Anti-Fungal Medications

Question 1

Amphoteracin B: Mechanism

Answer 1

Binds to Ergosterol and forms channels through fungal cell membranes

Question 2

Amphoteracin B:
Route of Elimination
Toxicities

Answer 2

Elimination: Hepatic and Renal

Tox: Nephrotoxicity
attenuated by lipo forms

Question 3

AmphoB:
Spectrum
Clinical Uses

Answer 3

Spectrum: Broad
Yeast and Filamentous Fungi

Clincal uses: hospital Setting Only

• Zygomycosis
• Aspergillosis ( vs Voraconazole)
• Cryptococcus - in addition to 5fc

Question 4

Nystatin
Mechanism
Clinical uses

Answer 4

Binds to Ergosterol

Topical Application: oral, cutaneous and vaginal thrush

Question 5

Azoles

• Mechanism
• Route of Elimination
• Toxicity
• Spectrum

Answer 5

Mechanism: Inhibition of Lanosterol C14 Demethylase; thereby preventing Ergosterol synthesis

Elimination: Hepatic

Toxicity: Hepatic

Spectrum: Yeasts

Question 6

Clotrimazole

- clinical uses

Answer 6

Topical

Clinical use: oral, cutaenous and vaginal.
Eg Tinea Pedis

Question 7

Fluconazole

• clinical uses
• Elimination

Answer 7

• Clinical uses: MucoQ Candidiasis

- Elim: mostly renal, some hepatic

Question 8

Itraconazole

• Spectrum
• Clinical uses

Answer 8

Spectrum - Yeast and Filamentous fungi

Clincal Uses: the pathogenic mycoces
- Histo, cocci, blasto

Question 9

Voriconazole:

• Spectrum
• clinical uses

Answer 9

Spectrum: Yeast and Filamentous

Clinical - first approach aspergillus (if liver is healthy); if unhealthy liver, use AmpB

Question 10

Echinocandins:
mechanisms
Elimination:
Spectrum/Clinical Use

Answer 10

Mechanism: Inhibits Cell wall Synthesis (1,3, Beta Glucan formation)

Elimination: Hepatic

Target: Deeply Invasive Candida, Aspergillus

Question 11

5-fluorocytosine

• Mechanism
• Elimination
• Toxicity
• Spectrum/Clinical Use

Answer 11

Mechanism: Inhibits thymidylate synthase and synthesis of DNA and RNA (originally used as chemotherapy)

Elim: Renal

Toxicity: Myelosuppression

Spectrum/Use: Yeasts;
Cryptococcus = Ampho B + 5Fc