Anti-fungals

Question 1

Unique component of fungal cell wall

Answer 1

Ergosterol

Question 2

Interruption of sterol biosynthesis (cell and mitochondrial membranes)

a. Polyenes
b. 5-Fluorocytosine
c. Azoles

Answer 2

C

Question 3

Interruption of DNA and RNA synthesis

a. Polyenes
b. 5-Fluorocytosine
c. Azoles

Answer 3

B

Question 4

Examples of Polyene antifungal drugs

Answer 4

Nystatin, Primacin, Amphotericin B

Question 5

What is the MOA of Polyenes?

Answer 5

cell membrane destruction via disruption of osmotic gradient leading to cell gradient

Question 6

True about azole antifungals excepts

a. Class of 5-membered nitrogen heterocyclic ring compounds containing at least one other non-carbon atom of either nitrogen, sulfur or oxygen
b. Fungicidal
c. Usually topical
d. Inhibits CYP 450 dependent enzymes(e.g. C14 demethylase)

Answer 6

B; Fungistatic only

Question 7

Inhibitor of both DNA and RNA synthesis via the intracytoplasmic conversion of 5-fluorcytosine to 5-fluorouracil

Answer 7

Antimetabolites

Question 8

Inhibits peptide in synthesis of B(1,3)glucan resulting in disruption of fungal cell wall and cell death

Answer 8

Echinocandins

Question 9

Inhibits different stages of ergosterol synthesis: e.g. at the level of squalene eposidase or later step

Answer 9

Allylamines and Morphine antifungal drugs

Question 10

Inhibits conversion of lanosterol to ergosterol

Answer 10

Azoles

Question 11

Inhibits conversion of squalene to lanosterol

a. Terbinafine
b. Griseofuluin
c. lucytosine

Answer 11

A

Question 12

Differntiate amphotericin and echinocandins based on MOA

Answer 12

Amphotericin disrupts cell membrane while echinocandins act on cell wall

Question 13

Amphotericin is from which organism?

Answer 13

Streptomyces

Question 14

Gold standard and broadest spectrum for yeast?

Answer 14

Amphotericin B

Question 15

What are the indications for amphotericin B? (give 7)

Answer 15

a. disseminated candidiasis
b. cryptococcal meningitis
c. fungal septicemia
d. disseminated histoplasmosis
e. acute pulmonary
f. disseminated coccidiomycosis
g. severe aspergillosis

Question 16

Which group of antifungals are used for chronic therapy or prevention of relapse? for induction of therapy?

Answer 16

Newer azoles; amphotericin

Question 17

What will you give to a cancer patient with neutropenia who remains febrile on broad spectrum antibiotics?

Answer 17

amphotericin B

Question 18

Spectrum of activity of antifungal activity of amphotericin

Answer 18

CCHBCA

Cryptococcus, Candida, Blastomyces, Histoplasma, Coccidiodes, Aspergillus

Question 19

Topical use for amphotericin include

Answer 19

Mycotic corneal ulcers and keratitis
Fungal arthritis
Candiduria

Question 20

T/F Amphotericin B does not readily pass the BBB

Answer 20

T

Question 21

Adverse effects if amphotericin B involve mainly which organ?

Answer 21

Kidney

Question 22

Which is available in the Philippines?

a. Nystatin
b. Natamycin

Answer 22

A

Question 23

Imidazoles include the following except

a. ketoconazole
b. fluconazole
c. miconazole
d. clotrimazole

Answer 23

B; KeMiCo

Question 24

Trizoles include (Give 3)

Answer 24

(IVF) Itraconazole, Fluconazole, Voriconazole

Question 25

Which enzyme is inhibited by azoles?

Answer 25

14-a-demethylase during ergosterol synthesis from lanosterol

Question 26

Which has greater specificity?

Imidazole or triazoles?

Answer 26

Imidazoles