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Respiratory Medicine > Anti fungal drugs > Flashcards

Anti fungal drugs Flashcards

1
Q

Later toxicity of Amphotericin B Deoxycholate

A

Nephrotoxicity

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2
Q

what is the MOA of echinocandins?

A

inhibition of fungal cell wall synthesis

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3
Q

Drug of choice for cryptococcal meningitis

A

Amphotericin B

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4
Q

Side effects of ketoconazole?

A
  • Gynexomastia

- decrease libido

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5
Q

Tiazole that clearance is altered by genetics

A

Voriconazole

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6
Q

Triazoles and pregnancy?

A

Avoid All

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7
Q

Synergism of nephrotoxicity of Amphotericin B with Trasplant and allograft patients

A
  • Cyclosporin
  • Sirolimus
  • Tacrolimus
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8
Q

Azole of choice for Histo, cocci, and blasto

A

itraconazole

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9
Q

What therapy has been found to be associated with Histoplasmosis

A

anti-TNFalpha therapy

  • infliximab
  • Etanercept
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10
Q

What enzyme to echinocandins inhibit?

A

beta-(1,3) glucan synthase

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11
Q

mechanism of action of the Azoles

A

-inhibit Lanosterol to Ergosterol biosynthetic pathway

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12
Q

What 2 azoles have good CSF access?

A

Fluconazole and Voriconazole

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13
Q

What azole has strong cyp450 inhibition and therefore interacts with other drugs?

A

itraconazole and voriconazole

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14
Q

What is given with amphotericin B to treat cryptococcal meningitis

A

5-FC (5-Fluorocytosine anti metabolite)

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15
Q

What enzyme is inhibited by Azoles

A

14-alpha-demethylase (Cytochrome p450)

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16
Q

Fluconazole is narrow spectrum in that it only targets what?

No activity against what?

A
  • Candida Albicans
  • also Cryptococcous

No activitiy vs Aspergillus

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17
Q

What is the third line Azole that comes in pill form

A

Ketoconazole

18
Q

Drug of choice for mucormycosis

A

Amphotericin B

19
Q

Toxicity of amphotericin B deoxycholate upon onset of infusion

A
  • chills
  • fever
  • anemia
  • hypotension
20
Q

Therapeutic indications for echinocandins?

A

serious opportunistic infections such as

  • invasive candidiasis, candidemia
  • invasive Aspirgillosis

especially if refractory to other therapies

21
Q

mechanism of action for polyenes (amphotericin B)

A

associates with ergosterol and creates pores

22
Q

What would you give an AIDS patients with oropharyngeal candidiasis who had failed to recover on fluconazole, amphotericin B, and itraconazole

A

Caspofungin

23
Q

Azoles create a surplus of what?

A

Lanosterol

24
Q

What does 5-FC do?

uses what fungal enzyme that humans don’t have?

A

uses cytosine deaminase to ultimately inhibit DNA synthesis by blocking thymidylate synthase and also inhibits proteins synthesis

25
Q

Mechanisms of resistance to Azoles

A
  • mutation or overexpression of lanosterol 14alpha demethylase
  • efflux
  • changes in sterol and/or phospholipid composition
26
Q

Azole for cryptococcus

A

fluconazole

27
Q

Triazoles and liver damage

A

All can

28
Q

is Caspofungin effective against pathogenic fungal infections such as histo, cocci, and fusarium

A

NO

29
Q

Synergism of nephrotoxicity of Amphotericin B with gram - and MRSA infections

A
  • aminoglycosides

- vancomycin

30
Q

mechanism of resistance to 5-FC

A
  • mutated cytosine permease

- mutated cytosine deaminase

31
Q

What azoles have good bioavailibility

A

Fluconazole and voriconazole

32
Q

Synergism of nephrotoxicity of Amphotericin B with HIV patients

A
  • Foscarnet

- Pentamidine

33
Q

Triazole that disturbs vision

A

Voriconazole

34
Q

There is a way for 5-FC to still work and get into the fungal cells even if there is a mutation in cytosine permease . . explain this

A

can go through the pores that are created by amphitericin B

35
Q

Describe the effects of Amphotericin B on the kidney

A

Direct damage to DISTAL TUBULE membrane leading to Na, K, and Mg wasting and the hyponatremia leads decreased GFR and Arteriole constriction

36
Q

drug to use for Candiduria

A

Fluconazole . . . (renal excretion and high bioavailibility)

37
Q

What azole is cleared renally

A

fluconazole

38
Q

What is the Broad spectrum Azole

A

Itraconazole

39
Q

What is the echinocandin fungal drug?

A

Caspifungin

40
Q

Azole used for Aspergillus

A

voriconazole

Respiratory Medicine (37 decks)

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