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GI/GU II Exam 1 > Tx for Select GI Infections > Flashcards

Tx for Select GI Infections Flashcards

1
Q

What is the agent of choice for

Tapeworm- ADULT forms: Diphyllobothrium latum & Taenia Spp (including T. solium, EXCEPT cystercosis specific)

A

Praziquantel

(boards: D. latum - Vit B12 deficiency- megoblastic anemia

T. solium: intestinal tapeworm)

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2
Q

What is the MOA of Ivermectin

what is used for?

A

Binds selectively (high affinity) to Glu-gated Cl- ion channels

induce hyperpolarization resulting in tonic paralysis of the worms’ Ns/Ms –> immobilization & death

(use = strongyloides stercoralis)

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3
Q

What is the agent of choice for

Roundworm: Ascaris lumbricoides

A

Albendazole (Mebendazole)

(boards: obstruction of ileocecal valve, biliary obstruction, intestinal perforation, migrated from nose/mouth)

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4
Q

What is the MOA for Nitazoxanide

what is it used for?

A

interfere w/ pyruvate: ferredoxin oxidoreducatase (PFOR) enzyme-dependent e- transfer reaction (essential for anaerobic energy metabolism)

(cryptosporidium parvum, giardia labmlia, entamoeba histolytica)

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5
Q

how often should you monitor levels of VAN after prescribing for C. diff

A

YOU DONT HAVE TO! :) *pimp question*

VAN usually given by IV for MRSA and have to monitor to prevent ear & kidney toxicity

BUT orally (given in C. diff) does not get abs-ed in a similar fashion

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6
Q

What is the agent of choice for

Tapeworm - LARVAL form: T. solium cysticercosis specific

A

Albendazole

(boards: cystic CNS lesions, seizures)

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7
Q

What is the MOA of Pyrantel Pamoate

what is it used for?

A

depol NM blocker – opens non-selective cation channels and induce persistent activation of nAch receptors –> increase release of Ach

inhibit cholinesterase –> spastic paralysis of parasite

(enterobius vermicularis, ascaris lumbricoides, ancylostoma spp, trichinella spiralis, adult form)

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8
Q

What is the MOA and use of Paromomycin

A

works similar to other aminoglycosides on 30S subunit

(entamoeba histolytica, diphyllobothrium latum, echinococcus granulosus, taenia spp, schistosoma spp)

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9
Q

What is the agent of choice for

Shigella spp

A

Cipro

Azithromycin

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10
Q

If a pt was recently treated for C. diff with metronidazole, now presents again with C. diff. What medication will you treat them with?

A

VAN

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11
Q

What is the agent of choice for Entamoeba histolytica

A

Metronidazole followed by paromomycin

(boards: Sxs = bloody diarrhea, liver abscess (anchovy paste exudate), RUQ pain, histology of colon Bx = flask shaped uclers)

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12
Q

what are the classification of drugs:

Vancomycin

Ciprofloxacin

Fidaxomicin & Azithromycin

A

Vancomycin: glycopeptide

Ciprofloxacin: Fluoroquinolone

Fidaxomicin & Azithromycin: Macrolide

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13
Q

What is the recommended treatment for C. Diff

A

Vancomyosin Oral ONLY!

previously metronidazole was used alot but less now bc of resistance

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14
Q

What is the agent of choice for

Giardia Spp

A

Metronidazole (Tinidazole)

(boards: bloating, flatulence, foul smelling fatty diarrhea (hikers/campers))

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15
Q

What is the MOA for Benzimidazole

A

inhibit microtubule polymerization via beta-tubulin binding –> reduced glucose transport

inhibit mitochondrial fumarate reductase –> immbolization & death

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16
Q

What is the agent of choice for

Pinworm: Enterobius vermicularis

A

Mebendazole (Albendazole)

(boards: anal itchy - seeing egg via tape test)

17
Q

What is the agent of choice for

Tapeworm: LARVAL form: Echinococcus granulosus

A

Albendazole PLUS Praziquantel

(boards: hydatid cysts - eggshell calcification in liver; cyst rupture can cause anaphylaxis)

18
Q

What is the recommended treatment for C.diff is the pt presents w/ hypotension/shock, ileus, megacolon

A

VAN & metronidazole

19
Q

What is the MOA and use of atovaquone-proguanil

A

Atovaquone: selectively interfere w/ mitochondrial e- transport & ATP/pyr biosynthesis

Proguanil: selectively (-) bifxnal dihydrofolate reductase-thymidylate synthetase enzyme of plasmodia –> (-) DNA synthesis & cause depletion of folate cofactors

(plasmodium falciparum)

20
Q

What is the agent of choice for

Cryptosporidium spp

A

Nitazoxanide

(boards: severe diarrhea in AIDS, mild dz-watery diarrhea in immunocompetent hosts)

21
Q

What is the agent of choice for

Hookworms: Ancylostoma spp. & Necator americanus

A

Albendazole (Mebendazole)

(boards presentation: microcytic anemia; cutaneous larva migrans = itchy, serpiginous rash from walking barefoot on beach)

22
Q

What is the MOA for Praziquantel?

what is it used for?

A

increased cell membrane permeability –> loss of intracell Ca2+ –> massive contractions ending in paralysis of Ms

disintegration of schistosome tegument followed by attachment of phagocytes leading to death

(schistosoma spp, echinococcus granulosus, taenia spp, diphyllobothrium latum)

23
Q

What is the agent of choice for

Schistosomiasis spp.

A

Praziquantel (+ steroids for neurological dz)

(boards: HSM, fibrosis, inflamm, portal HTN; chronic infection –> bladder SCC, painless hematuria and pul HTN)

24
Q

What are the drugs under the miscellaneous category for helminths

A

ivermectin

nitazoxanide

praziquantel

pyrantel pamoate

25
Q

What is the agent of choice for

Campylobacter jejuni

A

Cirpo

Azithromycin (esp if allergic to cipro)

(boards: bloody diarrhea (esp kids), consumption of undercooked contaminated poultry/meat, unpastuerized milk)

26
Q

What is the agent of choice for

Salmonella Spp

A

Cipro

Azithromycin

27
Q

If a patient was previously treated for C. diff and they have a reoccurance of C. diff. What do you prescribe?

A

Fidaxomicin (FDX)

28
Q

What is the agent of choice for

Threadworm: Strongyloides stercoralis

A

Ivermectin

(boards: GI, pul, skin symptoms; hyperinfection syndrome caused by autoinfection)

29
Q

What medications are used as GI focused anti-protozoals

A

Paromomycin (aminocylgoside)

Metronidazole & Tinidazole

30
Q

What is the agent of choice for

Trichinella spp.

A

Albendazole (Mebendazole) (+ steroids for severe dz)

(boards: encyst in striated muscle, myositis; trichinosis- fever, vomiting, nausea, periorbital edema, myalgia)

31
Q

What is the agent of choice for

Whipworm: Trichuris trichiura

A

Mebendazole (Albendazole)

(boards: often asymp, loose stools, anemia, rectal prolapse in kids)

32
Q

What are the MC drug used for helminths?

A

Benzimidazoles

Albendazole

Mebendazole

Thiabendazole (skin only)

33
Q

What is the agent of choice for

Cyclospora cayetanensis

A

TMP-SMZ (bactrim)

Cipro -for sulfa allergic pts

34
Q

What is the MOA and uses of Metronidazole & Tinidazole

A

= prodrugs activated by e- transfer process creating nitro-radicals which disrupts DNA –> kill the organism

(entamoeba histolytica, giardia lamblia, c. diff)

GI/GU II Exam 1 (16 decks)

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