Anti-Eukaryote Therapies ✅

Question 1

Why are some anti-fungals limited to topical application?

Answer 1

Due to their toxicity

Question 2

What are the classes of anti-fungal agents?

Answer 2

• Polyenes
• Azoles
• Echinocandins

Question 3

Give 2 examples of polyenes?

Answer 3

• Nystatin

- Amphotericin B

Question 4

What is the mechanism of action of polyenes?

Answer 4

They bind to ergosterol in the fungal cell wall, causing lysis of the cell membrane and cell death

Question 5

Are polyenes specifically toxic to fungi?

Answer 5

Some are toxic only to fungi, but others also cause toxicity in the host

Question 6

Give a polyene which can cause toxicity in the host?

Answer 6

Amphotericin

Question 7

How does amphotericin cause toxicity in the host?

Answer 7

It binds to cholesterol in the kidneys causing nephrotoxicity

Question 8

How are the nephrotoxic effects of amphotericin reduced?

Answer 8

Lipid preparations

Question 9

Are polyenes broad or narrow spectrum?

Answer 9

Broad

Question 10

Give 3 examples of azoles

Answer 10

• Fluconazole
• Itraconazole
• Voriconazole

Question 11

What is the mechanism of action of azoles?

Answer 11

Block the synthesis of ergosterol, leading to fungal cell wall dysfunction

Question 12

What is fluconazole used to treat?

Answer 12

Candida infections

Question 13

What is voriconazole used to treat?

Answer 13

Conditions where activity against Aspergillus is required

Question 14

Give 2 examples of echinocandins?

Answer 14

• Caspofungin

- Micafungin

Question 15

What is the mechanism of action of echinocandins?

Answer 15

They inhibit an enzyme responsible for beta-glucan synthesis and prevent fungal wall synthesis, leading to cell death

Question 16

What organisms are echinocandins active against?

Answer 16

• Candida

- Aspergillus

Question 17

Are anti-fungal agents fungistatic or fungicidal?

Answer 17

Can be either

Question 18

Give an example of a anti-fungal that varies if it is fungostatic or fungicidal depending on the organism

Answer 18

Voriconazole is fungicidal against Aspergillus, but fungostatic against Candida

Question 19

What is the problem with the treatment of helminth infections?

Answer 19

Effective agents with anti-helminth activity are limited

Question 20

Give 3 anti-helminth agents

Answer 20

• Mebendazole
• Albenazole
• Praziquantel

Question 21

What is mebendazole used to treat?

Answer 21

Intestinal nematodes

Question 22

What effect does mebendazole have on intestinal nematodes?

Answer 22

Causes immobilisation and death

Question 23

Why is mebendazole only used for intestinal nematodes?

Answer 23

It is poorly absorbed so can only act locally

Question 24

What is the difference between mebendazole and albenazole?

Answer 24

Albenazole is better absorbed

Question 25

What is albenazole used to treat?

Answer 25

Blood and tissue nematodes

Question 26

What is praziquantel used to treat?

Answer 26

• Cestodes

- Trematodes

Question 27

What limits the use of anti-protozoal agents?

Answer 27

Geographical resistance

Question 28

How is geographical resistance to anti-malarial agents managed?

Answer 28

Knowledge of malaria species and travel destination are essential for appropriate prescribing