Anrifungals

Question 1

Griseofulvin

Answer 1

Inhibits microtubules by binding to TUBLIN protein

Question 2

Flucytosine

Answer 2

Converted to 5-FU —> inhibits DNA replication and transcription

Question 3

ECHINOCANDINS — Micafungin , caspofungin

Answer 3

Inhibit beta (1, 3) GLUCAN SYNTHASE ( essential for cell wall synthesis) . decrease cw resistance to osmotic forces

Question 4

TERBINAFINE

Answer 4

Inhibit SQUALENE EPOXIDASE ( Dec erogosterol synthesis )
cell membrane stability decrease

Question 5

AZOLES

Answer 5

Inhibit CYP450 14 -ALPHA DEMYTHLASE ( Dec ergosterol from lanosterol)

Question 6

TRIAZOLES — very powerful

Answer 6

Voriconazole
ITRA
ISAVU
POSA
FLU

Question 7

IMIDAZOLES

Answer 7

Micaonazole
Clotrimazole
Ketoconazole

Question 8

POLYENES. Amphoteric B
NYSTATIN

Answer 8

2 surfaces - 1 hydrophilic and 1 hydrophobic——> makes pore channels in cmemb.
Electrolyte imbalances — > cell lysis

Question 9

Aspergillosis

Answer 9

VORICONAZOLE (Tx)
Isavuconazole
Echinocandins
Amohotericin

Question 10

Cryptococcus pneumonia/ meningitis

Answer 10

1st 2 weeks —-> Amphotericin B + Flucytosine
After —–> Flucanozole

Question 11

Blasto/Histoplasmosi/ coccidomycosis

Answer 11

ITRACONAZOLE
Fluconazole
Amphtericin B ,—refractory

Question 12

Mucormycosis—– rhinocerebral sinusitis

Answer 12

ISAVUCINAZOLE +debridement
Amphotericin B

Question 13

Tinea versicolor

Answer 13

Ketconazole/ micanozole. Topical

Question 14

Onchomycosis

Answer 14

Terbinafine

Question 15

Amphotericin

Answer 15

NEPHRITOXIC—-RFT
PHLEBITIS
BM SUPRESSIOM - ANEMIA
K+/Mg2+ decrease— torsade de pointe

Question 16

Terbinafine

Answer 16

Hepatotoxic —-LFTs
Dysguesia – loss of taste

Question 17

Echinicandins

Answer 17

Hepatoxic
Flushing type of reaction

Question 18

Azoles

Answer 18

Hepatoxic
Inhibit of drug metabolism ( warfarin– Inc conc of drug — Inc bleeding risk)
Gynaecomastia and ADRENAL insufficiency( cortisol and aldosterone) –‐—-> ketaconazole
Torsade de points ( low K+ –> Inc QT interval)
Visual dysfunction—–Voriconazole

Question 19

Griseofulvin —-cyp450 inducer

Answer 19

TERATOGENIC
Hepatoxic
Dec drug efficacy

Question 20

Flucytosine

Answer 20

TERATOGENIC
BM suppress–*pancytopenia(

Question 21

Candidiasis oropharyngeal / intertrigous area

Answer 21

Nystatin (swish and swallow )
Clotrimazole lozenges

Question 22

Cand - esophageal

Answer 22

Flu/ itraconazole

Question 23

Cand - vulvovagina

Answer 23

Mica/Clotrimazole topical
Flucanozole po
Flucytosine

Question 24

Cand – systemic ( endocarditis , uti, ocular)

Answer 24

Echinocandins
Fluconazole po
Amphotericin B

Question 25

Cand – systemic ( endocarditis , uti, ocular)

Answer 25

Echinocandins
Fluconazole po
Amphotericin B