Antiparasitic +fungal

Card Set Information

Author:
bshin
ID:
76293
Filename:
Antiparasitic +fungal
Updated:
2011-06-09 01:12:36
Tags:
antiparasitic fungal
Folders:

Description:
antiparasitic+ fungal
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user bshin on FreezingBlue Flashcards. What would you like to do?


  1. Suramin
    • Anti-protozoan
    • inhibits enzymes involved in energy metabolism

    • USE- blood-borne African Sleeping Sickness (Trypanosoma brucei)
    • - NO CNS involvement
  2. Melarsoprol
    • Ant-protozoan
    • - Inhibits sulfhydryl groups in parasite enzymes

    USE- CNS-involved African Sleeping Sickness ( Trypanosoma brucei)
  3. Nifurtimox
    • Anti-protozoan
    • -Forms intracellular free radicals, toxic to parasites

    USE- Chaga's disease (Trypanosoma cruzi)
  4. Sodium stibogluconate
    • Anti-protozoan
    • -Inhibits glycolysis at PFK reaction

    USE-Leishmaniasis (cutaneous, mucosal, visceral)
  5. Chloroquine
    • Anti-malarial (anti-protozoan)
    • -MECH- Block plasmodium heme polymerase-> accum toxic Hb breakdown products that kill it.
    • block TNF-a
    • -USE- Malaria- BLOOD schizonticide. (PO)
    • good for P. malaria. But P. vivax, and P.ovale will replapse b/c liver hypnozoite.
    • -most P.falciparam are resistant!
    • -SE- hemolysis in severe G6PD deficiency
    • vertigo, pruritis, urticaria, toxic psychosis, ocular toxicity (at high doses)
    • BUT STILL SAFE IN PREGNANCY AT LOW DOSE
  6. Mefloquine
    • Anti-malarial (anti-protozoan)
    • unknowm mech
    • USE- multdrug-resistant Plasmodium falciparum
  7. Quinine (Quinine sulfate, Quinine gluconate)
    • Anti-malarial, Anti-protozoan
    • -USE- emergency RX for SEVERE or Drug-resistant P. falciparum (use in combo with pyrimethamine/sulfonamide)
    • - treat Babesiosis (Babesia) (Quinidine + clindamycin)

    • Quinine sulfate- oral
    • Quinine gluconate- IV

    SE- cardiotoxicity!!
  8. Primaquine
    • Anti-malarial (anti-protozoan)
    • -USE-(PO) tissue schizonticide for P. vivax, P.ovale. to prevent replase from dormant liver hypnozoite.
    • -Kill gametocide.
    • -Use in combo with blood schizonticide (chloroquine).

    • MECH- inhibit heme polym.
    • SE- GI upset, pruritis, headaches
    • G6PD-deficiency patients can get hemolysis, methemoglobinemia.
    • DO NOT GIVE IV! GET HYPOTENSION!
    • DO NOT GIVE TO PREGNANT WOMEN OR G6PD PATIENTS!!!
  9. Artemisinin (qinghaosu)
    • chinese wormwood, Artemisia annua- ancient herbal remedy for malaria!
    • MECH- bind malarial pigment--> free radicals
    • great potency
  10. Praziquantel
    • Antihelminthic
    • USE-Kill tapeworms (cestodes), flukes (trematodes)
    • increase membrane permeability of calcium->contraciton, paralysis of tapeworms and flukes
  11. Pyrimethamine
    • Antiprotozoan
    • -inhibit dihydrofolate reductase in parasite--> inhibit THF syn.

    • USE-chloroquine-resistant P. falciparum malaria
    • - Toxoplasmosis !
    • Fansidar=Pyrimethamine+ sulfadizine (cheap, so used in 3rd worlds)

    (resistance by mutation in DHFR enzyme)
  12. Metronidazole
    Antibacterial +Antiprotozoal.

    -MECH- free radical toxic metabolites

    • -USE- anaerobes BELOW diaphram!
    • Giardia, Entamoeba, Trichomonas, Gardnerella baginalis, Anaerobes (Bacteroides, Clostridium)
    • -NOT actinomycetes!

    -SE- metallic taste, Antabuse rxn, peripheral neuropathy, inhibit warfarin breakdown (increase PT)
  13. Inhibitors of folate metabolism
    • Pyrimethamine
    • Fansidar
    • Sulfonamides
    • Proguanil
  14. Malarone
    • Antimicrobial, Antiprotozoal
    • Atovaquone + Proguanil

    • USE- acute, uncomplicated P. falciparum malaria.
    • -combo is synergistic! (Atovaquone cause rapid resistance)

    • MECH- Atovaquone- inhibit ETC of Plasmodium (Cyt bc1). Proganil- inhibit DHFR (via metabolite cycloguanil)
    • -resistance to Atovaquone via mutation in cyt-b
  15. Atovaquone
    Antimicrobial

    USE- alone-Pneumocystis carinii pneumonia (PCP)
  16. anti helminth
    • most intestine nematodes
    • -Mebendazole (decr glu uptake)
    • -Pyrantel pamoate (NM agonist-->spastic paralysis)

    • Most tapeworms (cestodes) and flukes (trematodes)
    • -Praziquantel (incr Ca influx, vacuolization)
  17. Ivermectin
    • Antihelminthic
    • -broad spectrum antiparasitic, kills nematodes and arthropod parasites.

    USE-kill Stronglyloides stercoralis, kill Onchocerca volvulus (river blindness)

    • MECH- macrocyclic lactones made by Streptomyces avermitillis.
    • - GABA-agonist--> paralyze the parasite. Safe for humans b/c GABA in CNS only, and this doesn't cross BBB
  18. Mebendazole
    • Antihelminth
    • - inhibit glucose uptake, microtubule synthesis

    • USE- kill nematodes!
    • also tapeworm Echinococcus granulosus

  19. Pyrantel pamoate
    • Antihelminth
    • - Nm agonist at NMJ--> depol blockade--> paralysis.
    • -No effect on tapeworms or flukes!

    • USE- kill tapeworms!
    • Ascaris lumbicoides, Ancyostoma duodenale, Necator americanus (as alternative to bendazoles)
  20. Diethylcarbamazine
    Antihelminth

    • USE- kills tissue nematodes!
    • Loa loa, Wuchereria bancrofti , Toxocara canis
  21. Amphotericin B
    Antifungal

    • USE-Serious, systemic mycosis! Cryptococcus, Blatomyces, Coccidioides, Aspergillus, Histoplasma, Candida, Mucor.
    • -Fungal meningitis (intrathecal)

    MECH- bind ergosterol (unique to fungi)--> holes in mem.

    • UNIQUE- Synergistic with Flucytosine.
    • No resistance! only IV, intrathecal!, NOT cleared by dialysis.
    • -Antagonistic with -azole antifungals.
    • -binds heavily to plasma proteincs
    • - does NOT cross BBB

    • SE- Nephrotoxicity (80%!), fever/chills, tachypnea, nausea/vomit, hypotension, arrhythmias, anemia, IV-phlebitis, hypokalemia, hypomagnesemia, weight loss.
    • -Newer forms (lisosomal amphotericin) less toxic, but expensive!
  22. Nystatin
    Antifungal

    USE- topical! - oral candidiasis (thrush), diaper rash, vaginal candidiasis.

    • MECH- same as Amphotericin B
    • -bind ergosterol--> poke holes in mem.

    SE- same as Amphotericin B (nephrotoxicity, anemia, fever/chills..) too toxic for systemic, so only topical!
  23. Flucytosine
    • Antifungal
    • -synthetic cytosine-analog

    USE- oral, systemic mycosis (Candida, Cryptococcus) in combo w/ Amphotericin B.

    MECH- inhibit thymidylate synthetase-->inhibit pyrimidine synthesis.

    • UNIQUE- do NOT use alone! rapid resistance!
    • - good distribution everywhere
    • -cleared unchanged by urine, dyalisis

    • SE- bone marrow suppression, nausea/vomit, diarrhea,
    • MUST ADJUST DOSE FOR RENAL PATIENTS, DON'T USE ABOVE 120ug/ml!!
  24. Caspofungin
    Antifungal

    USE- Invasive aspergillosis, Candida

    MECH-inhibit beta-glucan syn--> inhibit cell wall synthesis

    SE- GI upset, flushing
  25. Terbinafine
    Antifungal

    USE- dermatophytoses (esp. onychomycosis- fungus in finger, toenails.)

    MECH- inhibit enzyme squalene epoxidase
  26. Griseofulvin
    Antifungal

    • USE- oral, superficial fungal infections.
    • - dermatophytes (tinea, ringworm)

    • MECH- inhibit microtubule fxn--> inhibit mitosis
    • - deposit in keratin-containing tissues (nails)

    SE- teratogenic, carcinogenic, confusion, headache, induce Cyps! (increase Warfarin breakdown).
  27. Fluconazole
    • Antifungal
    • "-azole"

    USE- Candida (all types), Cryptococcal meningitis (can cross BBB), Coccidiodal meningitis.

    MECH- inhibit P450-->inhibit syn of ergosterol from lanosterol.

    • UNIQUE- well absorbed, cross BBB, excreted unchanged in urine.
    • -adjust dose for renal failure patients!

    SE- inhibit hormone synthesis (gynecomastia), hepatotoxicity (inhibit Cyps), fever, chills
  28. Itraconazole
    • Antifungal
    • "-azole"

    • USE- systemic mycoses in immunocompromised pts.
    • -Blasomycosis, Histoplasmosis, Aspergillosis, Onychomycosis (nail fungus).

    MECH- inhibit P450-->inhibit syn of ergosterol from lanosterol.

    • UNIQUE- IV, oral
    • -need acid to be absorbed, so take with food.
    • -metabolized exclusively by liver!
    • -don't need to adjust dose for renal fxn.

    SE- inhibit hormone synthesis (gynecomastia), hepatotoxicity (inhibit Cyps), fever, chills
  29. Voriconazole
    • Antifungal
    • "-azole"

    USE- severe Aspergillus infections, Fluconazole-resistant Candidal infections.

    MECH- inhibit P450-->inhibit syn of ergosterol from lanosterol.

    UNIQUE- well absorbed, but low CSF levels.dose adjust for both renal and liver failure!!

    SE- inhibit hormone synthesis (gynecomastia), hepatotoxicity (inhibit Cyps), fever, chills

    -antagonistic with Amphotericin B (b/c decrease syn of its sterol target)
  30. Posaconazole
    • Antifungal
    • "-azole"

    USE-prophylaxis for Aspergillosis and Candida for immunocompromised.

    UNIQUE- broad spectrum

    MECH- inhibit P450-->inhibit syn of ergosterol from lanosterol.

    SE- inhibit hormone synthesis (gynecomastia), hepatotoxicity (inhibit Cyps), fever, chills

    -antagonistic with Amphotericin B (b/c decrease syn of its sterol target)
  31. Ketoconazole
    Antifungal"-azole"

    • USE- Blastomyces, Coccidiodes, Histoplasma, Candida albicans.
    • - also used for hypercortisolism!

    UNIQUE- older, more toxic than others.

    MECH- inhibit P450-->inhibit syn of ergosterol from lanosterol.

    SE-adrenal suppression, inhibit hormone synthesis (gynecomastia), hypocholesterolemia, hypothyrodism, hepatotoxicity (inhibit Cyps), fever, chills

    -antagonistic with Amphotericin B
    (b/c decrease syn of its sterol target)

What would you like to do?

Home > Flashcards > Print Preview