ANTI-FUNGALS Flashcards
Study of fungi
Mycology
TOPICALS: FATTY ACIDS
Natural antifungal agent that is part
of the innate immune system
Sebum
TOPICALS: FATTY ACIDS
0.1% fungicidal, present in sweat
Propionic Acid
TOPICALS: FATTY ACIDS
Fungicide on adhesive tapes
Zinc Proprionate
TOPICALS: FATTY ACIDS
Cream-colored granules for superficial dermatomycoses
Sodium caprylate
TOPICALS: FATTY ACIDS
Fine white powder fungicide that is unstable in moisture
Zinc caprylate
TOPICALS: FATTY ACIDS
From the destructive distillation of castor oil (tangan-tangan; ricinoleic acid)
Undecylenic Acid
(10-undecenoic acid, Decenex, Cruex)
TOPICALS: FATTY ACIDS
Glyceryl Triacetate
Enzactin, Fungacetin
Triacetin
TOPICALS: FATTY ACIDS
Only antifungal that cannot penetrate the skin
Benzoic Acid
TOPICALS: FATTY ACIDS
Properties of salicylic acid and resorcinol
- Salicylic Acid: antifungal, keratolytic
- Resorcinol: antiseptic, keratolytic
TOPICALS: FATTY ACIDS
AP-AP Solution
Salicylic Acid + Resorcinol + Benzoic Acid
TOPICALS: FATTY ACIDS
Whitfield’s Ointment
Salicylic Acid + Benzoic Acid
(+ Base: White Petrolatum)
1:1
TOPICALS
Interfere with cell membrane integrity and function in susceptible fungi
Phenol and its derivatives
TOPICALS: PHENOL & DERIVATIVES
For superficial tinea infection
Haloprogin
Halotex
TOPICALS: PHENOL & DERIVATIVES
Substitute for iodoform
Clioquinol
Vioform
TOPICALS: PHENOL & DERIVATIVES
For jock itch, athlete’s foot, and vaginitis (3%)
Clioquinol
Vioform
TOPICALS: PHENOL & DERIVATIVES
Second line agent for onychomycosis (ringworm of the nails)
Ciclopirox olamine
Loprox
TOPICALS: PHENOL & DERIVATIVES
Agent of choice for:
* Cutaneous candidiasis
* Tinea corporis
* Tinea cruris
* Tinea pedis
* Tinea versicolor
Ciclopirox olamine
Loprox
TOPICALS: NUCLEOSIDE
For systemic Candida and
Cryptococcus spp. infections
Antimetabolite
Flucytosine
5-FC, Ancobon
TOPICALS: NUCLEOSIDE
Flucytosine is a prodrug that will be converted to ____.
5-Fluorouracil
5-FU
TOPICALS: NUCLEOSIDE
Mechanism of action of flucytosine
Inhibition of DNA and protein synthesis
ANTI-FUNGAL ANTIBIOTICS
Polyenes are isolated from soil bacterium ____.
Streptomyces
ANTI-FUNGAL ANTIBIOTICS
These are isolated from Streptomyces
Polyenes
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Natamycin has ____ carbons in its lactone ring.
26
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Amphotericin B has ____ carbons in its lactone ring.
38
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Nystatin has ____ carbons in its lactone ring.
38
ANTI-FUNGAL ANTIBIOTICS: POLYENES
This is the glycosidically linked deoxyaminohexose sugar in polyenes.
Mycosamine
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Conjugated double bonds: Natamycin
Pentaene
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Conjugated double bonds: Nystatin
Hexaene
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Conjugated double bonds:
Amphotericin B
Heptaene
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Polyenes have a series of ____ groups on the acid portion of the ring.
OH
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Mechanism of action of Polyenes
- Esterification of ergosterol -> Pore - > Leak of cellular components
- False membrane component
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Isolated from Streptomyces nodosus
Amphotericin B
Fungizone
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Amphotericin B is isolated from ____.
Streptomyces nodosus
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Last option for systemic antifungal therapy due to nephrotoxocity
Amphotericin B
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Amphotericin B is the last option for antifungal therapy due to its ____.
Nephrotoxicity
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Amphotericin B is an aqueous colloidal dispersion stabilized by ____.
Sodium deoxycholate
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Amphotericin B is never admistered ____.
Intramuscularly
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Colloidal dispersion forms of Amphotericin B
(Cholesterol Sulfate)
- Amphocil
- Amphocyte
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Amphotericin B - 7:3 phospholipid mixture
Abelcet
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Liposomal form of Amphotericin B
AmBisome
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Nystatin is isolated by Hazen and Brown in 1951 from ____.
Streptomyces noursei
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Isolated from Streptomyces noursei
Nystatin
Mycostatin
ANTI-FUNGAL ANTIBIOTICS: POLYENES
The ring (aglycone) of nystatin is called ____.
Nystatinolide
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Isolated from Streptomyces natalensis
Natamycin
Natacyn
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Natamycin is isolated from ____.
Streptomyces natalensis
ANTI-FUNGAL ANTIBIOTICS: POLYENES
Tx of conjunctivitis, blepharitis, and keratitis
Natamycin
Natacyn
ANTI-FUNGAL ANTIBIOTICS: OTHERS
Isolated from Penicillium griseofulvum
Griseofulvin
Grisovin
ANTI-FUNGAL ANTIBIOTICS: OTHERS
Griseofulvin is obtained from ____.
Penicillium griseofulvum
ANTI-FUNGAL ANTIBIOTICS: OTHERS
Mechanism of action of Griseofulvin
Mitotic spindle poison
ANTI-FUNGAL ANTIBIOTICS: OTHERS
Meal requirement for griseofulvin
High-fat meal
GRIS = GREASE = FAT (ALSO LIPOPHILIC)
ALLYLAMINES
1% cream/gel for ringworm, athlete’s foot, and jock itch
Naftifine HCl
Naftin
ALLYLAMINES
Same use as Naftifine but active against ochynomycosis
Terbinafine HCl
Lamisil
ALLYLAMINES
Thioester of beta-naphtol that inhibits squalene epoxidase
Tolnaftate
Tinactin
ALLYLAMINES
MOA of allylamines and tolnaftate
Squalene epoxidase inhibition
for Ergosterol synthesis
AZOLES
Two types of azoles
- Imidazoles
- Triazoles
AZOLES
Mechanism of action of azoles
Lanosterol 14α-demethylase inhibition
Produces Ignosterol = Toxic sterol
AZOLES
New azole under post-marketing surveillance
Isavuconazole
AZOLES
3 imidazole antifungals
- Miconazole
- Clotrimazole
- Ketoconazole
AZOLES
Tx for systemic fungal infection and chronic mucocutaneous candidiasis
Miconazole Nitrate
Daktarin
AZOLES
1st orally active broad spectrum (imidazole)
Cream + Shampoo only; Not available for oral administration anymore
Ketoconazole
Nizoral
AZOLES
Useful for systemic infection but hepatotoxic
Also: Highly protein bound
Ketoconazole
Nizoral
AZOLES
Ketoconazole may lead to ____ among male patients.
Gynecomastia
AZOLES
The bioavailability of Ketoconazole is decreased when taken with ____.
Antacids (Basic)
AZOLES
Ketoconazole has an antagonistic effect when taken with ____.
Amphotericin B
AZOLES
Best substitute for ketoconazole
Itraconazole
Sporanox
AZOLES
____ environment is required for optimum solubilization and oral absorption of itraconazole.
Basic or Acidic
Acidic
AZOLES
2 triazole moieties of itraconazole
- Weakly basic 1,2,4-triazole
- Non-basic 1,2,4-triazol-3-one
AZOLES
Itraconazole is best taken in a/an ____ stomach.
empty
AZOLES
Only water soluble azole (bis-triazole) with broad spectrum activity
Fluconazole
Diflucan, Funzela
AZOLES
Agent of choice for cryptococcal meningitis
Fluconazole
Diflucan, Funzela
AZOLES
Drug of choice for fungal meningitis
Fluconazole
Diflucan, Funzela
Large cyclic peptides linked to a long fatty acid
Echinocanadins
ECHINOCANADINS & PNEUMOCANADINS
Mechanism of action of echinocanadins
(1,3)-b-d-glucan synthase inhibition
Cell wall component
ECHINOCANADINS & PNEUMOCANADINS
3 Products of echinocanadins
- Caspofungin
- Micafungin
- Anidulafungin
Cell wall component
AUREOBASIDINS
Aureobasidins are produced by ____.
Aureobasidium pullulan
AUREOBASIDINS
Aureobasidins have a ____ structure.
Cyclic Depsipeptide
AUREOBASIDINS
Mechanism of action of aureobasidins
Inositol phosphorylceramide (IPC) synthase inhibitor
Non-competitive; For fungal sphingolipid biosynthesis