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[THER 201] 3rd Lecture Exam > [2] Anti-Fungals > Flashcards

[2] Anti-Fungals Flashcards

1
Q

[Mechanism of Action]

Polyene Antifungal Drugs

A

Cell membrane destruction via disruption of osmotic gradient

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2
Q

[Mechanism of Action]

Azoles

A

Cell membrane destruction via interruption of ergosterol synthesis

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3
Q

Polyenes are products of?

A

Streptomyces

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4
Q

Gold standard and has the broadest spectrum for yeasts

A

Amphotericin B

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5
Q

Effect of hepatic or renal impairment on Amphotericin B metabolism

A

Little to no impact, no dose adjustment is required

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6
Q

[Route of Administration]

Amphotericin B

A

IV

Intrathecally

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7
Q

Most significant adverse reaction to Amphotericin B

A

Renal damage, specifically K+ bicarbonate wasting that can lead to hypokalemia

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8
Q

First successful antifungal antibiotic to be developed

A

Nystatin

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9
Q

Nystatin is an effective broad-spectrum antifungal drug but because of its toxicity it is limited to this kind of use

A

Topical

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10
Q

Are Azoles fungistatic or fungicidal?

A

Fungistatic

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11
Q

Classification of Azoles

A

Imidazoles (2)

Triazoles (3)

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12
Q

Examples of Imidazoles

A

Ketoconazole
Miconazole
Clotrimazole

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13
Q

Examples of Triazoles

A

Itraconazole
Fluconazole
Voriconazole

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14
Q

What specifically do Azoles inhibit during ergosterol synthesis

A

Inhibits 14-a-demythylase from lanosterol

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15
Q

This classification of azoles has a lower specificity as compared to the other class which results to greater numbers of drug interactions and side effects

A

Imidazoles

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16
Q

What class of drug does Ketoconazole fall under?

A

Imidazole

Azoles

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17
Q

What class of drug does Fluconazole fall under

A

Triazole

Azoles

18
Q

This drug is the standard for azoles, replacing Amphotericin B for managing certain forms of systemic mycoses

A

Fluconazole

19
Q

[Route of Administration]

Fluconazole

A

Oral

20
Q

Fluconazole is a 2nd line drug for? Why?

A

Cryptococcal meningitis

This is because it is able to attain a high level of CSF concentration

21
Q

This specific azole has the least adverse effects or number of drug interactions

A

Fluconazole

22
Q

These fungi are resistant to Fluconazole

A

Candida glabrata

Candida krusei

23
Q

Fluconazole is most commonly used to treat

A

Mucocutaneous candidiasis

24
Q

What class of drug does Itraconazole fall under

A

Triazole

Azoles

25
Q

Itraconazole is the azole of choice for treatment of?

A

Dimorphic fungi:

Histoplasma
Blastomyces
Sporothrix

26
Q

Azole of choice for aspergillosis

A

Voriconazole

27
Q

Adverse effect associated with intake of Voriconazole

A

Visual Disturbances

28
Q

[Mechanism of Action]

Flucytosine

A

Converted to 5-fluorouracil -> 5 -fluorodeoxyuridine monophosphate FdUMP and fluorouridine triphosphate FUTP which inhibits DNA and RNA synthesis respectively

FdUMP -> DNA
FUTP -> RNA

29
Q

What is the interaction of Flucytosine with Amphotericin B

A

Synergy, may be related to enhanced penetration through damaged fungal cell membranes

30
Q

Most common adverse effect of Flucytosine

A

Bone marrow toxicity with anemia, leukopenia, and thrombocytopenia

31
Q

[Mechanism of Action]

Echinocandins

A

Inhibit beta (1-3) glucan synthase, disrupting fungal cell wall and causing cell death

32
Q

Drug used for empirical therapy of presumed fungal infections in febrile and neutropenic adult patients

A

Echinocandins

33
Q

Griseofulvin is used only for?

A

Systemic treatment of dermatophytosis

34
Q

Drug of choice for Onychomycosis

A

Terbinafine

35
Q

What class of drug does Terbinafine fall under

A

Allylamine

36
Q

Clinical use for Terbinafine

A

Taken orally for dermatophytes

37
Q

Griseofulvin and Terbinafine are both used as keratophilic medication, what makes them different?

A

Terbinafine is a fungicide

38
Q

Nystatin is commonly used to treat this

A

Vaginal Candidiasis

39
Q

What classes of antifungals are Fungicidal?

A

Polyene

Terbinafine

40
Q

What classes of antifungals are Fungistatic?

A

Azoles
Flucytosine
Griseofulvin

41
Q

What antifungals can penetrate the CNS?

A

Fluconazole

Flucytosine

[THER 201] 3rd Lecture Exam (8 decks)

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