Week 3 Pearls Deck 2

Question 1

Systemic Azoles and Other Antifungals

Clinical use and dosing

Answer 1

Oral antifungals used to treat superficial infections caused by yeasts (Candida, pityriasis versicolor) and dermatophytes (tinea infections) and invasive systemic mycoses

Question 2

Fuconazole required a

Answer 2

loading dose

Question 3

Rational drug selection for systemic Azoles and other Antifungals: Fluconazole

Answer 3

Fluconazole: has the fewest drug interactions but there is growing resistance

Question 4

System Azoles and other antifungals monitoring: Ketoconazole

Answer 4

Ketoconazole: aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and bilirubin before starting and every 3 to 4 months

Question 5

Systemic Azoles and Other Antifungals

Patient education

Answer 5

Patient education
Instruct to take with food.
Discourage alcohol use. ****
Educate regarding signs of liver toxicity.

Question 6

Systemic Azoles and Other Antifungals take homes

Answer 6

hard on the liver

if treating longer than 10 days. make sure their liver can handel it and test liver before and during. Every three to four months at a minimum

Question 7

Anthelmintics (worms) Intestinal nematodes are treated with

Answer 7

mebendazole, pyrantel, and thiabendazole.

Question 8

Tissue nematodes are treated with

Answer 8

mebendazole, thiabendazole, albendazole, or ivermectin.

Question 9

In the US this is common

Answer 9

pinworms/roundworms/hookworms (intestinal nematomdes). 50 million cases treated per year

Question 10

Anthelminteics ADR

Answer 10

Nausea, vomiting, diarrhea, transient abdominal pain
Mebendazole: may cause transient neutropenia
Ivermectin: may cause Mazzotti reaction

Question 11

Anthelmintics rational drug slection

Answer 11

CDC recomendations

Question 12

Anthelmintics monitoring

Answer 12

Monitoring
Assess for the eradication of the helminth.
Roundworms, hookworms, ascariasis, trichuriasis, and whipworms: stool samples are obtained before and 1 to 3 weeks after treatment for proof of cure.

Question 13

Metronidazole treats (should know this for the test)

Answer 13

both parasitical and bacterial infections.**
Active against Trichomonas vaginalis, Entamoeba histolytica, Helicobacter pylori, Clostridium difficile

STDs and H.pylori

Question 14

Nitazoxanide is used to treat

Answer 14

is used to treat Giardia lamblia and Cryptosporidium infections.

Question 15

Tinidazole is active against

Answer 15

is active against amebiasis, giardiasis, and trichomoniasis.

Question 16

Metronidazole is well

Answer 16

absorbed when taken orally

Question 17

ADRs

Mitronidazole

Answer 17

anorexia, nausea, abdominal pain, dizziness, headache, metallic taste

Question 18

Clinical use and dosing

Metronidazole and tinidazole

Answer 18

are used against the protozoal infections by T. vaginalis, G. lamblia, and E. histolytica.

Metronidazole is used for anaerobic bacterial infections and bacterial vaginosis and is one of the drugs in H. pylori treatment.

Question 19

Rational drug selection

Metronidazole

Answer 19

Metronidazole is on $4 retail lists.

Avoid metronidazole in first trimester of pregnancy.

Question 20

Metronidazole, Nitazoxanide, and Tinidazole

Monitoring

Answer 20

Resolution of symptoms

Signs of leukopenia

Question 21

Metronidazole, Nitazoxanide, and Tinidazole

Answer 21

Patient education
Administration
Metallic taste with metronidazole
Avoiding alcohol if taking metronidazole or tinidazole because of disulfiram-like reaction
Concurrent treatment of partner if sexually transmitted infection is present

Question 22

Important for the test – do not take metronidazole with

Answer 22

ETOH. They will get very very sic. Disulfiram-like reaction