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PHARMA 3.0 > Anti-fungal > Flashcards

Anti-fungal Flashcards

0
Q

Give the property of ampho that makes it insoluble in water

A

Lipid

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1
Q

True or false. Amphotericin B cannot be used for systemic diseases since it is poorly absorbed in the GIT but categorized as systemic antifungal

A

Ampho B

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2
Q

Mde of acrion is that it creates pores in the cell membrane

A

Ampho B

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3
Q

This antifungal drug has the broadest spectrum of action

A

Ampho B

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4
Q

True or false. DOSE must be ADJUST during hepatic and renal impairment

A

No, it cannot be absorbed systematically. Localized in the GIT only.

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5
Q

This is used as part of an initial therapy to decrease fungal burden

A

Ampho B

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6
Q

This causes the toxicity associated with ampho B

A

Some strains bind to human cholesterol

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7
Q

Give examples of condition requiring localized treatment with Ampho B.

A

Bladder wash out. Local infiltration in fungal arthritis, corneal ulcers.

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8
Q

What is the effect of cumulative toxicity in ampho B

A

Renal damage

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9
Q

End point of induction therapy for ampho b

A

1-2g

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10
Q

Cumulative toxicity level of ampho b

A

> 4 g

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11
Q

Adverse effect asso with ampho b is called infusion related toxicity, what should the management be?

A

Symptomatic treatment.

Do premeditation.

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12
Q

A pyrimidine fungal analog.

A

Flucytosine

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13
Q

Narrow spectrum compared to ampho?

A

Flucytosine

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14
Q

Ampho can be used for cryptococcal meng?

A

False. Cannot extensively cross BBB. 2-3%

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15
Q

Can effectively cross BBB thus used for cryptococcal meningitis

A

Flucytosine and FLUCONAZOLE

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16
Q

This antifungal inhibits both RNA and DNA synthesis

A

Flucytosine

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17
Q

What enzyme is needed for 5FC to be taken up by fungal cells

A

Cytosine permease

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18
Q

True or false. Ampho has good synergy with 5FC

A

True- cryp meng

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19
Q

Itraconazole plus 5fc can be used for.

A

Chromoblastomycosis

20
Q

Adverse effect of 5FC

A

Bone marrow depression.

Remember, it has been considered as an antineoplastic nut proven to be not.

21
Q

This antifungal drug is used to inhibit ergosterol synthesis

A

Azoles

22
Q

Through what mechanism can azoles inhibit ergosterol synthesis

A
  • inhibition of fungal cyp450

- demethylation of lanosterol (precursor)

23
Q

Precursor of ergosterol

A

Lanosterol

24
Q

Between azoles, which inhibits cyp450 more, thus more drug interactions

A

IMIDAZOLES

  • KMC
    Keto, Mico, Clotrimazole

Remember, in KMC it takes two people.

25
Q

Give drugs under triazoles

A

IF i were a VP

Itraconazole - chromoblastomycosis with 5FC
Fluconazole
Voriconazole
Posaconazole

26
Q

Azoles and ampho acts on same organisms?

A

True. YEM

Yeast - candida
Endemic mycosis - histoplasma
Molds - aspergillus

27
Q

Common side effect of imidazoles

A

Elevated liver enzymes

28
Q

Oral form of IMIDAZOLE

A

Ketoconazole. Not used anymore, greater propensity for human cyp

29
Q

DOC for aspergillosis

A

Itraconazole or VORICONAZOLE

30
Q

Azole of choice for CRYPTOCOCCAL MENINGITIS

A

FLUCONAZOLE

31
Q

Among azoles, this has the greatest CSF penetration and least cyp activation

A

Fluconazole

32
Q

Both itra and voriconazole have low biavailability, what can be given to increase

A

Cyclodextran

33
Q

Used as salvage therapy for invasive aspergillosis

A

Posaconazole

34
Q

Newest triazole

A

Posaconazole

35
Q

Broadest among azoles and DOC for mucomycosis

A

Posaconazole

36
Q

Inhibts b(1-3) glucan

A

Echinocandins

37
Q

Another salvage therapy for aspergillosis

A

Echinocandins

38
Q

Used as empiritc tx during febrile neutropenia in candida infxn

A

Echinocandins

39
Q

Give mucocutaneous drugs for systemic fungal

A

Griseofulvin - static

terbinafine - cidal

40
Q

Synthetic allylamide. Inhibits ergosterol synthesis via inhibiting squalene epoxidase.

A

Terbinafine

41
Q

More specific on onchomycosis

A

Terbinafine

42
Q

Deposits to newly formed skin and binds to keratin

A

Griseofulvin

43
Q

Which systemic mucocutaneous must be taken with food

A

Griseofulvin

44
Q

This topical antifungal has properties that of ampho b

A

Nystatin

45
Q

Nystatin is time dependent?

A

True, it has litttle absorptio thus requires prolonged exposure.

46
Q

Topical azole for vulvovaginal candidias and oral trush mainly intertriginous

A

Nystatin

47
Q

Used for tinea

A

Clotrimazole and Miconazole

PHARMA 3.0 (7 decks)

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