antifungal Flashcards
what antibiotics works in cell synthesis?
-PCN , CPN, carbapenem, aztreonam
-Vancomycin, televancin, Oritevancin
- abx with 50 s inbibitor MOA?
Erythromycin
Clarithromyicn
Linezolide/ Tedizolid
Abx with 30s MOA
Protein synthesis 30 s Inhibitor
Aminoglycoside
Tetracycline
ABX that work on DNA gyrase
Quinolone
Abx that works on DNA synthesis
Metronidazole
Abx that works on inhibiting transcription of DNA to mRNA
Rifaximin
ABX that work on phospholipid membrane
Polymixin B
Antifungal that works on cell Nucleic acid Synthesis
Flucytosine
Anti-fungal that works on
cell wall
Caspofungin
Anidulafungin (Eraxis)
Ibrexafungerp (Bexafeme)
Anti-fungal that works on DECREASING ERGOSTEROL SYNTESHIS AND INHIBITING CELL WALL MEMBRANE
IT WORK ON CYTOCHROME 450 ACTIVITY
AZOLE
Antifungal that binds to cell membrane altering membrane permeability
- Amphotericn B
Amphotericin B
*AMpho D
MOA:
- Binds to ergosterol
- SE
Infusion related shaking chills, hypotension, Nephrotoxicity, dec in K, Mg - Dosing conc for infusion
- **1mg/10mL **
- Ampho D.. give in Dextrose
Amphotericin in DEXTROSe
Ampho B conc is 1mg/10ml
Ampho B lipid forumulation
- Abelcet
- Ambisome
- Amphotec
AMpho B lipid form less toxic and must meet one criteria to use Lip formualtion
- Significant renal imp (CrcL<50 ors Scr>2.4)
- Patient unable to tolerate regular Ampo
- Transplant recipient
conventional ampho b
- protect from moisture, light and refrigerated
- reconstitue w/steriler water then mix with D5W
store in dark at room after reconstituion
Azole antifungal
fluconazole
Itraoconazole
voriconazole
ketoconazole
isavuconazonium
Azole antifungal
MOA: dec ergosterol synthesis
SE: Hepatoxicity
DUR: CYP450 3A4
- (Inc warfarin)
- itraconazole and ketoconazole need acidic env- take with food
Fluconazole
Difulcan
indication
- vaginal candidadis
- Oropharngeal/ esophageal
- Crytococal menigtis
Pregnancy: 150mg is Category C . CDC recom only topical atifungal (vagin
Itraconazole
Sporanax
Dose: 200mg PO QD X 12 wks for Onchomycosis
- used for Aspergillus
SE: Hepatoxicity and neg Inotrope
CYP3A4 substrate and Inhib
ketoconazole
Nizoral
Form/Indication
- 1% shampoo:
- 2% shampoo for Tinea versicolor
- systemica fungal infection
Needs acidic env
CYP3A4 substrate and inhib
tineas versicolor: discoloration patch of skin; overgrowht of type of ye
Voriconazole
VFend
Indication
- Aspergillus
- forms : Tab, Inj, susp
- EMPTY STOMACH
WARNNG
VORICONAZOLE
O: OPTIC (Monitor for vison imp)
O: Photosensitivity
O: QT
C: CNS
cyp3A4 substrate and inhib
isavuconazonium
Cresemba
Indication
- Aspergillus
- oral/ IV
- major CYP3A4 substrate
Caspofungin
Cancidas
MoA: Inhibits cell wall
Indication
- Aspergillosis
- dilute in NS or lactated ringer
Anidalfungin
Eraxis
IV
Posconazole
Noxafil
MOA: inhibit ergosterol synthesis
Indication
- prevent/tx invasive aspergillos
- oral susp
- avoid in renal imp Crcl <50
Clotrimazole
- topical for athlete foot
- troch lonzes for oral thrush
- gyne-lotrimin for vaginal yeast inf
- vaginal tablet for vaginal yeast inf
Nystatin
Topical and oral
oral thrush: swish and swallow
terbinafine
Lamisil
MOA: inhibits ergosterol synthesis
indication
- fingernail for 6 wks
- toenail for 12 weeks
Ciclopirox
Penlac- top solution
topical nail lacquer for onchomycosis of fingernails and toenails
Efinacazole
Jublia
QD for 48 weeks
therpy for onchomycosis
PO
- terbinafine (lamisi)
- itraconazole (Sporonax)
Topical
- Ciclopirox (Penlac)
- Efinacozole (Jublia)
- Tea tree oil
flucytosine
Ancobon
PO
synergestic with ampho B or fluconazole in cryptococcal menigntis
