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review Q's by me > 42: antifungals > Flashcards

42: antifungals Flashcards

1
Q

MoA of polyene antibiotics?

A

bind to ergosterol –> inc. permeabiltiy –> leak content

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2
Q

resistance to polyene antibiotics?

A

reduced ergosterol in membrane

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3
Q

amphotericin B ROA:

A

topical
IV
intrathecal
intraventricular

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4
Q

amphotericin B - available in formulation:

A

lipid formulation

(deoxycholate) - colloid suspension

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5
Q

which polyene is broad spectrum?

A

amphotericin B

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6
Q

what will u use for cryptococcal meningitis ?

A
  1. amphotericin B + flucytosine

2. fluconazole

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7
Q

amphotericin B is indicated for:

A 
histoplasmosis,
cryptoccal mengitis
candida
coccidiodes 
mucormycosis
fusariosis
blastomyces
aspergillus 
mycotic corneal ulcers
keratitis
fungal arthritis
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8
Q

amphotericin B - Adverse effects - infusion related?

A 
fever
chills
muscle spasm
vomiting
headache
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9
Q

amphotericin B - increase dose toxicity causes:

A 
nephrotoxicity
acute liver failure
cardiac arrythmias
anemia
leukopenia
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10
Q

if amphotericin B is given intrathecally it might cause?

A

seizures, chemical arachnoiditis

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11
Q

what is the route of administeration of Amphotericin B for treatment of meningitis?

A

IV

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12
Q

nystatin ROA:

A

topical , oral

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13
Q

which polyene antibiotic can be given orally and topically?

A

nystatin

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14
Q

oral nystatin is used to treat?

A

intestinal candidiasis

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15
Q

natamycin is available as what type of fomulation ?

A

ophthalmic suspension

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16
Q

natamycin is inidcated for? (3)

A

blephritis
conjunctivitis
keratitis

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17
Q

which group of drugs is acting by inhibiting 14 a-demethylase ?

A

azole derivatives

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18
Q

which azole is least likely to inhibit CYP3A4

A

fluconazole

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19
Q

topical antifungals include?

A 
nystatin
clotrimazole
econazole
amphotericin B
ciclopirox
allylamines (naftafine, terbinafine)
tolnaftate
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20
Q

itraconazole ROA?

A

oral

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21
Q

itraconazole formulation

A

capsule, liquid as cyclodextrin

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22
Q

treatment for oncyhomycosis - oral?

A
  1. itraconazole

2. terbinafine

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23
Q

chronic use of which antifungal leads to increased risk of birth defects during 1st trimester?

A

fluconazole

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24
Q

which antifungal best penetrates CSF and is used for fungal menigitis treatment?

A

fluconazole

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25
Q

single of dose of which antifungal can eradicate acute vaginal candidiasis ?

A

fluconazole

26
Q

prophylaxis/treatment of cryptococcal meningitis in AIDS patients we use:

A

fluconazole

27
Q

if patient was treated with amphotericin B and flucytosine for meningitis he should be given, which drug as followup therapy?

A

fluconazole

28
Q

which azoles can be given IV?

A

voriconazole
fluconazole
posaconazole

29
Q

which azoles require gastric acid for absorption and should not be given with gastric acid inhibitors?

A

ketoconazole
itraconazole
posaconazole

30
Q

adverse effects of azoles?

A

gi distress
skin rash
hepatotoxicity
hematologic toxicity

31
Q

which antifungal is 60-100 times better than fluconazole at treatment of candidiasis?

A

voriconazole

32
Q

which antifungal has greater fungicidal activity then amphotericin B against invasive aspergillosis?

A

voriconazole

33
Q

adverse effect of voriconazole

A 
visual disturbance (altered light preception, abnormally colored vision, photophobia)
hepatic failure
34
Q

what is used for treatment of seborrheic dermatidis?

A

ketoconazole

35
Q

for topical oncyhomycosis?

A

efinaconazole

36
Q

clortimazole is used for?

A

topical for:

  1. mucocutaneous candida - mouth, throat, vagina. vulva
  2. mallasezia furfur - tinear versicolor
  3. dermatophyte tinea pedis
37
Q

posaconazole indication?

A

rhizopus , mucor

fusarium, aspergillus

38
Q

which antifungal acts by inhibiting squalene epoxidase?

A

allylamine drugs

39
Q

which allylamine is available oral and topical?

A

terbinafine

40
Q

side effects of terbinafine?

A 
steven johnson syndrome
toxic epidermal necrolysis
liver failure
SLE exacerbation
neutropenia
lymphopenia
41
Q

terbinafine indication?

A

oral: oncyhomycosis
topical: superficial dermatophyte infection

42
Q

echinocandin drugs: MOA

A

inhibit 1,3 B glucan –>inhibit cell wall synthesis

43
Q

casponfungin ROA

44
Q

micafungin indication

A

prophylaxis/treatment of systemic candidal/ invasive aspergillus

45
Q

which antifungal is a pyrimidine antimetabolite?

A

flucytosine

46
Q

flucytosine ROA

47
Q

5-fluorouracil is an active form of which drug?

A

flucytosine

48
Q

cardiopulmonary arrest is an adverse effect of which antifungal?

A

flucytosine

49
Q

flucytosine is used in combo with amphotericin B for treatment of: (4 clinical indications)

A
  1. pneumonia
  2. septicemia
  3. meningitis
  4. endocarditis
    - -> by candida, cryptococcus
50
Q

which antifungal is highly lipophilic ?

A

griseofulvin

51
Q

griseofulvin MOA:

A

deposits in precursors of keratin cells of skin, hair, nails –> inhibit microtubule formation –> inihibition of mitosis of dermatophytes (it is fungistatic)

52
Q

grisofulvin ROA:

53
Q

griseofulvin acitve against:

A

dermatophyte (epidermophyton, trichophyton, microsporum)

54
Q

adverse effects of griseofulvin?

A
  1. dizziness
  2. headache
  3. insomnia
  4. GI bleeding
  5. hepatitis
  6. skin rash
  7. leukopenia
55
Q

does griseofulvin inhibit CYP3A4?

56
Q

does caspofungin inhibit CYP3A4?

57
Q

ciclopirox ROA?

58
Q

nail lacquer solutions available for fungal nail infections?

A

ciclopirox, amorolfine

59
Q

which antifungal is a nonprescription thiocarbamate drug?

A

tolnaftate

60
Q

interesting fact: clotrimazole is used for treatment of tinea versicolor (googled it)

A

keep in mind: clotrimazole is used for treatment of tinea versicolor (googled it)

61
Q

microtubule formation is associated with MOA of which drug?

A

griseofulvin ;)

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