Anti-infective Drugs 1 Flashcards
Antifungal Drugs: Polyene Antibiotics (3)
- Amphotericin B
- Natamycin
- Nystatin
Antifungal Drugs: Azole Derivatives (6)
- Clotrimazole
- Fluconazole
- Itraconazole
- Ketoconazole
- Voriconazole
- Posaconazole
Antifungal Drugs: Allylamine Drugs (2)
- Terbinafine
2. Naftifine
Antifungal Drugs: Echicocandin Drugs (1)
Capsofungin
Antifungal Drugs: Other Antifungals (4)
- Ciclopirox
- Flucytosine
- Griseofulvin (Disulfiram like action)
- Tolnaftate
Antifungal Drugs: Polyenes - Amphotericin B: Buzzword
IV for SERIOUS and LIFE-THREATENING INFECTIONS
Aspergillus
Candidda
Cryptococcus
Histoplasma
Antifungal Drugs: Polyenes - Amphotericin B: MOA
Binds to ergosterol
Antifungal Drugs: Polyenes - Amphotericin B: Side Effects 1 (5)
- Amphoterrible Dose Dependent
- Nephrotoxicity
- Hypokalemia
- Normochromic normocytic anemia
* Lipid formulations of Amphotericin B cause less renal toxicity
Antifungal Drugs: Polyenes - Amphotericin B: Side Effects 2 and Premedicate with?
Infusion dependant
Flu-like symptoms
Premeidicate patients with antipyretic, antihistaminic, and anti-emetic agents
Antifungal Drugs: Polyenes - Amphotericin B: Distribution (2)
- Low penetration into CSF
2. No BBB crossing (given intrathecally)
Antifungal Drugs: Polyenes - Amphotericin B: Drug Interactions
Synergistic with fluocytosine
Antifungal Drugs: Polyenes - Amphotericin B: Rx of resistant?
Cryptococcus and cnadidiasis
Antifungal Drugs: Polyenes - Amphotericin B: Resistance leads to?
Decreased ergosteral levels
Antifungal Drugs: Polyenes - Nystatin Use
Used topically for candidiasis
Too toxic for systemic use
Antifungals: Azoles - Buzzword (5)
- Ketoconazole
- Fluconazole
- Itraconazole
- Clotrimazole
- Miconazole
Antifungal Drugs: Azoles - MOA
Block synthesis of ergosterol by inhibiting 14-alpha demethylase in the fungal P450 complex
Antifungal Drugs: Azoles - Resisance
Decrease intracellular levels of drugs
Antifungal Drugs: Azoles - Indications (4)
- Given PO
- Candidiasis and coccidiomycosis (respiratory)
- Paracoccidiomycosis
- Blastomycosis and histoplasmosis
Antifungal Drugs: Azoles - Clotrimazole and Miconazole given and rx of?
Given topically
Rx of candida and dermatophytic infections
Antifungal Drugs: Azoles - Ketaconazole Use (3)
Gynecomastia and decrease libido
Menstrual irregularities
Seborrheic dermatitis
Antifungal Drugs: Azoles - Kinetics
- Fluconazole penetrates CSF rx of cryptococcal meningitis
- Itraconazole: No CSF
Rx of blastomycosis, histoplasmomsis, and onychomycosis
Antifungal Drugs: Azoles - Absorption increased by?
Food
Antifungal Drugs: Azoles - Fluconazole and itraconazole available by?
IV
Newly Approved Triazole: Voriconazole Type, Rx, and
IV and Oral
Rx of invasive aspergillosis and candidiasis
Newly Approved Triazole: Voriconazole Side Effects
Visual disturbances
Newly Approved Triazole: Posaconazole Type and USe
Oral
Propphylaxis in neutropenic and immunosuppressed patients
Newly Approved Triazole: Posaconazole Side Effects
Hepatic failure and QT prolongation
Antifungals: Echicocandin Drugs (New) MOA
Inhibits fungal cell wall synthesis
Antifungals: Echicocandin Drugs - Caspofungin
Rx of candida species and aspergillus species
Only given IV with few adverse effects with amphotericin B
Antifungals: Echicocandin Drugs - Caspofungin Adverse Effects (4)
- Headache
- Fever
- Phlebitis
- Abnormal liver function
Antifungals with Limited Indications: Griseofulvin MOA
Disruption of mitotic spindle by interfering with microtubules
Antifungals with Limited Indications: Griseofulvin Rx of?
Tinea cruris (jock itch)
Antifungals with Limited Indications: Griseofulvin Side Effects
Increase effects of alcohol
Antifungals with Limited Indications: Griseofulvin Contraindicated in?
Intermittent porphyria
Antifungals with Limited Indications: Terbinafine MOA
Inhibits squalene epoxidase
Antifungals with Limited Indications: Terbinafine rx of?
Onychomycosis (nail fungal infection)
Antifungals with Limited Indications: Terbinafine Side effects
Elevated liver function tests
Antifungals with Limited Indications: Flucytosine MOA
5 FC —-> 5FU (via fungal cytosine deaminase)
5 FU –> 5-fluorodeoxyuridine MP –> *inhibits thymidylate synthetase –> decrease thymind
Antifungals with Limited Indications: Flucytosine Used with what in severe candidiasis?
Amphotericin B
Antifungals with Limited Indications: Flucytosine Side Effects (3)
- Decrease bone marrow
- Leukopenia and thrombocytopenia
- GI: Severe enterocolitis, hepatitis
Antifungals with Limited Indications: Ciclopirox Rx of? (3) and Use
- Dermatophytes
- C. Albicans
- M. furfur
Used topically
Antifungals with Limited Indications: Tolnaftate Rx of? And used
Rx of tinea versicolor and mild dermatophyte
Used topically