericin B

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31
Q

treat serious mucor!

A

amphotericin B

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32
Q

what do you need to supplement treatment of amphotericin B with

A

potassium and magnesium - altered renal tubule permeability

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33
Q

what are the toxicities fo amphotericn B

A 
FEVER and CHILLES (shake and bake)
hypotension
nephrotoxicity
arrhythmias
anaemia
IV phlebitis
34
Q

how to decrease nephrotoxicity in amphotericin B

35
Q

what form of amphotericin can decrease toxicities?

A

liposomal

toxos: nephrotoxicity, hypotension, arrhythmias, fever, chills, IV phlebitis

36
Q

what is the MOA of nystatin

A

same as amphotericin B

binds to ergosterol and makes pores in membrane so electrolytes leak

37
Q

what is the clinical use of nystatin

A

topical only bc too toxic for systemic use
swish and swallow for oral candidiates
topical at diaper rash and vaginal candidaisis

38
Q

treat diaper rash @ the munchkins!

39
Q

treat vaginal candidiasis @ the ladies!

40
Q

treat oral candidiasis @ the immunocompromised

41
Q

what is the MOA of flucytosine

A

DNA and RNA biosynthesis inhibition

converted to 5-FU by cytosine deaminase

42
Q

what is the use of flucoytosine

A

cryptococcal systemic/meningitis with amphotericin B

43
Q

what is the toxo of flucytosine

A

bone marrow suppression

44
Q

list the azoles

A 
clotrimazole
fluconazole
itraconazole
ketoconazole
miconazole
voriconazole
45
Q

what is the moa of the azoles

A

inhibit funcal sterol/ergosterol synthesis by inhibiting the cytochrome _450 enzyme that converts lansterol to ergosterol

46
Q

what are azoles used for

A

less serious systemic and local mycoses

47
Q

treat: chronic suppression of cyroptococcal meningitis in AIDS patients

A

fluconazole

48
Q

treat: candida infection of all types

A

fluconazole

49
Q

treat: blacstomyces, cocciodiosis, histoplasmosis non serious systemic

A

itraconazole

50
Q

treat topical funcal infections

A

clotrimazole

miconazole

51
Q

what is fluconazole used for

A

chronic suppression fo cryptococcal meningitis in ADIs patients
candida infetino of all types

52
Q

what is itraconazole used for

A

balstomyces, cocciodiosos, histplamsoms - not so serious infections

53
Q

what are clotrimazole and miconazole used for

A

treatment of topical fungal infections

54
Q

what is the moa of terbinafine

A

inhibits the funcal enzyme squalene epoxidase

55
Q

used of terbinafine

A

dermatophytoses - especially onychomycosis

56
Q

whats the toxo of terbinafine

A

gi upset
headaches
hepatotoxicity
taste disturbance

57
Q

what are the toxo fo azoles

A

testosterone synthesis inhibition - gynecomastia especially @ ketoconazole
liver dysfunction - inhibits cytochrome P450

58
Q

list the echinocandins

A

anidulaFUNGIN
caspoFUNGIN
micaGUNFIN

59
Q

what is the MOA of anidulafungin, caspofungin, micafungin

A

echinocandins: inhibit cell wall synthesis by inhibiting synthesis of beta glucan

60
Q

what is the clinical use fo echinocandins

A

invasive aspergillosis candida

61
Q

treat invasive aspergillus!

A

echinocandin!!
anidulaFUNGIN
caspoFUNGIN
micaFUNGIN

62
Q

what are the a/se of anidulafungin, caspofungin, micafungin

A

gi upset
flushing
HISTAMINE RELEASE
@ echinocandins

63
Q

what is the MOA of griseofulvin

A

interferes with microtubule founction - fustuprs mitosis

deposts in keratine containing tissues

64
Q

what are your options of dematophyte infections

A

terbinafine and girseofulvin

65
Q

cxl use of griseofulvin please

A

oral reatment of superficial infections

inhibits growth of fermatophyts - tinea and ringworm

66
Q

what is the toxicity of griseofulvin

A 
teratogenic
carcinogenic
confusion
heaaches
increases cytP450 and warfarin metabolism
67
Q

toxoplasmosis thearphy please

A

pyrimethamine

68
Q

treatment of trypansoma brucei pelase

A

seramin and melarsoprol

69
Q

treatment of T cruzi

A

nifurtimox

70
Q

treatment of leishmaniasis

A

sodium stibogluconate

71
Q

list the drugs used for mite/louse treatment

A

permethrin
malathion
lindane

72
Q

what is the use and moa of permethrin

A

scabies and lice

blocks Na channels - neurotoxicity

73
Q

what is the use and moa of malathion

A

scabies and lice

inhibit acetylcholinesterase

74
Q

what is the use and moa of lindane

A

blocks GABA channels - neurotoxicity

scabies and lice

75
Q

permethrin
malathion
lindane
?

A

scabies and lice

76
Q

function of chloroquine

A

inhibits the conversion of heme into hemozoin - heme accumulates and is toxic to the plasmodia

77
Q

what is chloroquine used for

A

plasmodia EXCEPT falciparum

78
Q

how is falciparum resistant to chloroquine?

A

membrane pump that decreases intracellular drug concentration

79
Q

how do you treat plasmodium falciparum

A

artemether/lumefantrine
OR
atovaqone/proguanil

80
Q

what ot use for life threatening malaria?

A

quinidine or artesunate

81
Q

what toxos to worry about with chloroquine

A

retinopathy

prurutis esp at dark skinned individuals

82
Q

list the antihelmninthic therapies

A 
mebendazole
pyrantel pamoate
ivermectin
diethylcarbamazine
praziqantel

Pharmocology - step (16 decks)

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