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Pharma > Anti-Fungals > Flashcards

Anti-Fungals Flashcards

1
Q

Fungi are eukaryotes with rigid cell walls containing

A

Chitin and polysaccharide

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2
Q

Antifungals attack this vital fungal membrane component inhibiting synthesis or binding to its pores

A

Ergosterol

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3
Q

Given for serious systemic infections

A 
Amphotericin B (IV)
Itraconazole (PO)
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4
Q

Given to less serious fungal infection

A

Azoles (PO)

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5
Q

Given for superficial infections

A

Griseofulvin PO
Nystatin topical
Azole

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6
Q

Naturally occuring
Produced by Streptomyces nodosus

Drug of choice for systemic mycotic infection

A

Amphotericin B

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7
Q

Binds to ergosterol present in cell membrane disrupting membrane function
Allows electrolytes to leak out from cell resulting in cell death

A

Amphotericin B

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8
Q

Effective against Candida, Histoplasma, Cryptococcus, Blastomyces, Aspergillus, Coccidiodes

A

Amphotericin B

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9
Q

Amphotericin B is excreted through

A

Bile

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10
Q

Amphotericin SE

A 
Hypotension
Arrythmia
Neurologic effect
Nephrotoxic
Fever
Hypochromic, normocytic anemia
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11
Q

First isolated from a strain of streptomyces noursei
Used for Candida
Administered as an oral agent for treatment of oral candidiasis
Negligibly absorbed from GI tract so adverse effects are rare

A

Nystatin

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12
Q

Allylamine examples

A

Naftifine

Terbinafine (Lamisil)

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13
Q

Benzylamine example

A

Butenafine (Mentax)

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14
Q

Inhibits squalene epoxidase for the synthesis of ergosterol in fungal cell membrane

Accumulation of squalene (a sterol) which is toxic to fungi

Good for nails

SE: headache, GI upset

A

Terbinafine

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15
Q

Also blocks sterol formation via inhibition of squalene 2,3 epoxidase

Antifungal
Anti inflammatory
Antibacterial

A

Naftifine

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16
Q

Inhibits sterol synthesis via squalene epoxidase

A

Butenafine

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17
Q

Obtained from the mold Penicillium griseofulvum

A

Griseofulvin

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18
Q

Interacts with microtubules within fugus to disrupt the mitotic spindle and inhibit mitosis (arrests cell division in metaphase)

A

Griseofulvin

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19
Q

Griseofulvin absorption is increased by

A

fatty acids

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20
Q

Inhibits microtubule function

A

Griseofulvin

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21
Q

Covers Trichophyton
Microsporum
Epidermophyton

A

Griseofulvin

22
Q

Griseofulvin AE

A 
Teratogenic*
Hepatotoxic
Increases Warfarin metabolism*
Headache
GI irritation
23
Q

Similar to 5 FU

A

Flucytosine

24
Q

Griseofulvin is an enzyme

A

inducer

25
Q

Inhibits thymidylate synthetase

For subcutaneous chronomycoses

Used in combination with Amphotericin B for treatment of systemic mycoses, subcutaneous chronomycoses, and meningitis by Cryptococcus neoformans and Candida* CD4 <100

The combination is

A

Flucytosine

synergistic

26
Q

Flucytosine SE

A

Reversible bone marrow depression
Increased hepatic enzymes
Nausea vomiting diarrhea

27
Q

Interacts with C14 A Demethylase to block demethylation of lanosterol to ergosterol, the principal sterol in fungal membrane

Alter permeability of fungal cell membrane

A

Azole

28
Q

Covers Histoplasma, Candida, Cryptococcus, Blastomycosis, Ketoconazole

Never give with amphotericin B because they

A

Ketoconazole

will antagonize each other

29
Q

Ketoconazole AE

A 
Gynecomastia
Decreased libido
Impotence
Menstrual irregularity
Milk alkali syndrome
30
Q

It lacks the endocrinologic effects of ketoconazole

A

Itraconazole

31
Q

DOC for subcutaneous chromomycosis (Blastomycosis)

Broad based budding yeast

A

Itraconazole

32
Q

Itraconazole AE

A

Hypokalemia
GI distress
Hypertriglyceridemia

33
Q

Administered orally and intravenously

Has excellent penetrability into the CSF

A

Fluconazole

34
Q

DOC for Cryptococcal meningitis

cryptococcus neoformans

A

Fluconazole 6 months

35
Q

Antifungals for superficial infection

A 
Griseofulvin
Nystatin
Miconazole
Clotrimazole
Econazole
36
Q

For subcutaneous and systemic mycoses

Similar to ketoconazole

A

Ketoconazole
Miconazole
Econazole
Clotramizole

37
Q

For superficial mycoses

A 
Clotrimazole
Miconazole
Econazole
Griseofulvin
Nystatin
38
Q

Interferes with cell wall synthesis/permeability via inhibition of B 13 D glucan synthesis

Effective against most species of Candida but not Cryptococcus

A

Echinocandins

capsofungin
micafungin
anidulafungin

39
Q

Effective in invasive Aspergillosis in patients refractory to or intolerant of other antifungals

Also effective against Candida

A

Capsofungin

40
Q

Capsofungin SE

A 
Induration
Facial swelling
Pruritus
Headache
Fever
Infusion site reactions
Nausea
Vomiting
41
Q

Interrupts with active membrane transport of trivalent cations (essential cellular precursor)

Anti-inflammatory

A

Ciclopirox olamine

Loprox, Penlac

42
Q

Reversible and noncompetitive inhibitor of squalene epoxidase

Skin infection

A

Tolnaftate (Tinactin)

43
Q

Fungistatic

Zinc component in this drug provides astringent component

Unclear MOA

A

Undecylenic acid (Desenex)

44
Q

Notorius for arythmia

A

Amphotericin

45
Q

Impairs absorption of ketoconazole

A

Cimetidine

Antacid

46
Q

Polyene antifungals

A

Nystatin

Anphotericin B

47
Q

Griseofulvin

A

Solid: thyroid, hepatic tumors

Hematologic

48
Q

Improves survival of C meningitis

A

Amphotericin B
Flucytosine

+ Fluconazole

49
Q

Imidazoles

A

Miconazole
Toconazole
Clotrimazole

50
Q

Triazole

A

Itraconazole
Fluconazole
Ketoconazole

51
Q

Terbinafine SE Blackbox

A

Tinnitus

Taste disturbance

Pharma (26 decks)

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