Treatment of GIT infections Flashcards

1
Q

Antagonistic drug combination against Enterobacteriaceae

A

Aminoglycoside and chloramphenicol

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2
Q

Antagonistic drug combination against strep pneumoniae

A

Broad spectrum penicillin and chloramphenicol

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3
Q

Antagonistic drug combination against gram negative bacilli

A

Broad spectrum penicillin and imipenem

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4
Q

Synergistic drug combination against enterococci

A

Aminoglycoside and ampicillin or penicillin G

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5
Q

Synergistic drug combinations against gram negative bacilli

A

Aminoglycoside and broad spectrum penicillin

Aminoglycoside and cephalosporin

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6
Q

Synergistic drug combination against Cryptococcus neoformans

A

Amphotericin B and flucytosine

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7
Q

Synergistic drug combination against staphylococci

A

Vancomycin and aminoglycoside

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8
Q

Synergistic drug combination against HIV

A

Reverse transcriptase inhibitor and protease inhibitor

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9
Q

Treatment for Bacillus cereus GIT infection

A

No antimicrobial therapy, supportive care

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10
Q

Treatment for severe C jejuni gastroenteritis

A

Erythromycin
Ciprofloxacin

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11
Q

Treatment for severe cholera

A

Tetracyclines
Azithromycin

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12
Q

Treatment for pseudomembranous colitis

A

Metronidazole
Vancomycin

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13
Q

Treatment for C perfringens GIT infection

A

No antimicrobial treatment, supportive care

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14
Q

E coli strains where treatment with antimicrobial is not recommended

A

EIEC
EHEC

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15
Q

Possible treatments for ETEC and EPEC

A

Fluoroquinolones
Doxycycline
Rifaximin
TMP-SMZ

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16
Q

Treatment for severe salmonellosis

A

Fluoroquinolones
Ampicillin

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17
Q

Treatment for shigella dysentery

A

Ciprofloxacin
Azithromycin

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18
Q

Treatments for typhoid fever

A

Fluoroquinolones
Ceftriaxone
Azithromycin

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19
Q

Treatment for severe Yersinia gastroenteritis

A

Fluoroquinolones
Aminoglycosides

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20
Q

Treatments for ANUG

A

Amoxicillin + metronidazole
Clindamycin
Doxycycline

Oral hygiene

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21
Q

Treatment for actinomycosis

A

Penicillin G

Surgery

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22
Q

How to estimate fluid replacement?

A

Difference between pt’s normal weight and weight at presentation

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23
Q

Oral rehydration solution

A

1/2 tsp salt
6 tsp sugar
1 L water

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24
Q

Empiric treatment choice for acute diarrhea

A

Azithromycin or fluoroquinolone

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25
Q

Empiric treatment choices for traveler’s diarrhea

A

Fluoroquinolone
Azithromycin
Rifaximin

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26
Q

Indications for empiric treatment in acute diarrhea

A

Severe disease
Bloody or mucoid stools –> suggestive of invasive infection
Advanced pt age
Comorbidities

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27
Q

Antimicrobial used to prevent carrier state in diphtheria

A

Penicillin G

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28
Q

Drug combination that causes sequential block of bacterial folate mechanism

A

Trimethroprim and sulfamethoxazole

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29
Q

Mechanism of fluoroquinolones

A

Inhibit bacterial topoisomerase II and topoisomerase IV –> inhibiting DNA synthesis

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30
Q

Side effects of fluoroquinolones

A

Tendonitis and tendon rupture

Contraindicated in children

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31
Q

Side effects of aminoglycosides

A

Nephrotoxicity
Ototoxicity
Neuromuscular blockade

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32
Q

Side effect of clindamycin

A

Pseudomembranous colitis

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33
Q

Side effects of vancomycin

A

Red man syndrome
Ototoxicity
Nephrotoxicity

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34
Q

Antimicrobial that suppresses bacterial ammonia formation and is used for prevention of hepatic encephalopathy

A

Rifaximin

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35
Q

Drugs effective on tissue amebiasis

A

Chloroquine
Emetines
Metronidazole
Tinidazole

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36
Q

Drugs effective on luminal amebiasis

A

Diloxanide furoate
Iodoquinol
Paromomycin

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37
Q

Drug of choice for asymptomatic amebiasis

A

Diloxanide furoate

38
Q

Alternative drugs for asymptomatic amebiasis

A

Iodoquinol
Paromomycin

39
Q

Drug of choice for mild to moderate amebiasis

A

Metronidazole plus luminal agent

40
Q

Drug of choice for severe amabiasis

A

Metronidazole or tinidazole, plus luminal agent

41
Q

Drug of choice of hepatic abscess and other extraintestinal amebiasis

A

Metronidazole or tinidazole plus luminal agent

42
Q

Mechanism of emetines

A

Inhibit protein synthesis by blocking ribosomal movement along mRNA

43
Q

Use of emetines

A

Severe amebiasis when metronidazole cannot be used

44
Q

Side effects of emetines

A

GI distress
Muscle weakness
Cardiovascular dysfunction (arrhythmias and CHF)

45
Q

Risks with high doses of iodoquinol

A

Thyroid enlargement
Iodine toxicity –> skin reaction
Neurotoxic effect

46
Q

Mechanism of metronidazole and tinidazole

A

Inhibits PFOR
Interferes with decarboxylation of pyruvate and ATP
Forms free radicals

47
Q

Most common side effects of metronidazole

A

Anorexia
Nausea
Metallic taste

Disulfiram like reaction

48
Q

Contraindication for use of metronidazole

A

Neurological disease, risk of seizure

49
Q

Risk with prolonged administration of metronidazole

A

Peripheral neuropathy

50
Q

Mechanism of nitazoxanide

A

Disrupts energy metabolism by inhibiting PFOR

51
Q

Drugs active against nematodes

A

Albendazole
Diethylcarbamazine
Ivermectin
Mebendazole
Pyrantel pamoate

52
Q

Drugs active against trematodes

A

Bithionol
Metrifonate
Oxamniquine
Praziquantel

53
Q

Drugs active against cestodes

A

Albendazole
Mebendazole
Niclosamide
Praziquantel

54
Q

Mechanism of albendazole

A

Inhibits microtubule assembly

55
Q

Albendazole is larvicidal in these helminth infections

A

Ascariasis
Cysticercosis
Hookworm
Hydatid disease

56
Q

Albendazole is ovicidal in these helminth infections

A

Ascariasis
Ancylostomiasis
Trichuriasis

57
Q

Primary drug for ascariasis

A

Albendazole or mebendazole

58
Q

Primary drug for hookworm

A

Albendazole or pyrantel pamoate

59
Q

Primary drug for pinworm

A

Albendazole or mebendazole

60
Q

Primary drug for whipworm

A

Albendazole or mebendazole

61
Q

Alternative drug for threadworm

A

Albendazole

62
Q

Alternative drug for filariasis

A

Albendazole

63
Q

Alternative drug for visceral and cutaneous larva migrans

A

Albendazole

64
Q

Adverse effects of albendazole

A

Reversible leukopenia
Alopecia
LFT elevation with long term use

65
Q

Drug of choice for Wuchereria bancrofti

A

Diethylcarbamazine

66
Q

Drug of choice for brugia malayi

A

Diethylcarbamazine

67
Q

Drug of choice for eye worm disease (Loa loa)

A

Diethylcarbamazine

68
Q

Drug of choice for onchocerciasis

A

Ivermectin

69
Q

Drug of choice for cutaneous larva migrans

A

Ivermectin

70
Q

Drug of choice for strongyloidiasis

A

Ivermectin

71
Q

Drug of choice for some forms of filariasis

A

Ivermectin

72
Q

Alternative drug for visceral larval migrans

A

Mebendazole

73
Q

Adverse effects of high dose mebendazole

A

Granulocytopenia
Alopecia

74
Q

Drug that paralyzes ascaris by blocking Ach at the myoneural junction

A

Piperazine

75
Q

Drug that stimulates nicotinic receptors present at the neuromuscular junctions of nematodes

A

Pyrantel pamoate

76
Q

Alternative drug for pinworm

A

Pyrantel pamoate

77
Q

Drug of choice for roundworm

A

Pyrantel pamoate

78
Q

Alternative drug for strongyloidiaisis and trichinosis that is similar to mebendazole

A

Thiabendazole

79
Q

Rare, serious side effects of thiabendazole

A

Irreversible liver failure
Stevens-Johnson syndrome

80
Q

Drug that causes marked contraction and then paralysis of trematode and cestode muscles

A

Praziquantel

81
Q

Drug of choice for schistosomiasis

A

Praziquantel

82
Q

Drug of choice for clonorchiasis

A

Praziquantel

83
Q

Drug of choice for paragonimiasis

A

Praziquantel

84
Q

Drug of choice for small and large intestinal flukes

A

Praziquantel

85
Q

Combination of praziquantel and niclosamide is used for what?

A

Cestode infections

86
Q

Alternative to albendazole for cysticercosis

A

Praziquantel

87
Q

Side effects of praziquantel in neurocysticercosis

A

Intracranial HTN
Seizures

88
Q

Bithionol and triclabendazole are combined to treat what?

A

Fascioliasis

89
Q

Alternative treatment for paragonimiasis

A

Bithionol

90
Q

Alternative for praziquantel for tapeworm and intestinal flukes

A

Niclosamide