Term
| Metronizadole therapeutic uses |
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Definition
| used to treat trichomoniasis, giardiasis, amebiasis, and infections caused by the anaerobic bacteria (bactericidal) = Bacteroides fragilis and Clostridium dif |
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Term
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Definition
Good po abs
Metabolized by the liver and cleared by the kidneys |
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Term
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Definition
ETC contains ferredoxins which donate electrons to metronidazole to form a highly reactive nitro radical
the nitro radical attacks the protozoal DNA and destroys its helical structure to cause cell death
thus aerobic organisms do not produce the toxic metabolite from the prodrug metronidazole |
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Term
| Metronidazole Contraindicated drugs |
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Definition
increased bleeding with warfarin
ethanol can cause n/v, abdominal pain, flushing due to accumulation of acetaldehyde in the blood, disulfiram inhibits acetaldehyde dehydrogenase |
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Term
| Side Effects of Metronidazole |
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Definition
n/v/d, dizziness, headache, metallic taste, dry mouth xerstomia, abdominal pain
uncommon - leukopenia, uticaria, vag cand, periph neuropathy
Monitor CBC and LFT with prolonged treatment of recurrent trichomoniasis
Avoid use during 1st trimester of pregnancy |
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Term
| Trichomoniasis treatment and clinical presentation |
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Definition
DOC is metronidazole oral or topical
incubation 5-28 days , vaginal discharge greenish yellow and frothy
males are often symptomatic |
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Term
| Giardiasis Overview and Presentation |
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Definition
poor fecal oral hygeine and drinking untreated surface water
acute onset of diarrhea, cramping, bloating, flatulence
profuse watery and explosive stool initially then greasy and foul smelling later
NO blood pus or mucus in the stool |
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Term
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Definition
DOC is metro for both children and adults
Nitazoxanide
rapidly converted to active metab tizoxanide
interferes with pyruvate: ferrodoxin oxidoreductase dependent ETC reaction which is required for anaerobc energy metabolism
S/E's abdominal pain, diarrhea, headache and nausea |
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Term
| AMebiasis Overviw and presentation |
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Definition
most common in southwest
asymptomatic to fatal liver abscess
fecal oral, poor housing sanitation
Presents as:
1) non-invasive infection: abdominal pain, chronic liquid diarrhea
2) invasive (forms cysts): diarrhea, abdom pain, blood in stool, fever and enlarged liver |
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Term
| Amebiasis (Ent Hist) Treatment |
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Definition
Metro is DOC for mixed amebicide, kills both luminal and systemic organisms
metro treatment may be followed with a luminal amebicide such as paromomycin |
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Term
| Cryptosporidiosis clinical pres and treatment |
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Definition
oocysts spread via driect contact of contaminated water
Chlorination of water does NOT kill oocyts
Day care, male homosex, vets,
Milwakee dairy farm story
TREATMENT
Nitazoxanide
AIDS DOC: combined therapy with paromomycin and zithromycin is DOC |
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Term
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Definition
Trypanosoma cruzi, spread by kissing bug triatomid, central south america
Nifurtimox is available from CDC |
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Term
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Definition
cyclic fever with RBC lysis, CNS dysfunction
acute renal failure, black urine, pulmonary edema
P. falciparum is most fatal b/c this parasite occludes capillaries in the lungs, kidneys and brain |
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Term
| P. faciparum and P. malariae life cycle |
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Definition
one cell cycle occurs in the liver, so the lover is free of infection after 4 weeks, this is why prophylactic therapy must be continued for several weeks
Treatment of RBC stage only, cures the infection |
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Term
| P. ovale and P. vivax life cycle |
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Definition
| hepatic infection is persistent, in order to cure the infection, you have to kill both the RBC stage and the hepatic stage |
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Term
| Malaria treatment main two |
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Definition
chloroquine kills eryth stage so good for P. falcip and P. mal.
primaquine kills hepatic, so good for all, but don't give to preg women and may cause hemolytic anemia |
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Term
| Used to treat MDR malaria |
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Definition
| Doxycycline and clindamycin, active against the erythrocyctic forms |
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Term
| used to treat severe infections caused by P. falciparum when the patient is NPO |
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Definition
quinidine, however it has cardiac toxicity
used in combination with pyrimethamine, tetracycline, or clinda mycin
also used in combination iwth doxy clinda or pyr-sulfa to treat chloroquine resistant P. falciparum |
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Term
| Used for prophylaxis of malaria and for the treatment of chloroquine Resistant P. falciparum |
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Definition
atovaquone-proguanil
atov blocks cytochrome mediated ET which in turn destroys mitoch membrane potential difference |
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Term
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Definition
rapidly clears parasites from the blood including gametocytes
produces a very high cure rate, even in MDR resistatn strains
has a low incidence of R |
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Term
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Definition
Chloroquine in Chl sensitive area - safe in children
For Chloroquine Res areas:
atovaq +proguanil best tol. and safe children
mefloquine - safe children
doxycycline
primaquine |
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Term
| Treatment of toxoplasma gondii (Toxoplasmosis) |
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Definition
combination of pyrimethamine-sulfadiazine is the DOC in immunocomp patients
Trimeth-sulfa is used for prophylaxis of toxoplasmosis in patients with AIDS |
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Term
| Treatment of PCP, Pneumocystis jiroveci, Pneumocystis carinii |
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Definition
DOC is trim-sulfa, but may cause side effects
Pentamidine is 2nd choice, but less efficacious and even more toxic |
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Term
| Drug that kills round and tape worms |
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Definition
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Term
| drug that kills round worms |
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Definition
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Term
| kills all worms in mixed infections |
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Definition
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Term
| albendazole and mebendazole MOA |
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Definition
inhibits synthesis of microtubules needed for glucose uptake, parasite is immobilized and clear from the GI tract, also larva cidal and ovicidal
targets the bendy parts |
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Term
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Definition
| ganglionic nicotinic cholinergic agonists = muscular tetany. Resulting neuromuscular paralysis allows peristaltic clearance from the GI tract |
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Term
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Definition
| a GABA agonist at the NM jxn; increased CL conductance hyperpolarizes muscles and prevents the excitation caused byt Ach -> flaccid muscle paralysis |
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Term
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Definition
| releases Gaba and incr Gaba binding, opens chl channels in NM jxn which gives flaccid muscle paralysis |
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Term
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Definition
| opens calcium channels to cause muscular tetany; also causes tegmental damage which activates the host immune system |
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Term
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Definition
| kills cestodes by inhibition of oxidative phosphorylation, not in US |
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Term
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Definition
| mebendazole, pyr pam, or albendazole |
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Term
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Definition
| albendazole, or piperazine, but pip has contraindications so use albendazole |
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Term
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Definition
albendazole, pyr pam, mebendazole
poor sewage or walking barefoot |
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Term
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Definition
| ivermectin, single dose given twice yearly kills the inf causing river blindness. Give to livestock 1x 30 days |
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Term
| Cestodes or tapeworm treatemetn |
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Definition
DOC is albendazole, with a laxative
infections are usually asymptomatic but children will have focal neural findings, increases intracranial pressues and seizures. Larval cysts can become calcified and seen with imaging
can also treat with Niclosamide, but it is not available in the US |
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Term
Trematode (fluke) treatment
Schistosomiasis |
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Definition
DOC is praziquantal
presents as dermatitis from worm penetration, anemia, fever, chills, abdominalpain, fatigue, diarrhea, sweating, enlarged liver/spleen/lymph nodes, hepatitis |
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Term
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Definition
broad spectrum: kills pinworms round worms,hookworms, threadworms, tapeworms, and flukes
DOC for mixed worm infections
very low bioavailabiltiy
S/E's abd pain, alopecia, increased LFT |
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Term
| Treatment of lice, pediculosis |
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Definition
DOC is permthrin 1% cream
Malathion is available for infestations caused by lice resistant to permethrin
a 1% lindane shampoo is also available, DDT derivative |
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Term
| Treatment of Scabies and clinical presentation |
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Definition
DOC is 5% permethrin
Caused by itch mite, intense itching which is more severe at night, classic burrows made by tunneling mites, screatching btwn fingers, buttocks, groin and scalp lead to 2ndary bacterial inf, skin scrapings under the microscope reveal the presence of mites |
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Term
| Treatment of lice and scabies |
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Definition
| 1% permethrin is pediculicidal and 5% permethrin is scabicidal |
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Term
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Definition
| especially useful int he treatment of scabies in immunocompormised patients, and patients with severely encrusted scabies or patients who have failed therapy with topical permethrin. Not FDA approved. |
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