antihelminth, antifungal, antiparasite, anti
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- mebendazole
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antihelminthic
MOA: inhibits glucose uptake
use: broad action, except strongyloides and echinococcus (hydatid disease)
(category: energy metabolism) - albendazole
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antihelminthic
MOA: causes degeneration of intestine and tegument of helminths
use: hydatid disease (echinococcus - a cestode) - thiabendazole
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antihelminthic
Z: strong thiaghs ->strongyloides
MOA: inhibits fumarate reductase
USE: broad spectrum, drug of choice for strongyloides
*also for saprophytic pathogenic fungi
antipyretic, antiinflammatory, and analgesic. this prevents some of the tissue damage from adaptive immunity - ivermectin
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antihelminthic
Z: alan iverson became paralyzed, GABA
USE: heartworm and sleeping sickness, also strongyloides
MOA: potentiates GABA action - paralysis - niclosamide
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antihelminthic
Z: cestodes and NICKELS are flat
USE: cestodes
MOA: inhibits glucose and oxygen uptake - praziquantel
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antihelminthic
Z: prazi is the wonderful drug b/c of its synergism and lack of side effects.
USE: all trematodes (incl. schistosomiasis), some cestodes
MOA: increases membrane permeability to Ca - tetany/death
* syngergism b/t immune system and drug
No side effects, great drug! - metrifonate
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antihelminthic
Z: fo - phosphate, organophosphate
USE: schistosomiasis
MOA: organophosphate, irreveresible AchE inhibitor. In schistosomes, Ach is the anti-movement NT, so metrifonate causes paralysis. active only against h. haematobium in vivo b/c it lets go and winds up in lungs instead of liver. in lungs it can be killed. h. mansoni and h. japonicum let go and wind up in liver, where they can recover - niridazole
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antihelminthic
MOA: glycogen phosphorylase can't be inactivated, all glycogen is used up and organism dies
use: schistosomiasis, cheap drug, used in Africa - oxamiquine
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antihelminthic
Z: "The Ox!" - nucleic acids
MOA: may inhibit nucleic acid utilization
USE: S. mansoni, American strains, some African - amphoterecin B
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polyene antifungal
binds to ergosterol and acts as a pore. osmotic death (cidal)
low TI - nephrotoxicity!
broad spectrum, but nephrotoxicity limits its use
decreases renal blood flow ->tubule ischemia and death
don't give with other nephrotoxic drugs or in person with renal condiction
also - infusion related toxicity - the shake and bake - rigors and chills, fever
concentration dependent killing (makes sense)
lipid preparartions (liposomal, phospholipid, cholesterol disc)
decrease nephrotoxicity and infusion related shake and bake
also penetrate the CNS so it can be used for cryptococcal meningitis - ketoconazole
- azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)
- itroconazole
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azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)
Itro is good against Endemic Fungi (Coccidioides, Histoplasma, Blastomyces, Sporothrix).
Z: CAHABA is an INTRO to whitewater. must take food down the intro cahaba. - posaconazole
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azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)
posa is only effective treatment for Zygomyces
must eat a fatty meal for absorption
Z: RAMZ is a POS (Piece of Shit) - fluconazole
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azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)
Z: flu is important!
Fluconazole is the most important treatment for:
1. systemic and mucosal CANDIDA infections
2. Cryptococcal meningitis. use Amb + Fluconazole. can also use 5FC instead of fluconazole. - voriconazole
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azole antifungal (inhibit 14alpha demethylase - ergosterol synthesis)
Vori S/E: photopsia - tripping on acid! - strange colors/lights
Vori + echinocandin is first line for aspergillus
Z: (voracious asparagus) - anidulafungin
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Echinocandin anitfungal
Echinocandins inhibit glucan (CW) synthesis and are fungicidal (osmotic death)
used almost exclusively for
1. candida
2. aspergillus (with voriconazole)
IV only (too large and charged)
AUC/MIC must be > 10
Conc dep killing
AUC24/MIC > 10 or peak/MIC
AmB
Echinocandins
flu & posa
hepatic metabolism (watch out for liver failure) - caspofungin
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Echinocandin anitfungal
Echinocandins inhibit glucan (CW) synthesis and are fungicidal (osmotic death)
used almost exclusively for
1. candida
2. aspergillus (with voriconazole)
IV only (too large and charged)
AUC/MIC must be > 10
hepatic metabolism (watch out for liver failure)
Conc dep killing
AUC24/MIC > 10 or peak/MIC
AmB
Echinocandins
flu & posa - micafungin
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Echinocandin anitfungal
Echinocandins inhibit glucan (CW) synthesis and are fungicidal (osmotic death)
used almost exclusively for
1. candida
2. aspergillus (with voriconazole)
IV only (too large and charged)
AUC/MIC must be > 10
hepatic metabolism (watch out for liver failure)
Conc dep killing
AUC24/MIC > 10 or peak/MIC
AmB
Echinocandins
flu & posa - flucytosine
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antifungal - blocks DNA synthesis (pyrimidine synth) and RNA synth (protein synth)
used with AmB for cryptococcal meningitis b/c it penetrates the CNS and eye very well
s/e: bone marrow suppression, GI probs (just like a chemo drug)
Time > MIC
flucytosine
vori & itra