Anti Fungals

Question 1

Amphotericin B moa

Answer 1

binds ergosterol and froms membrane pores that allow leakage of electrolytes

Question 2

amphotericin B clinical use

Answer 2

serious systemic mycoses; intrathecally for fungal meningitis

Question 3

amphotericin B toxicity

Answer 3

fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis

Question 4

nystatin moa

Answer 4

binds ergosterol and forms membrane pores; topical only

Question 5

nystatin clinical use

Answer 5

topical or swish and swallow for oral candidiasis

Question 6

azoles moa

Answer 6

inhibit ergosterol synthesis by inhibiting the cytochrome P450 enzyme that converts lanosterol to ergosterol;

Question 7

chronic suppression of cryptococcus in AIDS

Answer 7

fluconazole

Question 8

azole toxicity

Answer 8

inhibition of testosterone synthesis (ketoconazole causes gynecomastia), liver dysfunction, inhibition of CYPs

Question 9

flucytosine moa

Answer 9

inhibits DNA and RNA synthesis by conversion to 5-FU by cytosine deaminase

Question 10

Cryptococcus treatment

Answer 10

flucytosine + Amphotericin B

Question 11

flucytosine toxicity

Answer 11

bone marrow suppression

Question 12

echocandins drugs

Answer 12

caspofungin, micafungin, anidulafungin

Question 13

echocandins moa

Answer 13

inhibit cell wall synthesis by inhibiting the synthesis of beta-glucan

Question 14

echocandins toxicity

Answer 14

GI and flushing due to histamine release

Question 15

terbinafine moa

Answer 15

inhibits the fungal enzyme squalene epoxies and blocks ergosterol synthesis

Question 16

terbinafine use

Answer 16

dermatophytoses

Question 17

terbinafine toxicity

Answer 17

GI, HA, hepatotoxicity, taste disturbance

Question 18

griseofulvin moa

Answer 18

interferes with microtubule function; disrupts mitosis; deposits in keratin-containing tissues (e.g. hair and nails)

Question 19

griseofulvin toxicity

Answer 19

teratogenic, carcinogenic, confusion, HA, P-450 induction