Wk 2 Antifungal Meds Flashcards Preview

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Flashcards in Wk 2 Antifungal Meds Deck (6)
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1
Q

Polyenes:

Amphoteracin B and Nystatin

A

Mechanism: bind ergosterol, create membrane holes –> fungicidal

Spectrum: systemic infections in immunocompromised pts

Adverse: nephrotoxicity ~70% pts, nystatin: topical Candida infection

Resistance: rare, decrease in membrane ergosterol

Distribution: long half-life, can cross blood-brain barrier

2
Q

Azoles:

Fluconazole, Itraconazole, Ketoconazole

A

Mechanism: inhibits fungal P450 (Erg111), decreasing ergosterol and increasing linosterol

Spectrum: varies by agent

Adverse: XX PREGNANCY XX, neurotoxicity, hepatotoxicity, hormone synthesis problems

Resistance: increased efflux, P450 binding changes

Distribution: increased absorption with acid

3
Q

Allylamines:

Terbinafine

A

Mechanism: inhibits squalene epoxidase, decreases ergosterol production, increases squalene

Spectrum: dermatophytes

Adverse: topical w/ CYP2D6 substrates

Resistance: CYP2D6 changes, increased efflux, decreased uptake

4
Q

Flucytosine

A

Mechanism: converted to 5-FU in fungi

Spectrum: yeast of Candida albicans and Crypotococcus

Adverse: bone marrow suppression

Resistance: changes in uptake or converting enzymes, often used with Amphoteracin B cotreatment to penetrate cells

Distribution: oral, penetrates CNS

5
Q

Griseofulvin

A

Mechanism: binds microtubules –> multinucleated cells –> fungistatic

Spectrum: dermatophytes

Adverse: XX PREGNANCY XX

Resistance: beta-tubulin changes

Distribution: increased uptake with lipid consumption

6
Q

Echinocandins:

Caspofungin

A

Mechanism: blocks beta-1,3-glucan polysaccharide synthesis. fungicidal-Candida, fungistatic-Aspergillis

Spectrum: Candida albicans, systemic

Adverse: rash, pain w/ injection

Resistance: beta-1,3-glucan synthase gene alteration

Distribution: IV, no CNS penetration w/ large MW