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Pharmacology > Anti-fungals > Flashcards

Anti-fungals Flashcards

1
Q

3 mechanisms of antifungals

A
  1. alteration in cell membrane function
  2. mitotic spindle inhibition
  3. antimetabolite
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2
Q

aspergillosis DOC (drug of choice)

A

voriconazole IV

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3
Q

blastomycosis (mild) DOC

A

itraconazole PO

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4
Q

blastomycosis (severe) DOC

A

amphitericin B IV

itraconazole PO

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5
Q

candidiasis DOC

A

fluconazole PO

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6
Q

coccidioidomycosis DOC

A

fluconazole PO/IV

itraconazole PO

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7
Q

cryptococcus DOC

A

amphitericin B IV + flucytosine PO
then
fluconazole PO

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8
Q

histoplasmosis DOC

A

amphotericin B IV + itraconazole PO

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9
Q

mucormytosis DOC

A

amphotericin B IV

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10
Q

sporotrichosis DOC

A

amphotericin B IV and/or

itraconazole PO

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11
Q

terbinafine MOA

A

blocks conversion of squalene to squalene epoxide via inhibition of squalene epoxidase (interrupts cell membrane ergosterol and also causes build up or squalene which is toxic intermediate)

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12
Q

azole group MOA (drugs that end in azole)

A

blocks conversion of lanosterol to ergosterol-mediate by P450 enzymes (within the fungus) (can cause drug-drug interactions through inhibition of CYP3A4)
-produce GI side effects

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13
Q

amphotericin B MOA

A

form pores in the fungal cell membrane by binding to ergosterol, IV administration only

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14
Q

nystatin MOA

A

identical to amphotericin B but topical only

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15
Q

echocandins MOA (drugs that end in fungi)

A

beta 1,3 glucan synthesis inhibition leading to loss of cell wall

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16
Q

Azole with renal excretion and able to penetrate CSF

A

fluconazole

17
Q

Azoles with hepatic excretion and unable to penetrate CSF

A

ketoconazole, itraconazole, vorionazole, posaconazole

18
Q

Only azole to cause adrenal insufficiency

A

ketoconazole, leads to reduction in aldosterone, cortisol, and testosterone, also effects hepatic function

19
Q

flucytosine MOA

A

enters fungus via cytosine permease
converted to 5-flurouracil which causes interruption in DNA and RNA synthesis.
mammalian cells don’t conduct first conversion step to 5FU but intestinal microflora do so typical side effects of cell cycle inhibition expected

20
Q

griseofulvin MOA

A

mitotic spindle inhibitor

21
Q

infusion reactions

A

amphoteracin B

caspofungin

Pharmacology (6 decks)

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