what is the most frequent helminth site in the human body?

where are they also found?

the intestines

liver, lymphatic system and blood vessels

What is Metronidazole and tinidazole's MOA?

Impairs DNA synthesis in microorganisms

PO or IV

Excellant Absorption, crosses BBB and placenta

reaches plasma levels in breast milk

hepatically metabolized

HA

nausea

unpleasant metallic taste

darkens urine

less common: stomatitis, V/D, vertigo

for someone with:

amebiasis

giardiasis

trichomoniasis

alcohol

disulfiram

inhibits metabolism of warfarin

increases levels of phenytoin and lithium

metronidazole

tinidazole

mebendazole

albendazole

pyrantel paramoate (safe for preg)

ascaris lumbricoides

enterobius vermicularis

ancylostoma duodenale

necator americanus

trichinella spiralis

trichuris trichiura

stongyloides stercoralis

ancylostoma duodenale or

necator americanus

larvae penetrate through skin (usually bottom of feet)

they attach to the walls of the small intestine

mebendazole

albendazole

pyrantel paramoate

mebendazole

albendazole

pyrantal paramoate

trichinella spiralis or

trichuris trichiura

trichinella spiralis

(larvae migrate into skeletal muscle and become encysted)

mebendazole (may not work against encysted larvae)

predinsone (reduce inflammation during larval migration)

mebendazole

what is the route of infection of strongyloides?

taeniasis

and

diphyllobothriasis

found in freshwater

they penetrate through exposed skin and invade the venous system

it paralyzes the worm by blocking glucose uptake

inhibits microtuble synthesis

the drugs used to treat worms are all taken ___________.

transient abdominal pain

diarrhea

ascariasis

enterobiasis

ancylostomiasis

necatoriasis

trichinosis

trichuriasis

strongyloidiasis

it is a depolarizing neuromuscular blocking agent

it paralyzes the worms which are then excreted in feces

NVD

stomach cramps

ascariasis

enterobiasis

necatoriasis

ancylostomiasis

disrupts nerve and muscle function in parasites

allows Chloride channels to open and chlorine to enter the cells which hyperpolarizes the nerves and muscles

parasite becomes paralyzed and dies

at low doses it produces spastic paralysis in the worm causing it to detach from body tissues

at higher concentrations, it disrupts the integument of the worms and allows host defenses to kill it

transient HA

Abd. discomfort

sometimes drowsiness (driving concern)

chloroquin

primaquin

quinine

mefloquine

atovaquine/proguanil

mild cinchonism

hemolysis in pts with G6PD def.

hypoglycemia

Nausea

dizziness

syncope

CNS toxicity

Primarily GI

possible rash

mefloquine

doxycycline

or

atovaquine/proguanil

metronidazole

tinidazole

what are the objectives of treatment for malaria?

1. treatment of acute attack

2. prevention of relapse

3. prophylaxis

1. falciparum

2. vivax malaria

How do you get giardiasis?

contact with contaminated objects or

by drinking contaminated water

what is the scientific name for pubic (crab) lice?

how is lice transmitted?

in clothing

(only one of the 3 lice that thrives in lower socioeconomic status areas)

underarms

eyebrows

lashes

facial hair

pyrethrins

malathion lotion 0.5%

lindane lotion 1%

where do pyrethrins come from?

just the adult lice, not the eggs

may need a second treatment 10 days later bc the eggs it didn't kill will have hatched by then

a organophosphate

pediculicidal and partial ovicidal

only use in those 6 yoa and up

when there is a history of resistance to other lice treatments

or for scabies

not first line in either case

on premature infants

folks with seizure disorders

anyone whose pregnant or breast feeding

anyone with irritated skin or sores where the shampoo would go

tinier than lice

burrow into skin and leave tell tale tracks

redness at end of tunnel

cause intense itching from eggs and droppings

wrists

butt

underarms

groin

and especially webs inbtwn fingers

permethrim 5% cream DOC (kills mites and eggs)

crotamiton lotion or cream 10% (adults only, freq. treatment failure)

lindane shampoo 1%

no OTC drugs approved

1. few drugs are selective enough to prevent viral replication without injuring the host

2. clinical sxs appear late in course of disease

_______________ against Influenza A is the preferred approach.

Oseltamivir (PO)

Zanamivir (inhalation)

Amantadine

Rimantidine

supplements to vaccinations

to treat and prevent influenza A

Amantadine and Rimantadine reduce the _____________ and _____________ of symptoms if taken within 48 hours of exposure to the virus.

GI

tiredness

lightheadedness

trouble sleeping

difficulty concentrating

the treatment of hospitalized infants and young children with severe LRT infections due to respiratory syncytial virus

ONLY RSV infections

PO

IV

aerosol

anemia

aerosol may cause resp. function to decrease initially

teratogenic

Some pathogenic hepatitises are...

Hep B

Hep C

causing chronic hep, cirrhosis and cancer of the liver

Interferon alpha + lamivudine

Sometimes lamivudine alone is used

Lamivudine

Adefovir

Entecavir (used for lamivudine-resistant Hep B)

inhibits reverse transcriptionase of Hep B and is assc. with reduced hepatic inflammation

(requires monitoring of renal function)

cold sores

encephalitis

genital infections

what does Acyclovir treat?

HSV-1

HSV-2

VZV

some Epstin-Barr

DOC for HSV encephalitis

most commonly used to treat genital herpes

depends on administration

topical: local irritation

PO: NVD, HA

IV: transient renal dysfunction

acyclovir

famciclovir

penciclovir (topical only)

HSV-1, HSV-2 and VZV

(PO)

CMV infections affect ______ people during their lifetime but ________ cause obvious illness

most

rarely

Cidofovir

FOSCARNET

Gancyclovir

nephrotoxicity

electrolyte distrubances

CMV retinitis

acyclovir-resistant HSV

Isonazid

Rifampin

Pyrazinamide

Ethambutol

(I Saw a Red PYRe-burning the liver)

4 drugs for 2 months

2 drugs for the next 4 months

Hepatotoxicity

Peripheral neuropathy

hypersensitivity reactions

Rifampin MOA

Rifampin AEs

asymptomatic jaundice, elevated liver enzymes

urine, sweat, tears become red-orange color

GI upset

legionella pneumphila

Staph aureus endocarditis

prophylaxis for N. Meningitis and H. flu

unknown

analog of nicotinamide

HEPATOTOXIC

gout

do not use in preg.

unknown

metal chelator

vestibular and ototoxic

nephrotoxic

NMB

do not use in preg.

GI upset

rare chlestatic jaundice

prolonged QT syndrome

azithromycin

clarithomycin

Rifabutin MOA

possible kidney and liver effects

bone marrow suppression

rash

fever

uveitis

orange discoloration of urine, sweat, and tears

Rifapentine MOA

Rifabutin

Rifapentine

Rifampin

Macrolides

Aminoglycosides

Capreomycin

Inhibits cell wall synthesis

(2nd line Anti-TB)

CNS effects

peripheral neuropathy

nephrotoxic

ototoxic

Inhibits protein synthesis

(2nd line Anti-TB)

Mycobacterium diseases tend to occur in the _________________

All mycobacteria are:

For someone to develop active TB disease, the following two events must take place:

1. The bacteria must enter the body, thereby causing an Mtb infection. This usually happens when a person breathes in Mtb-contaminated air and the inhaled TB bacteria make their way to the lungs.
2. The immune system cannot stop the TB bacteria from growing and spreading after the initial infection.

isoniazid

rifamycins

ethambutol

pyrazinamide

aminoglycosides

fluoroquinolones

macrolides

para-aminosalicylic acid

capreomycin

cycloserine

ethionamide

streptomycin

if organism is resistant use kanamycin or amikacin

levofloxacin

a fluoroquinolone

IM or IV

similar to aminoglycosides

like nephrotoxicity and ototoxicity

CNS problems

peripheral neuropathies (which respond to pyridoxine)

hepatoxicity

GI

peripheral neuropathies

optic neuritis

systemic mycoses

and

superficial mycoses

Candidiasis, Aspergillosis, Cryptococcosis, Mucormycosis

spirotrichosis

blastomycosis

histoplasmosis

coccidioidomycosis

what is fluconazole used to treat?

superficial and invasive candida,

cryptococcal meningitis,

coccidioidal,

and prophylaxis

Fluconazole MOA

inhibits synthesis of fungal cytoplasmic membrane

increase permeability and leakage of cellular componets

N/V/GI upset

LFT elevation

azoles

polyenes

nucleoside analogs (flucytosine)

echinocandins (-fungin)

NV

elevated LFTs

Elevated TGs

hyperkalemia

HA

dizziness

how is Amp B administered?

broad spectrum

used for nearly all life-threatening mycotic infections

antihistamines

antipyretics

corticosteroids

what is nystatin used for?

its an antifungal

used to treat oropharyngeal thrush

vagineal candidiasis

intertriginous candidal infections

creams

ointments

vaginal suppositories

suspensions

troches

Griseofulvin

(derived from a species of penicillin)

parathesias

photosensitivity

hypersensitivity

GI upset

HA

elevated LFTs

taste disturbances

Allyamine MOA

like terbinafine

inhibitor of cell wall synthesis

Amphotericin B

(a polyene)

mebendazole

albendazole

pyrantel pamoate

what is the DOC for trichuriasis and trichinosis?

metronidazole

tinidazole