Antifungals Flashcards Preview

[Ther 201] 3rd Exam Cluster 1 > Antifungals > Flashcards

Flashcards in Antifungals Deck (44)
1

What is an ideal antifungal?

Selectively eliminates fungal pathogens from a host with minimal toxicity to the host

2

What are the three targets of antifungals?

Cell wall, Cell membrane, cytoplasm

3

Used if refractory to other agents

Echinocandins

4

Site of action of griseofulvin?

binds to microtubules

5

site of action of echinocandins?

cell wall

6

Polyenes are products of _______ species

Streptomyces

7

What organisms are resistant to Amphotericin?

Pseudallescheria boydii, Fusarium spp., Trichosporon spp., certain isolates of Candida lusitaniae & Candida guilliermondii

8

T or F. Dose adjustment is required for Amphotericin B.

F. Hepatic and renal impairment, and dialysis have little impact on drug concentrations

9

Adverse effects of Amphotericin B

Elevation of LFT?s, anemia (reduced erythropoietin production), impaired hepatic function

10

List three imidazoles

ketoconazole, miconazole (topical), and clotrimazole (topical)

11

List three triazole

itraconzaole, fluconazole (prototype) and voriconazole

12

Excretion of itraconazole

Fecal

13

Does Amphotericin B cross the blood-brain barrier?

Yes. Kaya intrathecal yung administration for cryptococcal meningitis.

14

most significant toxic reaction for Amphotericin B

Renal damage causes K+ bicarbonate wasting

15

MOA of Azoles

Inhibits 14-?-demethylase during ergosterol synthesis from lanosterol

16

Fungistatic or Fungicidal? Azole

Fungistatic

17

Resistant to Amphotericin B

Pseudallescheria boydii, Fusarium spp., Trichosporon spp., certain isolates of Candida lusitaniae & Candida guilliermondii

18

Most common AE for Azoles

relatively minor gastrointestinal upset

19

Interferes with synthesis of adrenal hormones

Ketoconazole

20

resistant to fluconazole

Candida glabrata and Candida krusei

21

Most commonly used for the treatment of mucocutaneous candidiasis

Fluconazole

22

Used extensively in the treatment of dermatophytoses and onychomycosis

Itraconazole

23

May cause Stevens-Johnson Syndrome

Itraconazole

24

Azole of choice for aspergillosis

Voriconazole

25

Little interaction at CYP450

Voriconazole

26

Inhibits CYP3A4

Posaconazole

27

Taken up by fungal cells via enzyme cytosine permease

Flucytosine

28

Does Flucytosine penetrate CNS?

Yes.

29

Fungistatic or Fungicidal? Flucystosine

Fungistatic

30

Most common AE?s for Flucytosine

Bone marrow toxicity with anemia, leukopenia, and thrombocytopenia

31

Mechanism of Action of Echinocandins

Act at the level of the fungal cell wall by inhibiting beta (1-3) gucan synthase

32

Fungistatic or Fungicidal? Echinocandins

Fungicidal

33

histamine release may occur during IV infusion

Anidulafungin

34

For disseminated and mucocutaneous candida infections

Caspofungin

35

licensed for mucocutaneous candidiasis and prophylaxis of candida infections in BM transplant patients

Micafungin

36

approved for use in esophageal candidiasis and invasive candidiasis, including septicemia

Anidulafungin

37

Antifungal derived from species of Penicilium

Griseofulvin

38

orally administered in crystalline form

Griseofulvin

39

MOA of Griseofulvin

Binds to microtubules comprising the spindles and inhibits mitosis

40

Drug of choice for onychomycosis

Terbinafine

41

MOA of Terbinafine

Inhibits squalene 2, 3- epoxidase

42

Used in the ICU for vaginal candidiasis

Nystatin

43

pleasant- tasting alternative to nystatin

Clotrimazole, Miconazole

44

used to treat cutaneous and lymphocutaneous sporotrichosis

Potassium Iodide