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VET413 Infectious + Immunology > 51 Pharm Antivirals + Antifungals > Flashcards

51 Pharm Antivirals + Antifungals Flashcards

1
Q

What is the difference between fungistatic and fungicidal?

A

Fungistatic - inhibits growth
Fungicidal - kills

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2
Q

What is an important principle regarding duration of fungal treatment?

A

Treatment must be of sufficient duration because many drugs are fungistatic and fungi grow slowly

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3
Q

Why does antifungal treatment often cause signs to worsten before they get better?

A

Inflammation

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4
Q

What part of fungi do antifungals usually target?

A

Cell membrane or cell wall

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5
Q

What kind of case would you prescribe Amphotericin B for?

A

Severe systemic fungal infections

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6
Q

Amphotericin B is (fungistatic/fungicidal).

A

Fungicidal

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7
Q

What is the MOA of amphotericin B?

A

Binds ergosterol, causes rapid K+ efflux (and other cations), inhibits fungal glycolysis, causes oxidative damage

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8
Q

T or F: amphotericin B can be administered orally or IV.

A

F; poor oral bioavailability so IV

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9
Q

What kind of toxicity should you worry about when using Amphotericin B?

A

Nephrotoxicity (dose dependent)

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10
Q

(Imidazoles/triazoles) have a greater effect on mammalian cholesterol synthesis.

A

Imidazoles

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11
Q

What is the MOA of azole antifungals?

A

Inhibits ergosterol synthesis causing accumulation of toxic methylated sterols in the plasma membrane; alters membrane fluidity and barrier function.

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12
Q

Azole antifungals are (fungistatic/fungicidal).

A

Fungistatic

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13
Q

What negative effects can azoles have on the patient?

A

Inhibition of mammalian CYP450; hepatotoxicity

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14
Q

When in the day should ketoconazole be administered and why?

A

After a meal because it is only soluble in acidic environments

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15
Q

What are the clinical indications for ketoconazole?

A

Superficial yeast infections, dimorphic fungi, or dermatophytosis

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16
Q

What are some toxic/adverse effects of ketoconazole?

A

-Nausea, anorexia, vomiting
-Increase in hepatic enzymes not associated w/ injury
-Hepatic disease or failure
-Inhibition of mammalian CYP450
-Inhibits cortisol and testosterone synthesis

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17
Q

T or F: fluconazole is effective against yeast, molds, and dimorphic fungi.

A

F; not effective againt molds

18
Q

How is ketoconazole eliminated?

A

Hepatic metabolism

19
Q

How is fluconazole eliminated?

A

Renal excretion

20
Q

What is itraconazole effective against?

A

All significant fungi including molds

21
Q

What kind of toxicity can fluconazole cause?

A

Rare hepatic toxicity

22
Q

What are potential adverse effects of itraconazole?

A

Vomiting (esp cats), hepatotoxicity, cutaneous vasculitis

23
Q

What is voriconazole effective against?

A

Molds

24
Q

What drug is analagous to itraconazole?

A

Posaconazole

25
Q

T or F: flucytosine is toxic to cats.

A

F; toxic to dogs

26
Q

What is flucytosine effective against?

A

Candida and cryptococcus

27
Q

What adverse effects can flucytosine have?

A

Bone marrow suppression, nausea, vomiting, diarrhea, cutaneous eruptions in dogs

28
Q

What is griseofulvin used to treat?

A

Dermatophytosis

29
Q

What is the MOA of griseofulvin?

A

Binds microtubules of mitotic spindle to inhibit fungal mitosis

30
Q

What are some toxic effects of griseofulvin?

A

Idiosyncratic toxicity in cats; teratogenic during early gestation in mares

31
Q

What are common topical antifungals?

A

Clotrimazole (otomax), enilconazole, miconazole

32
Q

What would you use caspofungin for?

A

Treat systemic aspergillosis or candidiasis

33
Q

What is the MOA of caspofungin?

A

Inhibition of glucan synthesis; disruption of cell wall

34
Q

Why is it difficult to make selective antiviral agents?

A

Viruses are obligate intracellular parasites that use host cell machinery, have variable life cycles, and can become resistant. Plus screening is tested in vitro and not all viruses will grow in vitro

35
Q

What are acyclovir and valacyclovir used to treat?

A

Herpesvirus

36
Q

What is the MOA of acyclovir and valacyclovir?

A

Targets replication by inhibiting DNA polymerase

37
Q

What domestic species is valacyclovir toxic to?

A

Cats

38
Q

What is the MOA of penciclovir and famciclovir?

A

Inhibits DNA polymerase and is a substitute for guanosine

39
Q

What are idoxuridine/trifluridine used to treat?

A

FHV-1

40
Q

What is the MOA of idoxuridine/trifluridine?

A

Interrupts DNA polymerase; substitute for thymidine

41
Q

How is idoxurine administered and why?

A

Topical and ophthalmic because it can cause toxic neoplastic changes, genetic mutations, or infertility

VET413 Infectious + Immunology (26 decks)

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