Anti-fungal Agents Flashcards
What antifungals are used in subcutaneous and systemic mycotic infections?
- Polyenes: Amphotericin B
- Antimetabolite antifungal: Flucytosine
- Echinocandins: Caspofungin
- Azole: triazoles
What antifungals are used in cutaneous mycotic infections?
- Polyenes: Nyastatin
- Squalene epoxidase inhibitors: Terbinafine
- Azole: Imidazoles
How does polyenes work?
Bind to ergosterol on fungi cell wall and create pores, leading to leakage of intracellular materials
Amphotericin B iso coformulated with
Deoxycholate (liposomal prep)
Does Amphotericin B have good CSF pebetration?
No
Clearance of Amphotericin B
Renal
ADR of Amphotericin B
- Fever and chills
- Nephrotoxicity- hydrate adequately
- Electrolyte imbalances, hypotension
- Thrombophlebitis - add heparin
- BM suppression
MOA of echinocandins
Inhibit activity of glucan synthase complex, loss of cell wall integrity
Name 2 echinocandins
- Micafungin
- Anidulafungin
Administration of echinocandins
Parental
Azoles MOA
Inihibit C14 alpha demethylase, blocking demethylation of lanosterol to ergosterol
ergosterol biosynthesis inhibition disrupts membrane function and structure, inhibit growth
Name 3 triazoles
- Fluconazole
- Posaconazole
- Itraconazole
- Voriconazole
CI Azoles
DDI - INHIBIT CYP450 3A4
- preg
Name 2 imidazole
- Clotrimazole
- Miconazole
Is nystatin topical or systemic
Topical
What can be used for oropharyngeal candidiasis?
Nystatin (thrust)
MOA terbinafine
Inhibit squalene epoxidase inhibitor, blocking squalene conversion to lansterol
What can be used against trichophyton?
Terbinafine
