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Pharm Exam 8
Amphotericin B
Indications
Systemic Mycosis
Fungal Meningitis
Last Resort for Protozoan infections
Mechanism
Polyene
Binds Ergosterol
Forms Membrane Pores
1 min
Amphotericin B Side Effects & Toxicity
Side Effects
Fever/Chills "Shake and Bake"
Nephrotoxicity
Milder with Liposomes
Hypotension
Anemia
IV Phlebitis
Arrhythmias
1 min
Cryptococcus neoformans
Characteristics
Monomorphic
Encapsulated
Polysaccharide Capsule
Narrow-Based Buds
Latex Agglutination
Pigeons
India Ink
Mucicarmine stain
Signs and Symptoms
AIDS/Immunocompromised
Meningitis
Soap Bubble Lesions in Brain
Pneumonia
Treatment
Fluconazole
Flucytosine
Amphotericin
3 mins
Flucytosine
Indications
Cryptococcus
Candida
Used in Combination with Amphotericin B or Azoles
Mechanism
Inhibits DNA and RNA Synthesis
Converted to 5-FU by Cytosine Deaminase
Side Effects
Bone Marrow Suppression
1 min
Echinocandins
"-Fungin" Suffix
Indications
Invasive Aspergillosis
Candida
Mechanism
Inhibits Cell Wall Synthesis
Inhibits Synthesis of Beta-glucan
Side Effects
GI Distress
Flushing
1 min
Azoles (Ketoconazole)
"-azole" suffix
Indications
Local and Less Serious Systemic Mycosis
Mechanism
Inhibits Ergosterol Synthesis
Inhibits P450
Side Effects
Liver Dysfunction
Inhibition of Testosterone Synthesis
1 min
Griseofulvin
Mechanism
Disrupts Microtubules in Mitosis
Indications
Antifungal for Superficial Infections
Tinea and Ringworm
Side Effects
Teratogen
P450 Inducer
Confusion
Headache
2 mins
Terbinafine
Indications
Dermatophytosis
Onychomycosis
Mechanism
Inhibits Squalene Epoxidase
Side Effects
Hepatotoxicity
GI Distress
Taste Disturbances
Headache
2 mins
Nystatin
Indications
Candidiasis
Vaginal
Oral
Cutaneous
Mechanism
Polyene
Binds Ergosterol
Forms Membrane Pores
Topical form of Amphotericin B
Side Effects
Rash
1 min
Plasmodium General
Characteristics
Protozoa
Malaria
Anopheles Mosquito
Signs and Symptoms
Cyclic Fever
Headache
Anemia
Splenomegaly
Diagnosis
Blood Smear
Treatment
Chloroquine
Mefloquine for Resistant Types
3 mins
Plasmodium Specific
Malariae
Fever Every Three Days
Vivax/Ovale
Fever Every Two Days
Duffy Antigen Binding Site
Duffy often absent in Black Population
Primaquine treats dormant form in liver
Falciparum
Most severe
Irregular Cycles
Occludes capillaries in the brain, kidneys, and lungs
4 mins
Class IA Antiarrhythmics (Na+ Channel Blockers)
Indications
Arrhythmias
Mechanism of Action
Increase AP, ERP, and QT interval.
Drugs
Disopyramide
Procainamide
Drug-induced Lupus
Quinidine
Cinchonism
Shared Side Effects
Thrombocytopenia
Torsades de Pointes
1 min
Tetracycline Mechanism
Binds to 30 S to Prevent Attachment of Aminoacyl tRNA
Limited CNS Penetration
Divalent Cations Inhibit Absorption
Must Not Take with Milk, Antacids, Iron
1 min
Tetracycline Drug Names and Indications
Drug Names
Demeclocycline
Minocycline
Doxycycline
Fecally Eliminated
Can be Used in Renal Failure
Indications
Antidiuretic Hormone Antagonist
Chlamydia
Rickettsia
Borrelia burgdorferi
Helicobacter Pylori
Mycoplasma Pneumonia
3 mins
Tetracycline Toxicities
Inhibition of Bone Growth in Children
Teratogen
Discoloration of Teeth
Photosensitivity
GI Distress
2 mins
Sulfonamides Mechanisms
Bacteriostatic
Gram-Positive
Gram-Negative
Nocardia
Chlamydia
PABA antimetabolites
Inhibit dihydropteroate synthase
Sulfamethoxazole
Sulfisoxazole
Sulfadiazine
1 min
Sulfonamides Side Effects
Side Effects
Hypersensitivity
Nephrotoxicity
Photosensitivity
Kernicterus in Infants
Displaces Warfarin from Albumin
Considerations
Hemolysis with G6PD Deficiency
3 mins
Entamoeba histolytica
Pathophysiology
Protozoa
Amebiasis
Ingestion of Cysts in Food and Water
Signs and Symptoms
Bloody Diarrhea
Flask-Shaped Ulcer
Liver Abscess
Anchovy Paste
RUQ Pain
Diagnosis
RBCs in Cytoplasm of Trophozoite
Cyst With Four Nuclei
Treatment
Metronidazole
Iodoquinol
3 mins
Giardia lamblia
Characteristics
Protozoa
Ingestion of Cysts
Seen in Campers
Daycare Centers
Mental Hospitals
Infects Small Intestine
Signs and Symptoms
Bloating
Flatulence
Fatty Diarrhea
Diagnosis
Crescent-shaped Protozoa Adjacent to Epithelial Brush Border
Predisposed if Low IgA
Treatment
Metronidazole
3 mins
Trichomonas vaginalis
Characteristics
Protozoa
Signs and Symptoms
Vaginitis
Pruritus
Foul-smelling Greenish Frothy Discharge
Strawberry Cervix
Diagnosis
Corkscrew Motility on Wet Prep
Treatment
Metronidazole
2 mins
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