| 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
 |  | 
        |  | 
        
        | Term 
 
        | why do antiprotozoal drugs cause more side effects, where are they usualy at? (4) |  | Definition 
 
        | Protozoa are eukaryotes and  have metabolic processes closer to humans so drugs have more toxic effects 
 Increased in cells with high metabolic activity like kidney, neurons, intestinal, and stem cells
 |  | 
        |  | 
        
        | Term 
 
        | what is the most common ameoba pathogen and the disease it causes |  | Definition 
 
        | E. histolitica amebiasis (amebic dysentery)
 |  | 
        |  | 
        
        | Term 
 
        | what are the three categories of amebocides, what distinguishes them |  | Definition 
 
        | mixed: effective in lumen and systemic, concentration too low for single drug treatment 
 luminal: act on parasite in lumen of bowel
 
 systemic: act on parasite in intestine wall and liver
 |  | 
        |  | 
        
        | Term 
 
        | what are the three antiameoba drugs and their category |  | Definition 
 
        | mixed: metronidazole luminal: diloxanide furolate
 systemic: chloroquine
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | female anopheles mosquito |  | 
        |  | 
        
        | Term 
 
        | what are the 4 types of malaria, what is the their severity and prevelence |  | Definition 
 
        | plasmodium falciparum: severe, common P. vivax: mild, common
 P. malariae: mild very common
 P. ovale: mild, rare
 |  | 
        |  | 
        
        | Term 
 
        | what categories of drugs are used to treat malaria (2) |  | Definition 
 
        | tissue schizoniticides blood schizoniticides
 |  | 
        |  | 
        
        | Term 
 
        | what are the tissue schizoniticides |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | what are the blood schizoniticides (3) |  | Definition 
 
        | chloroquine quinine
 mefloquine
 |  | 
        |  | 
        
        | Term 
 
        | what two diseases do trypanosomiasis cause |  | Definition 
 
        | african sleeping sickness american sleeping sickness (Chagas')
 |  | 
        |  | 
        
        | Term 
 
        | what microbes cause african sleeping sickness (2) |  | Definition 
 
        | T. bruceo gambiense T. bruci rhodinese
 |  | 
        |  | 
        
        | Term 
 
        | what microbe causes american sleeping sickness |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | what is the treatment for trypanosomiasis (3) |  | Definition 
 
        | melarsoprol pentamidine
 isethionate
 nifurtimox
 |  | 
        |  | 
        
        | Term 
 
        | how is leshmianisis transmitted |  | Definition 
 
        | animal to human by bite of sand flies |  | 
        |  | 
        
        | Term 
 
        | what are the three types of leshimaniasis |  | Definition 
 
        | cutaneous mucocutaneous
 visceral
 |  | 
        |  | 
        
        | Term 
 
        | what is the treatment for leshimaniasis |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | what is the cause of toxoplasmosis |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | what is the transmission of toxoplasmosis gondii (2) |  | Definition 
 
        | raw meat or oocytes shed from cats |  | 
        |  | 
        
        | Term 
 
        | what is the treatment of toxoplasmosis gondii |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | what is the most commonly diagnosed intestinal parasite in the US |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | how is giardia transmitted |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | what are the two forms of E. histolytica, where are they located |  | Definition 
 
        | Cysts: survive outside the body 
 Labile: invasive trophozoites that cannot live outside the body
 |  | 
        |  | 
        
        | Term 
 
        | how is E. histolica transferred, where does it grow, how does it cause infection |  | Definition 
 
        | Cysts ingested through feces contamination and pass to intestines 
 Trophozoites are born and invade and ulcerate the mucosa and feed on intestinal bacteria
 
 As they increase in numbers they are able to invade systemically
 
 As they migrate to the rectum they return to cyst form and are excreted in feces
 |  | 
        |  | 
        
        | Term 
 
        | how is E. histolitca diagnosed |  | Definition 
 
        | E. histolytica in fresh feces |  | 
        |  | 
        
        | Term 
 
        | what are the signs of P. falciparum (5) |  | Definition 
 
        | persistent high fever orthostatic hypotension
 erythrocytosis (swollen limbs)
 capillary obstructiondeath
 |  | 
        |  | 
        
        | Term 
 
        | why is P. falciprum dangerous (3) |  | Definition 
 
        | it can infect RBC of any age increased drug resistance
 increased insectacide resistance
 |  | 
        |  | 
        
        | Term 
 
        | what is the main clinical concern for P. vivax |  | Definition 
 
        | may remain in the liver after the blood part of the disease is elminated |  | 
        |  | 
        
        | Term 
 
        | what is the main clinical concern for P. ovale |  | Definition 
 
        | may remain in the liver after the blood part of the disease is elminated |  | 
        |  | 
        
        | Term 
 
        | how is trypanosomiasis acquired, where does it go in the body, how does it cause pathoology, what are the signs |  | Definition 
 
        | Initially live and grow in the blood 
 Invade CNS and cause inflammation of the brain and spinal cord
 
 Produces lethargy and continuous sleep
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | ferredoxin like, low redox, e- transport chains occur in anaerobic abeobe making ROS. 
 nitro group of drug  accepts e- and forms  reduced cytotoxic compounds that bind to proteins and DNA causing cell death
 |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | chloroquine: MOA (4 parts) |  | Definition 
 
        | 1. decreases DNA synthesis but disrupting tertiary structure of DNA 
 2. alkalinization of food vacoule: tops Hb digestion of the parasite by going into food vacoule and picking up a protein and making the food basic
 
 3. interferes with heme polymerase: parasites eat Hb to get AA and Fe but this makes soluble Hb which is toxic so it uses heme polymerase and turns the Hb into hemozoin and puts it away in its food vacoule.
 
 4. binds ferriprotoprophyrin iX damaging membrane causing lysis of the parasite and RBC
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | intermediates act as oxidants which cause hemolysis and methemoglobenmia toxicities |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | inhibit heme polymerase 
 affect DNA synthesis
 
 damage the membrane
 |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | reacts with sulfhydryl inducing enzymes in organism and host |  | 
        |  | 
        
        | Term 
 
        | pentamide isethionate: MOA |  | Definition 
 
        | binds to parasite DnA and stops RNA/DNA/phospholipid/protein synthesis in parasite |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | undergoes reduction so it has a free e- to attack O2 forming superoxide, hydeoxyl, and H2O2 raicals. Organism dosent have catalase so it kills it |  | 
        |  | 
        
        | Term 
 
        | sodium sitbogluconate: MOA |  | Definition 
 
        | reduced to trivalent antiomy for activity 
 inhibits phosphofructokinase stopping glycolysis
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | stops diydrofolate reductase at a low enough concentration to not inhibit it in the host 
 this deprives it of tetrahydrofolate so it cant make purines and pyrimidines
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | some P. falciprum has become resistant |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | some trichomonas have become resistant |  | 
        |  | 
        
        | Term 
 
        | metronidazole: side effects (7) |  | Definition 
 
        | GI: nausea, vomiting, cramp 
 metalic taste
 oral moniliasis
 
 disulfiram like effect
 
 rare CNS: numbness upon drug discontinuation
 |  | 
        |  | 
        
        | Term 
 
        | diloxanide fulorate: side effects (3) |  | Definition 
 
        | mild flatulence 
 dryness of the mouth
 
 puritus
 |  | 
        |  | 
        
        | Term 
 
        | chloroquine: side effects (3) |  | Definition 
 
        | ECG changes - quinidine effect 
 chronic Tx: discoloration of nail beds, visual disturbances
 |  | 
        |  | 
        
        | Term 
 
        | primaquine: side effects (3) |  | Definition 
 
        | GI 
 drug induced hemolytic anemia in people with low G6PDH
 
 rare blood dyscrasia in patients with lupus
 |  | 
        |  | 
        
        | Term 
 
        | quinine: side effects (7) |  | Definition 
 
        | cinchonism: nausea, vomiting, tinnitus, vertigo 
 discontiune for positive coombs test for hemolytic anemia
 
 potentiation of neuromuscular blocking agents (surgery)
 
 elevation of digoxin levels
 |  | 
        |  | 
        
        | Term 
 
        | mefloquine: side effects (3) |  | Definition 
 
        | dizzy, disorientation, hallucinations (caution to SCUBA divers), neurotic and psychotic stuff |  | 
        |  | 
        
        | Term 
 
        | melarsoprol: side effects (1) |  | Definition 
 
        | CNS: encephalopathy may appear soon after therapy. Usually subsides, can be fatal |  | 
        |  | 
        
        | Term 
 
        | pentamide isethionate: side effects (3) |  | Definition 
 
        | renal dysfunction 
 hypotension
 
 toxic to B cells of pancreas
 |  | 
        |  | 
        
        | Term 
 
        | nifurtimox: side effects (3) |  | Definition 
 
        | anaphylaxis 
 delayed hypersensitivity
 
 peripherial neuropathy
 |  | 
        |  | 
        
        | Term 
 
        | sodium sitbogluconate: side effects (1) |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | pyrimethamine: side effects (2) |  | Definition 
 
        | megaloblastic anemia: reversable with leuconvorin 
 hypersensitivity (can be severe)
 |  | 
        |  | 
        
        | Term 
 
        | metronidazole: administration, absorption |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | diloxanide furolate: administration, absorption (and its significance) |  | Definition 
 
        | 90% absorbed, but the unabsorbed part is the amebocide |  | 
        |  | 
        
        | Term 
 
        | chloroquine: administration |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | primaquine: administration |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | melarsoprol: administration |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | pentamide isethionate: administration methods, why not the others |  | Definition 
 
        | IM or aerosol 
 Avoid IV: tachycardia, decrease in BP
 |  | 
        |  | 
        
        | Term 
 
        | sodium sitboqluconate: asministration |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | metronidazole: how is it metabolized (2), what can enhance this (1), what can increase the half life (1) |  | Definition 
 
        | hepatic oxidation of the side chain by oxidase and glucuronidation (accumulates in hepatic disease) 
 enhanced by phenobarbital
 
 cimetidine increases half life (heart burn)
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | some metabolic products retain antimalarial activity |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | rapidly oxidized to many other compounds |  | 
        |  | 
        
        | Term 
 
        | primaquine: distribution and its significance |  | Definition 
 
        | can get to the liver to get P. vivax and P. ovale but does not concentrate anywhere in particular |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | excretion decreased due to alkalinization of the urine |  | 
        |  | 
        
        | Term 
 
        | what antiprotozoa has the longest half life how long is it, who is the runner up |  | Definition 
 
        | mefloquine long half life (17d)
 
 pentamide isethionate
 |  | 
        |  | 
        
        | Term 
 
        | what antiprotozoa enters the CNS |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | host oxidizes non-toxic pentavalent arsenic compoind |  | 
        |  | 
        
        | Term 
 
        | what is pyrmithamine used to |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | what is sodium sitboglyconate used for |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | what is nifurtumox used for |  | Definition 
 
        | acute T. cruzi infection, chronic stage treatment results are variable (drug is supressive not curative) |  | 
        |  | 
        
        | Term 
 
        | what is pentamide isethionate used for (2) |  | Definition 
 
        | T. brucei gambinese in hematological stage 
 Pneymocystis carinii
 |  | 
        |  | 
        
        | Term 
 
        | what is melarsoprol used for |  | Definition 
 
        | drug of choice: late stages with CNS involvement for gambinense and rhodesiense |  | 
        |  | 
        
        | Term 
 
        | what is mefloquine used for (2) |  | Definition 
 
        | prophylaxis for chloroquine resistant malaria (also doxycycline) 
 treatment for chloroquine resistant malaria
 |  | 
        |  | 
        
        | Term 
 
        | what is quinine used for (2) |  | Definition 
 
        | reserved for resistant strains 
 treatment for chloroquine resistant malaria
 |  | 
        |  | 
        
        | Term 
 
        | what is primaquine used for (5) |  | Definition 
 
        | kills… *primary exoerythrocytic P. falciparum and P. vivax
 *secondary exoerythrocytic forms of P. vivax and P. ovale (in liver)
 *sexual forms of all plasmodia are destoried in blood or prevented from maturing
 *little activity on erythrocytic schizonts so often used in combo with blood schizoniticide
 |  | 
        |  | 
        
        | Term 
 
        | what is metronidazole used for (3), how is it used |  | Definition 
 
        | E. histolitica Giardia lamblia
 Trichomonas vaginalis
 
 usually combined with a luminal ameboside because it is rapidly absorbed
 |  | 
        |  | 
        
        | Term 
 
        | what is diloxanide furolate used for (2) |  | Definition 
 
        | asymptomatic passers of cysts 
 intestinal amebiasis
 |  | 
        |  | 
        
        | Term 
 
        | what is chloroquine used for (4) |  | Definition 
 
        | use with metronidazole and diloaxnide to treat and preent liver abscesses 
 drug of choice forerythrocytic  P. falciparum
 
 prophylaxis for chloroquine sensitive malaria
 
 treatment for chloroquine sensitive acute malaria
 |  | 
        |  | 
        
        | Term 
 
        | what drug has to be gotten from the CDC |  | Definition 
 | 
        |  |