Antifungal Flashcards
Amphotericin B mechanism of action
Tears holes in fungal membrane, binds to ergosterol and forms membrane pores causing leakage
Amphotericin B clinical uses
Serious systemic mycoses, cryptococcus (amphotericin B + 5-FC for cryptococcal meningitis) candida, aspergillus and other endemic fungi
Amphotericin B ways of administering
- Given intrathecally to treat fungal meningitis
- normally as slow IV infusion
Amphotericin B Adverse effects
Fever and chills (80% of patients), hypokalemia, anaphylaxis and convulsions, nephrotoxicity, anemia and hypotension (NAH dose dependent liposomal formulation reduces toxicity)
How to reduce Amphotericin B adverse effects
Hydration, k+ and mg2+ supplementation. and when Combination Amphotericin B + 5-FC (reducing doses of AmpB)
Nystatin mechanism of action
Similar mechanism to Amphotericin B
-Tears holes in fungal membrane, binds to ergosterol and forms membrane pores causing leakage
Nystatin way of administration
Topical only —> too toxic for systemic use
Nystatin clinical use
Oral candidiasis(trush) rash or vaginal candidiasis
Flucytosine mechanism of action
It is a fungistatic - inhibits DNA and RNA synthesis by 5FU conversion
Flucytosine clinical indication
Systemic infection (specifically meningitis by cryptococcus) in combination with amp B
Flucytosine AES
Bone marrow suppression
What are the azoles
Flucanzole, miconazole, ketoconazole, itraconazole, voriconazole, coltrimazole
Most azoles end with nazole
Azoles mechanism of action
Inhibits ergosterol synthesis by inhibiting CYP450 enzyme that converts Lanosterol to ergosterol
Are azoles teratogenic
They are teratogenic as fuck
Fluconazole clinical uses
Cryptococcal meningitis in AIDS patients and candidiasis
