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anti-fungal drugs Flashcards

1. List the prototype drugs used to treat systemic, mucocutaneous, and topical fungal infections, describe their mechanism of action, list their clinical uses, and list their significant side effects.

1
Q

MOA of flucyosine

A

inhibits fungal nucleic acid by interfereing with fungal thymidylate

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2
Q

MOA of griseofulvin

A

inhibits mitosis by binding to tubilin

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3
Q

Polyenes MOA

A

destabylizes fungal membrane

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4
Q

drugs that inhibit squalene expoxidase

A

allyl- and benzyl-amines

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5
Q

drugs that inhibit 14 alpha demethylase

A

Tri-, imid-azoles

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6
Q

MOA of echinocandins

A

inhibits cell wall synthesis

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7
Q

can cause bone marrow suppression

A

flucytosine

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8
Q

use of flucytosine

A

used with Ampotercin B to treat systemic candida and cyptococcal infections

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9
Q

accumultes in keratin precursor cells

A

griseofulvin,

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10
Q

use of griseofulvin

A

syperficial mycoses

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11
Q

must be used for 6 months to a year

A

griseofulvin

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12
Q

SE of griseofulvin

A

headache, hepatic enzyme induction , and disulfrim reactions

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13
Q

MOA of terbinafine and butenafine

A

prevent formation of lanosterol by squalene epoxidase inhibition, and produce accumulation of toxic squalene metabolite

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14
Q

accumulates in hair, skin and nails

A

terbinafine

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15
Q

cures most nail mycoses

A

terbinafine

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16
Q

SE of terbinafine

A

GI upset, headache, rare hepatic toxicity

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17
Q

300 hr half life drug

A

terbinafine

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18
Q

use of butenafine

A

superficial mycoses

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19
Q

-azole MOA

A

inhibit 14a demathylase, decreasing ergosterol formation and increasing accumulation of toxic 14a-methyl sterole

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20
Q

inhibits hepatic P450 and can cause drug interactiions

A

-azole

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21
Q

broad spectrum fungistatic at low doses, fungicidal at high doses

22
Q

SE of ketoconazole

A

inhibiton of P450 n/v, endocrine abnormalities

23
Q

DOC for systemic blastomyces, sporothix, and SQ chromoblastomycosis

A

itraconazole

24
Q

azoles that do not cross the BBB

A

intra, keto,

25
Q

azoles that DO cross BBB

26
Q

used as a single dose for vaginal candida

A

fluconazole

27
Q

absorption not effected by gastric pH

A

fluconazole

28
Q

used for phrolylaxis of crytococcal meningitis

A

fluconazole

29
Q

DOC for esophgeal and oropharyngel candidasis

A

fluconazole

30
Q

only azole used for mucormycosis

A

posaconazole

31
Q

DOC for invasic aspergillosis

A

vericonazole

32
Q

can cause visual disturbances

A

vericonazole

33
Q

inhibits CYP3A4

A

posaconazole

34
Q

form of posacanzole

35
Q

broadest spectrum -azole

A

posaconazole

36
Q

topical OTC -azoles with significant systemic toxicity

A

clotrimazole and miconazole

37
Q

DOC for serious systemic mycosis

A

amphotericin

38
Q

MOA of amhpotericin B

A

binds to fungal erosterol to form a pore, distrupting membrane stability

39
Q

reason amphotericin B has low toxicity

A

affinity is 500 times higher for fungal erosterol than human

40
Q

does amphotercin B cross the BBB?

41
Q

way amphocerterin must be administered

A

IV (highly insolulabe)

42
Q

dose related SE of amphotericin

A

kidney damage, anemia

43
Q

infusion related SE of amphotericin

A

fever, chills, muscle spasma, vomiting, hypotension

44
Q

way to treat infusion related SE of amphotericin

A

infuse slowly or pretreat with antihistamines

45
Q

formulation of ampotericin B that reduces toxity

A

lipid formulation

46
Q

MOA of echinocandins

A

target fungal cell wall sythesis

47
Q

caspofungin class

A

echinocandins

48
Q

use of caspofungin

A

IV for esophageal candiadis and spergillus

49
Q

used IV for esiphageal and invasive candidias

A

anidulafungin

50
Q

used Iv for mucocutaneous candidiadsis and prophalyxis for candida in BM transplant pts

A

micofungin

51
Q

can produce histamine release and flushing

A

micofungin and echinocandins

GI (22 decks)

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