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Pharm > Anti-fungals > Flashcards

Anti-fungals Flashcards

1
Q

Can you treat a fungal infection with an antibiotic?

A

No

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2
Q

what is the 4th cause of septicemia?

A

fungal infections (typically in immunosupressed patients)

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3
Q

WHat are the three groups of fungi?

A

Molds
True yeast
yeast-like fungi

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4
Q

what is a systemic infection with a mold?

A

Disseminated aspergillosis

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5
Q

what is the most “drying” of a prep? what is the least?

A

Gel is most (best for hairy areas)

Ointment is least

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6
Q

should powders be the only treatment of a fungal infection?

A

No, should be for additive (prevention)

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7
Q

how long are treatments for antifungals?

A

Weeks to months

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8
Q

What are three main antifungals?

A

Polyene Antibiotics
Imidazole antifungals
Triazole antifungals

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9
Q

What are 4 polyene antibiotics?

A

Amphotericin B
Nystatin
Flucytosine
Griseofulvin

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10
Q

What is the MOA of polyene antibiotics?

A

Bind to ergosterol in fungal cell membranes are form pore –> leak “-cidal”

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11
Q

is resistance a problem in antifungals?

A

Not as much as with antibiotics

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12
Q

what forms is amphotericin B available in? what form is less toxic?

A

IV

Liposomal preps are less toxic

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13
Q

What is the route for Nystatin ?

A

Cream, vaginal troches, suspension to oral mucosa

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14
Q

What Polyene would you use for severe systemic fungal infections?

A

Amphotericin B

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15
Q

What is nystatin mainly used to suppress?

A

Candidiasis on the skin and mouth

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16
Q

What are ADRs of amphoB?

A

hypotension
anemia (reversible)
nephrotoxicity (liposomal lessens this)
thrombophelbitis

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17
Q

What are ADRs of nystatin

A

N/V/D especially if swallowed

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18
Q

What is flucytosine used for?

A

Sytemic candidiasis
Cryptococcus meningitis
in combo w/ AmphoB

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19
Q

How is flucytosine administered?

A

Oral

has bad side effects of N/V

20
Q

What type antifungal is griseofulvin?

A

“-static_

21
Q

Where does griseofulvin concentrate?

A

Nails

22
Q

Who can you use griseofulvin for?

A

Children

23
Q

WHat is the drug of choice for nail fungal infections?

A

Terbinafine

24
Q

What is a concern with griseofulvin?

A

P450 inducer (barbiturates, warfarin, oral contraceptives)
increase absorption with high fat meal (more side effects)
potentiates effects of alcohol

25
Q

What is a broad spectrum antifungal that doesn’t cover aspergillus?

A

Ketoconazole

can see -cidial activity with higher doses

26
Q

Are most fungal medications “static” or “cidial”

A

static

27
Q

What can ketoconazole decrease in terms of steroid levels?

A

Decreased testosterone and cortisol production

28
Q

how is ketoconzaole administered? What does it require to be dissolved?

A

PO

gastric acid for dissolution

29
Q

Does ketoconazole enter teh CSF?

A

NO

30
Q

Is ketoconazole teratogenic?

A

Yes because of endocrine effects

31
Q

Ketoconzaole is an inhibitor of what?

A

P450

32
Q

Do ketoconazole or amphoB have more restiatnce?

A

ketoconazole

33
Q

What are 2 drugs that are only topical but are similar to ketoconazole?

A

Clotrimazole

Miconazole

34
Q

Topical miconazole is a potent inhibitor of what?

A

Warfarin metabolism

35
Q

What is a benefit of fluconazole?

A

Lacks endocrine side effects as seen with ketoconazole

can penetrate CSF

36
Q

What is fluconazole a DOC for?

A

cryptococcus neoformans
candidemia
Coccidiodomycosis
Mucocutaneous candidasis

37
Q

What is fluconazole a inhibitor of?

A

CYP3A4

CYP2C9

38
Q

Can fluconazole be administered to a preggo patient?

A

No, it is a teratogen

39
Q

What is a benefit of itraconazole

A

Cover aspergillis

no endocrine side effects

40
Q

What is a concernign side effect of itaconazole?

A

hypokalemia

41
Q

What is a “bigger gun” that is used for aspergillosis and serious infections?

A

Voriconazole

42
Q

What is a big ADR of voriconazole?

A

Visual disturbances

43
Q

What is an antifungal that isn’t avaliable as a tablet. Has aspergillis. More sucessful in immunocomprimised patients.

A

Posaconazole

44
Q

What is a “-cidial” anti fungal that is sipophilic- so it penetrates superficial tissues well. first line agent for nail infections.

A

Terbinafine (Lamisil)

45
Q

What is the main ADR you should monitor for terbenafine?

A

LFT’s and CBC

has had steven johnson rash

46
Q

What is a second line therapy for those who have failed amphoB or itraconazole? Limited to aspergillus and candida species.

A

Caspofungin

47
Q

What is used for esophageal candidiasis and prophylaxis for those undergoing stem cell transplant?

A

Micfungin

Pharm (29 decks)

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