4/3/17 Antifungal Drugs SMITH TEST #3 Flashcards
Fungi are mostly eukaryotic organisms that live as _____ or ______.
- Saprobes
- Parasites
Fungi have a rigid cell wall composed of what?
-Chitin
Antibacterial agents are generally ___ against fungal infections.
-Ineffective
Is a superficial or systemic infection one that involves the skin and other soft tissues?
-Superficial
Is a superficial or systemic infection that involves the whole body?
-Systemic fungal infections
Pulmonary aspergillosis is an example of superficial or systemic fungal infections?
-Systemic fungal infections
What are the four antifungal agent targets?
- Fungal cell membrane
- Cell wall synthesis
- Nucleic acid synthesis
- Microtubule function
What are the three primary drugs used for treating systemic fungal infections?
- Amphotericin B
- Azoles
- Echinocandins
What two antifungal drugs work to disrupt membrane function and permeability?
- Amphotericin B
- Nystatin
What antifungal drugs prevent ergosterol synthesis by inhibiting 14-a sterol demethylase?
- Itraconazole
- Fluconazole
Which antifungal drugs prevent ergosterol synthesis by inhibiting squalene epoxidase?
- Naftifine
- Terbinafine
What antifungal drug inhibits fungal cell wall synthesis?
-Caspofungin
What drugs bind to plasma membrane ergosterol and damages the membrane by forming pores which cause leakage of K+ ions? (Polyenes)
- Amphotericin B
- Nystatin
What is the 1st line therapy for invasive, life-threating systemic and localized Candidemia?
-Amphotericin B
T/F Amphotericin B can be used to treat Aspergillus infections
True
What is the most serious side effect that is a slower reaction of Amphotericin B?
-Renal toxicity
How is amphotericin B usually administered?
-IV in hospital
How is Nystatin usually administered?
-Topical only
What drug is a treatment for Topical treatment for oral and esophageal Candidiasis albicans (thrush) as mouthwash?
-Nystatin
What drug is a topical cream for vaginal candidiasis (yeast infections)?
-Nystatin
What drugs inhibit ergosterol synthesis by clocking lanosine 14-a-demethylase?
-Azoles
How are azoles typically administered?
- Topically
- Systemically
What are three contraindications of azole drugs?
- Pregnancy
- Lactation
- Hepatic dysfunction
What is the most commonly prescribed systemic antifungal?
-Fluconazole
What is the drug of choice for most Candidiasis albicans?
-Fluconazole
What antifungal drug is used to treat fungal cryptococcal meningitis in AIDS patients because of its good CNS penetration?
-Fluconazole
T/F Azole is highly teratogenic and should be avoided during pregnancy
True
What was the first azole that was developed?
-Ketoconazole
What azole is effective against aspergillis but is more toxic that fluconazole?
-Itraconazole
What two azoles are administered topically only?
- Clotrimazole
- Miconazole
What drugs are used to treat vulvo-vaginal candidiasis (yeast infection), oral candidiasis, athletes foot, and jock rash?
- Clotrimazole
- Miconazole
What is the 1st line treatment for Aspergillis infections?
-Vorconizole
What drug should never be given with Ketoconozale?
-Amphotericin B
What drug inhibits both DNA and RNA synthesis in fungi?
-Flucytosine
What type of fungal infections do you use flucytosine for?
-Systemic
What drug is synergistic when given in combination with Amphotericin B for cryptococcal meningitis?
-Flucytosine
What is the major adverse effect of flucytosine?
-Bone marrow suppression
What drugs are considered the penicillins of the antifungal drugs?
-Echinocandins
What drugs do you use in azole-resistant Candidia or and a 2nd line agent for refractory Aspergillosis?
-Echinocandins (Caspfungin)
What antifungal drug blocks B-glucan synthase?
-Caspofungin
What antifungal drug disrupts microtubule function, inhibiting fungal mitosis?
-Griseofulvin
What antifungal drug inhibits growth of dermatophytes?
-Griseofulvin
What antifungal drug inhibits the enzyme squalene epoxidase to inhibit ergosterol synthesis?
-Terbinafine
What drug has largely replaced Griseofulvin for treatment of onychomycosis?
-Terbinafine
Do you use topical or systemic antifungals for localized candidiasis in patients with normal immune function?
-Topcial
Do you use topical or systemic antifungals for individuals with disseminated disease and in immunocompromised patients?
-Systemic
What azole drug does not treat aspergillus?
-Fluconazole
