Anti-Fungals

Question 1

Amphotericin B

Answer 1

Polyenes (IV)

MOA: interact with ergosterol in fungal membranes to form artificial “pores”
-“pokes” hole in fungi

USE: broad spectrum
DOC for severe infections caused by aspergillus, candida, cryptococcus, histoplasma

AE:
infusion-related reactions (headache, fever, myalgia, chills)

Question 2

5-Flucytosine

Answer 2

5-FC

MOA: penetrates cell wall; deaminated by cytosine deaminase to 5-FU
-5-FU inhibits RNA and DNA synthesis

AE: hematologic toxicities (anemia, leukopenia, thrombocytopenia)

Question 3

Fluconazole

Answer 3

Azole (PO, IV)

MOA: blocks lanosterol 14-alpha demethylase from converting lanosterol to ergosterol –> no ergosterol

AE:
-Class: N,V, hepatotoxic
-Special: chapped lips, GI AE

DDI: many CYP interactions (azoles are cyp inhibitors; lanosterol 14-alpha demethylase is a CYP enzyme)

Question 4

Voriconazole

Answer 4

Azole (PO, IV)

MOA: blocks lanosterol 14-alpha demethylase from converting lanosterol to ergosterol –> no ergosterol

AE:
-Class: N,V, hepatotoxic
-Special: visual disturbances

DDI: many CYP interactions (azoles are cyp inhibitors; lanosterol 14-alpha demethylase is a CYP enzyme)

Question 5

Posaconazole

Answer 5

Azole (PO, IV)

MOA: blocks lanosterol 14-alpha demethylase from converting lanosterol to ergosterol –> no ergosterol

AE:
-Class: N,V, hepatotoxic
-Special: GI AE

DDI: many CYP interactions (azoles are cyp inhibitors; lanosterol 14-alpha demethylase is a CYP enzyme)

Question 6

Isavuconazole

Answer 6

Azole (PO, IV)

MOA: blocks lanosterol 14-alpha demethylase from converting lanosterol to ergosterol –> no ergosterol

AE:
-Class: N,V, hepatotoxic
-Special: GI AE

DDI: many CYP interactions (azoles are cyp inhibitors; lanosterol 14-alpha demethylase is a CYP enzyme)

Question 7

Micafungin

Answer 7

Ecinocandins (IV)

MOA: inhibit beta-glucan synthase enzyme –> inhibition of beta-glucan synthesis

AE: minor, some histamine release –> flushing, headache, urticaria, pruritus

Question 8

Caspofungin

Answer 8

Ecinocandins (IV)

MOA: inhibit beta-glucan synthase enzyme –> inhibition of beta-glucan synthesis

AE: minor, some histamine release –> flushing, headache, urticaria, pruritus

Question 9

Anidulafungin

Answer 9

Ecinocandins (IV)

MOA: inhibit beta-glucan synthase enzyme –> inhibition of beta-glucan synthesis

AE: minor, some histamine release –> flushing, headache, urticaria, pruritus

Question 10

Terbinafine

Answer 10

MOA: inhibits squalen-epoxidase

USE: dermatophyte skin infections (tinea), especially on the fingernails and/or toenails

AE: taste disturbances, GI upset, hepatotoxicity, headache