-
what type of organism is candida?
- diploid fungus
- normal commensal
-
what infections can candida cause?
oral and genital infection (thrush)
-
what is the treatment for mild oral candidiasis?
nystatin
-
what is the 1st line treatment for moderate-severe candidiasis?
fluconazole (PO)
-
what is the 2nd line treatment for moderate-severe candidiasis?
- itraconazole
- or amphotericin
-
what is the treatment for invasive oral candidiasis?
-
what is tinea?
dermatophyte infection (fungal infection of skin) - ringworm
-
name the 4 types of tinea infections and where they occur
- tinea capitis: scalp
- tine corporis: trunk, arms, groin
- tinea onychomycosis: nails (stubborn infection!)
- athlete's foot
-
what is the treatment for onychomysis tinea?
terbinafine - needs oral treatment
-
what are the treatments for tinea?
- ketoconazole, miconazole, clotrimazole: topical
- terbinafine: oral or topical
- griseofulvin: topical
-
what are the risk factors for invasive fungal disease?
- HIV
- neutropenia
- immuno-suppression: transplant or chemotherapy
- surgery
- IVDU
-
which organism is aspergillosis caused by?
aspergillus fumigatus
-
what are the different manifestations of aspergillosis?
- endocarditis
- organ abscess
- ABPA: allergic bronchopulmonary aspergillosis
- aspergilloma
- invasive aspergillosis
-
what is the 1st and 2nd line treatment of aspergillosis?
- 1st: fluconazole, itraconazole
- 2nd: amphotericin B
-
how is amphotericin B excreted?
some by kidney
-
does amphotericin B cross BBB?
not readily
-
what is amphotericin B used for?
- candidiasis
- invasive aspergillosis
- topical fungal infections
-
why is amphotericin given as a liposomal?
to increase the half life
-
what are the side effects of amphotericin B?
- hypersensitivity, anaphylaxis
- fever, chills, headache, nausea
- thrombophlebitis
- haemolytic anaemia
- hepatic damage
- hypokalaemia
- renal toxicity
-
what is the MOA of azaleas?
inhibit synthesis of ERGOSTEROL by blocking demethylation of lanosterol
-
what are the side effects of azoles?
- N&V, allergic rash
- hepatitis
- teratogenic
- fluid retention
- inhibits drug metabolism
-
give 3 examples of nucleoSide RT inhibitors?
- zidovudine
- didanosine
- lamivudine
-
give an example of nucleoTide RT inhibitors
tenefovir
-
give 2 examples of non nucleoside RT inhibitors
-
give 2 e.g. of protease inhibitors
-
what are the 2 main types of drugs used to treat HIV?
- reverse transcriptase inhibitors: NRTI(nucleoside), NNRTI
- protease inhibitors
-
when should ARV be started? 2 options (WHO)
- clinical: AIDS
- CD4 cell count: 200/mm3 or lower
-
what is the treatment of Hep C infection?
- peg INF alpha (inc half life so less frequency needed only one weekly)
- ribavarin (nucleoside analogue)
-
what is the treatment of Hep B infection?
- peg INF alpha (inc half life so less frequency needed only one weekly)
- lamivudine (nucleoside analogue)
-
what is the main side effect of peg INF?
neutropenia
-
what is the main side effect of ribavarin?
-
what are the side effects of NRTIs?
- lactic acidosis: all
- loss of subcut fat (lipodystrophy): all
- anaemia: zidovudine
- pancreatitis: ddI, ddC
- neuropathy: ddI, ddC, d4T
- hypersensitivity reaction: ABC
-
what are the side effects of NNRTI?
- hepatitis: all NNRTI
- CNS: efavirenz
- Stevens-johnson syndrome
-
what are the SE of PI?
- pancreatitis: lopinavir
- liver toxicity: all PIs
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