Treatments of GI Infections Flashcards
IV vancomycin’s claim to fame was treatment of…
MRSA
what is the first line treatment for initial, non-severe c. diff infection?
oral vancomycin
metronidazole was previously used for c. diff which has since developed resistance, so now we use…
the macrolide fidaxomicin
what is the treatment for initial episode, severe c. diff?
oral vancomycin
what is the treatment for initial episode c. diff when fulminant?
oral vancomycin + IV metronidazole
what is the treatment for the first recurrence of c. diff?
oral vancomycin if metronidazole was used for treatment initially…
…otherwise…
oral fidaxomicin if vancomycin was used for the initial episode
name the two agents used for treatment of c. diff
oral vancomycin + metronidazole
STAR
name the two agents used for treatment of campylobacter jejuni
ciprofloxacin + azithromycin
STAR
name the two agents used for treatment of salmonella spp.
ciprofloxacin + azithromycin
STAR
name the two agents used for the treatment of shigella spp.
ciprofloxacin + azithromycin
STAR
name the three drugs in the benzimidazoles
- albendazole
- mebendazole
- thiabendazole (cutaneous only)
what is the cutaneous only benzimidazole?
thiabendazole
name the drug class
MOA:
inhibition microtubule polymerization via beta-tubulin binding
- reduced glucose transport
inhibition mitochondrial fumarate reductase
- resulting in immobilization and death
benzimidazoles
albendazole tends to be treatment of choice
name the drug
MOA: selective for glutamate-gated chloride channel, results in paralysis and death of the worm
ivermectin
full description:
- binds selectively, with high affinity, to glutamate-gated chloride ion channels
- induces hyperpolarization –> tonic paralysis of the worm’s nerves/musculature (immobilization and death)
ivermectin is used with albendazole for the treatment of…
strongyloides stercoralis
name the drug
MOA: interferes with PFOR of ETC
nitazoxanide
full description:
interferes with pyruvate:ferredoxin oxioreductase (PFOR) enzyme-dependent ETC
name the drug
MOA: membrane permeability and paralysis
praziquantel
full description:
- increases cell membrane permeability resulting in loss of IC Ca, massive contractions ending in paralysis of musculature
- disintegration of schistosome tegument followed by attachment of phagocytes leading to death
name the drug
MOA: depolarizing muscular blocker; can result in spastic paralysis
pyrantel pamoate
full description:
- depolarizing neuromuscular blocker
- opens non-selective cation channels and induces a marked, persistent activation of nicotinic-acetylcholine receptors (stimulates release of acetylcholine)
- shown to inhibit cholinesterases (spastic paralysis of parasite)
name the GI focused anti-protozoal agents
- paromomycin
- metronidazole
- tinidazole
name the drug
MOA: unknown but works similar to aminoglycosides (30-S)
paromomycin
name the drugs
MOA: nitro-radicals disrupt DNA
metronidazole and tinidazole
pro-drugs, activated by electron transfer –> creation of nitro-radicals
name the drug
selectively interferes with mitochondrial electron transport and ATP/pyrimidine biosynthesis
atovaquone
name the drug
selective inhibition DHFR-TS –> decreased DNA synthesis + depletion of B9
proguanil
full description: selectively inhibits bifunctional dihydrofolate reductase-thymidylate synthetase enzyme of plasmodia resulting in inhibition of DNA synthesis and depletion of folate cofactors
atovaquone-proguanil is used to treat…
plasmodium falciparum
