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FungiParasiteDrugs

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eesohbel's version from 2015-07-27 17:37

Fungi

Question Answer
inhibits cell wall synthesiscaspofungin
binds ergosterol in cell membranesamphotericin B and nystatin
inhibits synthesis of ergosterolazoles and terbinafine
amphotericin Bbinds ergosterol; forms membrane pores that allow leakage of electrolyes
clinical use of amphotericin Bserious, systemic mycoses
Toxicity of amphotericin Bfever, chills, hypotension, nephrotoxicity, hypokalemia, hypomagnesemia, arrhythmias, anemia, IV phlebitis
Why is amphotericin so terriblebesides binding ergosterol, also binds cholesterol to some degree causing toxicity to human tissues.
nystatinswish and swallow for oral candidiasis
MOA of nystatinsame as amphtericin B, binds ergosterol. topical use only
flucytosine moaconverted to 5FU by cytosine deaminase. Then inhibits DNA and RNA biosynthesis
clinical use of flucytosinesystemic fungal infections
toxicity of flucytosinebone marrow suppresion
azoles moainhibit fungal sterol (ergosterol) synthesis by inhibiting the cytochrome P-450 enzyme that converts lanosterol to ergosterol
Clinical use of azolessystemic mycoses
Clinical use of fluconazolechronic suppression of cryptococcal meningitis in AIDS and candidal infections of all types
Clinical use of itraconazoleBlasto, Cocci, Histo, Sporothrix
Toxicity of azolesinhibits cytochrome P450
Mechanism of action of terbinafineinhibits fungal enzyme squalene epoxidase which decreases ergosterol synthesis
MOA of echinocandinsinhibit cell wall synthesis by inhibiting synthesis of B-glucan leads to cell lysis and death
Clinical use of echinocandinsinvasive aspergillosis, Candida
What are echinocandinsandidulafungin, caspofungin, micafungin
MOA of griseofulvininterferes with microtubule functions; disrupts mitosis.
Tox of griseofulvininduces cytochrome P450 and warfarin
Electrolyte disturbances in amphotericin B therapyhypokalemia and hypomagnesia
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Parasites

Question Answer
treatment vivax/ovalechloroquine plus primaquine for liver hynozoites (if normal G6PD)
primaquine side effectcinchonism
chloroquine resistantmefloquine or atovaquone/proguanil
falciparumatovaqune/proquanil
giardiametro
toxosulfadiazine plus pyrimethamine
t. cruzinifurtimox
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Treatment Summary

Question Answer
Histoplasmafluconazole or ketoconazole for supf inf, amphotericin B for systemic inf
blastomycosisfluconazole or ketoconazole for supf inf, amphotericin B for systemic inf
coccidioidomycosisfluconazole or ketoconazole for supf inf, amphotericin B for systemic inf
paracoccidioidomycosisfluconazole or ketoconazole for supf inf, amphotericin B for systemic inf
Malassezia furfurtopical miconazole, selenium sulfide (Selsun)
Candidanystatin for supf inf, amphotericin B for systemic inf
PneumocystisTMP-SMX, pentamidine, dapsone
Sporothrixitraconazole or potassium iodide
Aspergillusvoriconazole for sup inf, angioinvasive amphotericin B
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nematodes

Question Answer
enterobius vermicularisbendazoles or pyrantel
ascarisbendazoles or pyrantel
strongyloidesivermectin or albendazole
necatorbendazoles or pyrantel
onchocercaivermectin
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cesotodes and trematodes

Question Answer
taenia soliumpraziquantel; bendazoles for neurocysticercosis
diphyllobothrium latumpraziquantel
echinococcusbendazoles
schistosomapraziquantel
clonorchispraziquantel
paragonimuspraziquantel
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