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Pharmacology > Anti-Fungals > Flashcards

Anti-Fungals Flashcards

1
Q

Most powerful

A

Amphotericin B

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2
Q

Most used

A

the -azoles

Ketoconazole, itraconzaole, fluconazole

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3
Q

Which drug is produced by penicillium?

A

Griseofulvin

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4
Q

Griseofulvin

A

produced by penicillium
insoluble (in water)
fungistatic
only effective against dermatophytosis

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5
Q

Griseofulvin Mechanism of action

A

anti-mitotic (esp inhibits DNA synthesis)
incorporated into keratin and reaches skin in 4-8 hrs.
gone in 2-3 days

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6
Q

Griseofulvin metabolism

A 
variably absorbed (better with food)
oxidized in liver (way faster metabolism than humans)
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7
Q

______ weeks of tx required for successful therapy of dermatophytosis

A

4

(many patients req. 3+ months)

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8
Q

What decreases absorption of Griseofulvin

A

phenobarbitol

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9
Q

Why don’t we use Griseofulvin anymore?

A

GI (Naseau, v, d)
bone marrow suppression (esp cats, esp with FIV/FeLV or persians etc)
Teratogenicity (brain, skeletal malformations)

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10
Q

not absorbed orally

A

Amphotericin B

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11
Q

dehydration increases toxicity

A

amphotericin B

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12
Q

well tolerated, especially the ___________ preparation of Amphotericin B, which has less side effects & longer 1/2 life.

A

liposomal

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13
Q

adverse effects of amphotericin

A

thrombophlebitis, nephrotoxicity, hypokalemia, resistance overtime

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14
Q

Which anti-fungal do you choose last? When there’s no other options

A

amphotericin B

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15
Q

All the -azoles we have to know are

A

oral

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16
Q

ketoconazole

A

lipophilic, broad specturm, liver metabolism, interacts with P450-affinity for fungal and mammalian, GI and liver toxicity adverse effects common

17
Q

itraconazole

A

inc. affinity for fungal enzyme, fewer adverse effects, broad spectrum, poor penetration in CSF, less liver toxicity, vasculitis in high doses

18
Q

fluconazole

A

SAFEST-highest specificity for fungal enzymes(thus least drug interactions), broad spectrum, well tolerated in cats

19
Q

-azoles all interact with

A

cytochrome P450

20
Q

safest Antifungal - little/no side effects with mammals

A

terbinafine

21
Q

terbinafine

A

dermatophytosis, malessezia, well tolerated, inhibits ergosterol synthesis lipophilic& keratinophilic (persists in nails)

Pharmacology (20 decks)

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