Anti-fungals

Question 1

MOA and side effects of Terbinafine

Answer 1

MOA: inhibits squalene epoxidase

GI upset, HA, Hepatotoxicity, taste altering

Question 2

MOA and side effects of Azoles

Answer 2

inhibits lanesterol 12-a-demethylase, blocking ergosterol synthesis

inhibits HMG-CoA reductase inhibitors, benzos, warfarin and testosterone synthesis

Question 3

side effects of itraconazole and voriconazole

Answer 3

visual disturbance

hepatic failure

Question 4

What is a risk of chronic fluconazole use

Answer 4

birth defects

Question 5

Examples of polyenes

Answer 5

amphotericin B

Nystatin

Question 6

Amphotericin B MOA and side effects

Answer 6

binds to ergosterol, causing direct oxidative membrane damage, allowing cytoplasmic contents to escape the cell

Renal toxicity

hepatic toxicity

hypokalemia hypomagnesia cardiac arrhythmias

azotemia, hypotension, phlebitis

anemia, leukopenia thrombocytopenia chills fever, HA, N/V

Question 7

Examples of Echinocandins, their MOA and side effects

Answer 7

Caspofungin, Andulafungin, Micafungin

inhibit fungal cell wall synthesis by blocking Beta-1,3 D glucan

HA, fever, phlebitis,

abnormal LFTs

flushing (histamine release)

Question 8

Flucytosine MOA Side effects

Answer 8

converted to 5-FU by cytosine deaminase to inhibit RNA and RNA synthesis by blocking nucleic acid synthesis

bone marrow suppression

cardiopulmonary arrest

Question 9

Griseofulvin MOA Side effects

Answer 9

binds to fungal microtubules, inhibiting their function

teratogenic

carcinogenic

disulfiram-like reaction

GI bleeding

hepatitis

rash

confusion

Insomnia