Anti-Fungal

Question 1

Ergosterol Pathway

Answer 1

acetyl coa–>Squalene–>Lanosterol—>Ergosterol(FungalMem)

-allylamines azoles polyenes

Question 2

Flucytosine

Answer 2

Nucleic Acid Synth Inhibitor

• only gets transported into fungal cells
• —>inhibits thymidine sythase
• fungistatic
• Used in combo with Flucytosine and Amphotercin B
• Treats 1) SYSTEMIC CANDIDIASIS
  2) Cryptococcus neoformans
  3) Aspergillis

Adverse:Bone marrow suppression

Question 3

Griseofulvin

Answer 3

Mitosis Inhibitor
Fungistatic
Use:Scalp ringworm
-NEW GROWTH OF SKIN HAIR or NAILS is FUNGUS FREE
—>takes 2-6 wks to know if treatment was functional

-mostly replaced by allylamines and azoles

Adverse: Heaches are common, photosensitivity

Question 4

Terbafine

Answer 4

Squalene Epoxidase inhibitor
—->fungus cant convert squalene to lanosterol
FUNGICIDAL
Use:Topical=Ringworm
Oral-Onychomycosis(Toe/Fingernail Fungus)
——>takes 12 wks

Adverse:Inhibits CYP2D6, dysgeusia, hepatotoxicity

Question 5

Fluconazole(AZOLES)

Answer 5

14@Sterol Demethylase Inhibitor
—-> Blocks conversion from Lanosterol to Ergosterol
—–>Destabilized membrane
FUNGISTATIC

CHECK SUSCEPTIBILITY
ALL WORK AGAINST CANDIDA yeast

Single dose can treat vaginal yeast infection

Adverse: GI upset
NUMEROUS INTERACTIONS due to human CYPs–>TOXICITY results

Question 6

Amphotericin B

Answer 6

INHIBIT MEMB STABILITY, pores in membrane
-binds to Ergosterol directly–>destabilizes the membrane
FUNGISTATIC OR FUNGICIDAL
GIVEN IV

little to no resistance

USE: Life threatening mycoses including cryptococcal meningitis
——–> reduce fungal burden then switch to Azole for longterm therapy

Adverse:Cytokine Storm–fever, hypotension

Question 7

Caspofungin

Answer 7

CELL WALL SYNTH inhibitor(non-comp)

FUNGICIDAL