Antifungal

Question 1

Griseofulvin

Answer 1

Interferes w/ microtubule fxn, disrupts mitosis, deposits in keratin-containing tissue…use for ringworm, tinea…teratogen, carcinogen, P450 inducer

Question 2

Echinocandins

Answer 2

End in -fungin…inhibit cell wall synthesis by inhibiting beta glucan synthesis…used in invasive aspergillosis/candida…cause flushing due to histamine release

Question 3

Terbinafine

Answer 3

Inhibits squalene epoxidase…useful for dermatophytes/onychomycosis…causes taste disturbance, GI upset

Question 4

Azoles

Answer 4

Inhibit ergosterol synthesis…inhibit P450…fluconazole for crypto…itraconazole for histo/blasto/coccidio…others for topical…inhibit testosterone synthesis and cause gynecomastia (esp. ketoconazole)…liver dysfxn due to P450

Question 5

Flucytosine

Answer 5

Converted to 5-FU and inhibits DNA/RNA synthesis…used for crypto meningitis…causes bone marrow suppression

Question 6

Nystatin

Answer 6

Binds ergosterol and forms membrane pores (same MOA as ampho B)…only used topically as too toxic for systemic…used for thrush, diaper rash, vaginal candidiasis

Question 7

Amphotericin B

Answer 7

Binds ergosterol and forms membrane pores (same MOA as nystatin)…used for systemic mycoses…need to supplement with K/Mg due to altered renal tubule permeability…causes fever/chills, nephrotoxicity, phlebitis