Anti-Fungal Agents

Question 1

Name the agents that are used topically

Answer 1

polyene Ab–nystatin, amphotercin B, natamycin
ringworm–tolnaftate, ciclopirox, terbinafine
candida & ringworm–miconazole

Question 2

polyene Ab

Answer 2

used topically for fungal inf
bind ergosterol and form pores causing membrane leakage

nystatin (toxic if used parenternally)
amphotericin B
natamycin (eye)

Question 3

ringworm treatment

Answer 3

“worm told tate the sick ox would be fine”

tolnaftate, ciclopirox, terbinafine

Question 4

treatment for candida and ringworm

Answer 4

miconazole & other conazoles

Question 5

Agents that act systemically to treat fungal skin infections

Answer 5

griseofulvin & terbinafine

Question 6

griseofulvin

Answer 6

treats nail infections
concentrated in keratin
binds to microtubules and inhibits fungal mitosis
from penicillin–allergic rxn

Question 7

terbinafine

Answer 7

inhibits ergosterol synthesis by INHIBITING AN ENZYME

Question 8

amphotericin B

Answer 8

DOC for systemic mycotic infections
causes pore formation, fungicidal
SE: lots of them, toxic to the liver, fever, vomiting

Question 9

Imidazoles–ketoconazole

Answer 9

treats systemic mycotic infections
inhibits fungal p450
decreases cortisol and testosterone (can treat cushiness and prostate cancer)

Question 10

triazole

Answer 10

treats systemic mycotic infections
fungistatic
fluconazole, itraconazole (strongest on p450), posaconazole, voriconazole

Question 11

flucytosine

Answer 11

pyrimidine analog
inhibits thymidine synthesis in fungi 
prodrug--doesnt enter mammalian cells as readily
inhibits enzyme
SE: liver toxicity

Question 12

echinocandins

Answer 12

treats systemic mycotic infections
“FUNGIN”
caspofungin, micafungin, anidulafungin

fungicidal
inhibits synthesis of fungal cell wall component
not orally absorbed