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FIM > 24. a. Antifungals > Flashcards

24. a. Antifungals Flashcards

1
Q

What are the 4 main methods of action of antifungals?

A

Act on cell membrane
Act on cell wall
Interfere with DNA/RNA synthesis
Interfere with folate metabolism

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2
Q

Which antifungals act on the cell membrane?

A

Polyenes

Azoles

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3
Q

Which antifungals act on the cell wall?

A

Echinocandins

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4
Q

What antifungal interferes with DNA/RNA synthesis?

A

5-flurocysteine

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5
Q

Which antifungal interferes with folate metabolism?

A

Co-trimoxazole

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6
Q

Name 2 polyenes

A

Amphotericin B

Nystatin

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7
Q

What type of coverage is given by amphotericin B?

A

Broad spectrum against yeasts

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8
Q

What are possible side effects of amphotericin B?

A

Rigors

Renal impairment

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9
Q

Name 4 azoles

A

Fluclonazole
Miconazole
Posaconazole
Voriconazole

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10
Q

How do azoles act on the cell membrane?

A

Inhibit ergosterol biosynthesis

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11
Q

What fungus is fluclonazole active against?

A

Candida albicans

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12
Q

What fungi is voriconazole useful against?

A

All candida and aspergillus

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13
Q

What fungi is posaconazole useful against?

A

Candida, aspergillus, mucorales

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14
Q

List the side effects associated with azoles?

A

Visual disturbances with voriconazole
Hepatotoxicity
CYP450 interactions

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15
Q

What is the first choice empiric treatment for a systemic fungal infections?

A

Caspofungin

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16
Q

What class is caspofungin from?

A

Echinocandins

17
Q

How do echinocandins interfere with the cell wall?

A

Interfere with glucan synthesis

18
Q

What fungi is caspofungin active against?

A

Candida and aspergillus

19
Q

What is a possible side effect of caspofungin?

A

Liver toxicity

20
Q

What infections can terbinafine be used for?

A

Tinea and nail infections, as it accumulates in keratin

21
Q

What is the mechanism of action of terbinafine?

A

Interferes with ergosterol synthesis

22
Q

What TDM should be done for a patient on oral terbinafine treatment?

A

Monitor LFTs

23
Q

What treatment can be given for PCP?

A

High dose IV co-trimoxazole
Dapsone or clindamycin
Give corticosteroids if severe hypoxia

24
Q

What prophylaxis should be given to HIV patients?

A

Anti-candida or after a cryptococcus infection: fluconazole
Anti-PCP: oral trimoxazole
Not needed for patients on viral suppression meds

25
Q

What drug is given as anti-aspergillus prophylaxis?

A

Oral posaconazole

FIM (44 decks)

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