Term
| what are the systemic antifungal agents (9) |
|
Definition
amphotericin B
amphotericin B lipid complex
flucytosine 5-FC
ketoconazole
flyconazole
itraconazole
capofungin
vircanazole
posaconazole |
|
|
Term
| what are the superificial antifungal agents (7) |
|
Definition
frisofulvin
tervinafine
nystatin
ketocanazole
microanazole
clotrimazole
terconazole |
|
|
Term
| what fungal agents are clearly fungistatic (2) |
|
Definition
griseofulvin
ketoconazole depending on dose |
|
|
Term
| what fungal agents are celarly fungicdic (1) |
|
Definition
| ketoconazole depending on dose |
|
|
Term
| 4 ways to get a fungal infection and some examples for each |
|
Definition
1. loss of mechanical barrier: burn, surgery, catheter
2. organ transplant and anti-rejection therapy
3. Immunodeficiency: AIDs, diabetes
4. supression of competing organisms: antibiotics |
|
|
Term
|
Definition
binds to sterols (ergesterol) allows K followed by Mg out, deranges cell metabolism causing cell death
sometimes binds sterols in humans because isnt specific |
|
|
Term
|
Definition
binds to sterols (ergesterol) allows K followed by Mg out, deranges cell metabolism causing cell death
complexes two phospholipids so it can go into ergosterol fungal membranes without interfering with human cholesterol |
|
|
Term
|
Definition
needs amphotericin B synergy to allow it to penetrate wall
enters cell via cytosine-specific permease, converted to…
A. 5-FdUMP which inhibits thymudylate synthease lowering thymidylic acid (needed for DNA)
B. 5-FUMP which is put in fungal RNA disrupting protein synthesis |
|
|
Term
|
Definition
| interacts with P450 enzyme C14-a-demythylase and blocks demythelation of lanosterol to ergosterol disrupting membrane function and increasing permeability |
|
|
Term
|
Definition
| nteracts with P450 enzyme C14-a-demythylase and blocks demythelation of lanosterol to ergosterol disrupting membrane function and increasing permeability |
|
|
Term
|
Definition
| interacts with P450 enzyme C14-a-demythylase and blocks demythelation of lanosterol to ergosterol disrupting membrane function and increasing permeability |
|
|
Term
|
Definition
| inhibits formation of B(1,3)-D-glucans in fungal cell wal |
|
|
Term
| resistance to amphotericin B can happen by |
|
Definition
| fungi without or with decreased ergosterol |
|
|
Term
| resistance to ABLC can heppen by |
|
Definition
| fungi without or with decreased ergosterol |
|
|
Term
| resistance to flucotysine can happen by |
|
Definition
| develops fast when used as monotherapy (without amphotericin B) |
|
|
Term
| resistance to fluconazole can happen by |
|
Definition
| seen in HIV infected patients with more serious infections |
|
|
Term
| side effects of amphotericin B (7) |
|
Definition
fever, chills
renal failure
hypotension (shock)
thrombophlebitis
neuro when administered intrathecal
normocytic norochromic anemia deu to RBC production supression |
|
|
Term
| side effect for ABLC, why |
|
Definition
| less toxic than ampotericin B because it is more selective and does not bind human sterols as often |
|
|
Term
| side effects flucytosine (4) |
|
Definition
hematological toxicity: neutropenia, thrombocytopenia
hepatic dysfunction: elevation of serum transaminase and alkaline phosphatase |
|
|
Term
| side effects of ketoconazole (4) |
|
Definition
nausea, vomting
hepatic: rare but serious
endocrine: antiandrogen (stops C17-lyase which decreases testosterone causing impotence) |
|
|
Term
| side effects fluconazole (2) |
|
Definition
|
|
Term
| side effects of itraconazole (3) |
|
Definition
| hypokalemia, hypertension, edema |
|
|
Term
| side effects of capofungin (2) |
|
Definition
| histamine release, liver function issues sometimes |
|
|
Term
|
Definition
| occasional drug interactions |
|
|
Term
|
Definition
| occasional drug interactions |
|
|
Term
| amphotericin B: administration, administration instructions |
|
Definition
IV
intrathecal for meningitis |
|
|
Term
| ABLC: administration, administration instructions |
|
Definition
IV
intrathecal for meningitis |
|
|
Term
| flucytosine: administration, administration instructions |
|
Definition
|
|
Term
| ketoconazole: administration, administration instructions (4) |
|
Definition
oral
absorption impaired by food, antacids, cimetadine, rifampin
acid improves absorption (pop) |
|
|
Term
| fluconazole: administration, administration instructions |
|
Definition
|
|
Term
| itaconazole: administration, administration instructions |
|
Definition
oral- well absorbed
food increases bioavability |
|
|
Term
| capofungin: administration, administration instructions |
|
Definition
|
|
Term
| which systemic antifungals enter the CNS (4) |
|
Definition
amphotericin B and ABLC if administered intrathecal
flucytosine
fluconazole |
|
|
Term
| which systemic antifungals bind to plasma proteins (4) |
|
Definition
amphotericin B
ABLC
ketoconazole
fluconazole - minimal |
|
|
Term
| which systemic antifungals cross the plcaenta, which are teratogenic (3) |
|
Definition
amphotericin B
ABLC
fluconazole - teratogen |
|
|
Term
| what tissues does ketoconazole reach (4) |
|
Definition
| lung, bone, skin, soft tissue |
|
|
Term
| what tissues does itraconazole reach (4) |
|
Definition
| bone, sputum, adipose, most tissues |
|
|
Term
| which systemic antifungals are metabolized by the liver, how well or to what extent (3) |
|
Definition
fluconazole - poorly
ketoconazole - extensive
itraconazole - extensive |
|
|
Term
| which systemic antifungal are excreted by the kidney (2) |
|
Definition
|
|
Term
| what is the most broad spectrum azole of them all |
|
Definition
|
|
Term
| what is viraconazole used for (3) |
|
Definition
candidia
DOC
invasive aspergillosis |
|
|
Term
| what is capofungin used for (4) |
|
Definition
azole resistat isolates of C. albicans
aspergillus fumigantus
P. carinii
H. capsulatum |
|
|
Term
| what is itraconazole the drug of choice for (1), what else does it di (5) |
|
Definition
Broad
drug of choice: blastomycosis
AIDS associated histoplasmosis
aspergillosis, candidemia, coccidioidomycosis, cryptococcosis |
|
|
Term
| what is fluconazole the drug of choice for (4), what else does it do (2) |
|
Definition
Drug of choice: cryptococcus neoformans, candidemia, coccidiodomycosis
chronic ambulitory treatment, reduce fungal infection in marrow transplant |
|
|
Term
| what is ketoconazole good at killing (4), what combination should it be in and why, what combination shouldnt it be in and why |
|
Definition
same as amphotericin B but together antagonizes its activity, narrow
good at histoplasmosis andnonmeningeal coccidioidomycosis and blastomycosis
add to flucytosine for candida |
|
|
Term
| what does flucytosine kill (2) |
|
Definition
systemic mycosis and meningitis caused by…
cryptococcus neoformans
candidia |
|
|
Term
| what does amphotericin B and ABLC (6) |
|
Definition
broad
candidia albicans
histoplasma capsulatum
cryptococcus neoformans
coccidioides immitis
aspergillus
blastomyces dermatitidis |
|
|
Term
|
Definition
energy dependent enterance within microtubules
disrupts mitotic spindles
inhibits mitosis |
|
|
Term
|
Definition
| inhibits fungal enzyme squaline epoxidase causing accumulation of sterol swualine which is toxic |
|
|
Term
|
Definition
| polyene antibiotic resemboles amphotericin B in MOA |
|
|
Term
| MOA superificial ketonconazole |
|
Definition
| interacts with P450 enzyme C14-a-demythylase and blocks demythelation of lanosterol to ergosterol disrupting membrane function and increasing permeability |
|
|
Term
|
Definition
| interacts with P450 enzyme C14-a-demythylase and blocks demythelation of lanosterol to ergosterol disrupting membrane function and increasing permeability |
|
|
Term
|
Definition
| interacts with P450 enzyme C14-a-demythylase and blocks demythelation of lanosterol to ergosterol disrupting membrane function and increasing permeability |
|
|
Term
|
Definition
| interacts with P450 enzyme C14-a-demythylase and blocks demythelation of lanosterol to ergosterol disrupting membrane function and increasing permeability |
|
|
Term
| how do you get resisance or stop the drug griseofulvin from working |
|
Definition
| phenobarbital: epilepsy drug stops drug absorption |
|
|
Term
| what are the side effects of griseofulvin (4) |
|
Definition
induces P450 for many drugs
teratogenic
hepatotoxicity in patients with prophyria
disufram reaction |
|
|
Term
| what are the side effects of terbinafine |
|
Definition
|
|
Term
| how is terconazole aministered |
|
Definition
|
|
Term
| how is miconazole administered |
|
Definition
|
|
Term
| how is clotrimazole administered |
|
Definition
|
|
Term
| how is superificial ketoconazole administered |
|
Definition
|
|
Term
| how is nystatin administered, why |
|
Definition
topical and oral swish and swallow
not absorbed in the GI tract |
|
|
Term
| how is terbinafine administered |
|
Definition
|
|
Term
| how is griseofulvin administered, any instructions |
|
Definition
| oral - not absorbed well so take with fats |
|
|
Term
| what antifungal do you have to take for a long time, why |
|
Definition
griseofulvin
ust continue therapy until normal tissue replaces infected tissue
weeks to months |
|
|
Term
| where does griseofulvin distribute to (2) |
|
Definition
|
|
Term
| how is griseofulvin metabolized |
|
Definition
| metabolized in the liver via P450 |
|
|
Term
| what is nystatin used for |
|
Definition
|
|
Term
| what is superificial ketoconazole used for |
|
Definition
| tinea corporis, T. pedis, T. curis, T. versicolor, candidasis |
|
|
Term
| what is micronazole used for (5) |
|
Definition
| tinea corporis, T. pedis, T. curis, T. versicolor, candidasis |
|
|
Term
| what is clotrimazole used for (5) |
|
Definition
| tinea corporis, T. pedis, T. curis, T. versicolor, candidasis |
|
|
Term
| what is terconazole used for (5) |
|
Definition
| tinea corporis, T. pedis, T. curis, T. versicolor, candidasis |
|
|
Term
| what is terbinafine used for |
|
Definition
| same as grisofulvin but more effective |
|
|
Term
| what is griseofulvin used for (5) |
|
Definition
dermatophytes: trichophyton, microsporum, epidermophyton,
Tinea that didn’t respond to other treatment |
|
|
Term
| what anti-helminth drugs are used to treat nematodes (5) |
|
Definition
albendazole
pyrantel
thiabendazole
ivermectin
diethylbarbamazin |
|
|
Term
| what anti-helminth drugs are used to treat cestodes and termatodes |
|
Definition
|
|
Term
| cestode: aka, 4 features of its body, location in host, how to acquire (3) |
|
Definition
tapeworm
flat, segmented, attach to intestines, no mouth, no digestive tract
found in beef, pork, fish |
|
|
Term
| termatode: aka, shape, 4 places in host its found |
|
Definition
flukes
leaf shape
liver, lungs, intestine, blood |
|
|
Term
|
Definition
binds to microtubules, stops their synthesis
decreases glycose uptake
parasite is expelled in feces |
|
|
Term
|
Definition
| depolarizing neuromuscular blocking agent. Activates nicotinic receptors and paralizes worm which is then expelled |
|
|
Term
|
Definition
binds to microtubules, stops their synthesis
decreases glycose uptake
parasite is expelled in feces |
|
|
Term
|
Definition
| targets gamma-aminobutyric acid (GABA-A) letting Cl out hyperpolarizing the cells, causing worm paralysis and expulsion |
|
|
Term
|
Definition
| decrease muscle activity of parasites |
|
|
Term
|
Definition
permeability of cell membrane to Ca increases causing contracture and paralysis
inhibit mitochondrial anaerobic phosphorlyation (uncomple reaction from ADP to ATP) |
|
|
Term
| how can the effectiveness of thiabenzadiole be drecreased |
|
Definition
|
|
Term
|
Definition
dizzy
headache
abdominal cramps
vomiting
elevated liver enzymes
hepatic disease |
|
|
Term
| side effects thiabendazole (11) |
|
Definition
| behavorial changes, dizzy, fever, seizures, bradycardia, hypotension, hepatic disease, renal disease, jaundic, abormal smelling urine, Steven's Johnson syndrome |
|
|
Term
| side effects ivermectin (3) |
|
Definition
dizzy
diarrhea
leukopenia
Mazzotti reaction: rapid killing of microfilaria induces ocular inflammatory response |
|
|
Term
| side effects diethylcarbamazine (2) |
|
Definition
|
|
Term
| side effects praziquantel (5) |
|
Definition
nausea
vomiting
fever
rash
alcohol within 24h increases CNS issues |
|
|
Term
| how can the plasma level of praziquantel be |
|
Definition
| cimetidine is a P450 inhibitor for it |
|
|
Term
| what is the dosing redigimes for albendazole (2) |
|
Definition
1 tablet, repeat 3 weeks later for pinworms (treat everyone in home)
1 tablet twice a day for 3 days for other |
|
|
Term
| howis pyrantel administered, what administration instructions |
|
Definition
oral or suspension
if it is a pinworm infection treat everyone in the home |
|
|
Term
| how is thiabendazole administered |
|
Definition
| oral suspension or tablet |
|
|
Term
| how is ivermectin administered |
|
Definition
|
|
Term
| what interactions are there with ivermectin, why |
|
Definition
| benzodiasapines and barbitols act like the drug and may cayse OD |
|
|
Term
| how is praziquantel administered, administration instructions, why |
|
Definition
oral
take laxative before med to purge of death segments and allow for good ova liberation and avoid cysticerosis |
|
|
Term
| which antihelminth pass into the placenta, which a teratogenic (4) |
|
Definition
praziquantel - teratogenic
ivermectin - teratogenic
thiabendazole - teratogenic
pyrantel - teratogenic maybe |
|
|
Term
| which antihelminth passes into the CNS |
|
Definition
|
|
Term
| which antihelminths are metabolized in the liver (3) |
|
Definition
praziquantel
ivermectin
albendazole |
|
|
Term
| which antihelminths are excreted in the liver (2) |
|
Definition
albendazole
iveromectin (then feces) |
|
|
Term
| which antihelminths are excreted in the kidney (2) |
|
Definition
thiabendazole
praziquantel |
|
|
Term
| what is praziquantel drug of choice for, what else is it used for (3) |
|
Definition
all cestode infections, cysticerosis + termatodes
drug of choice for most tapeworm infections |
|
|
Term
| what is diethylcarbamazine used for (1) |
|
Definition
| Filariasis caused by Wuchereria bancrofti |
|
|
Term
| what is ivermectin used for (2) |
|
Definition
River Blindness: onchocerca volvus (where the worm was in the eye)
Scabes |
|
|
Term
| what is thiabendazole used for (3) |
|
Definition
Thread worm: strongyloides stercoralis
cutaneous larval margins
trichinella spiralis (trichinosis) |
|
|
Term
| what is pyrantel used for (3), when do you use it |
|
Definition
round worms
pin worms
hookworms
not as good as albendazole |
|
|
Term
| what is albendazole used for (5) |
|
Definition
Broad spectrum
Whip worm: trichuris trchiura
Pinworm: enterobius vermicularis
hookworm: necator americanus
round worm: ascariasis lumbricoides |
|
|
