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Pharm 4 > Antifungal > Flashcards

Antifungal Flashcards

1
Q
  • binds to ergosterol

- alters membrane permeability

A

amphotericin B

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2
Q
  • inhibits ergosterol synthesis

- membrane becomes leaky

A

azoles

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3
Q
  • pyrimidine analog
  • converted to 5-FU
  • interfere with RNA and DNA sythesis
A

flucytosine

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4
Q
  • inhibits synthesis of beta-glucans (cell wall)

- weakens cell wall –> greater osmotic stress

A

echinocandins

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5
Q

interferes with microtubule function –> disrupts mitosis

A

griseofulvin

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6
Q
  • inhibitors of enzyme sequalene epoxidase (ergosterol synthesis)
  • defective/damaged cell membrane
A

allylamines

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7
Q

Adverse effects of amphotericin B

A
  • infusion related

- nephrotoxicity

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8
Q

All azoles have what adverse effect?

A

interactions with P450

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9
Q

Which azole has highest degree of inhibition of P450?

A

Ketoconazole

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10
Q

Which azole has the lowest level of interaction with P450?

A

Fluconazole

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11
Q

Which azole requires acidic environment?

A

Itraconazole

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12
Q

Which azole has drug interactions with Rifampin?

A

Itraconazole

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13
Q

Adverse effects of voriconazole (3)

A
  • transient visual disturbances
  • liver enzyme abnormalities
  • drug interactions
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14
Q

Adverse effects of flucytosine (3)

A
  • BM toxicity
  • Hepatoxicity
  • GI intolerance
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15
Q

Adverse effects of echinocandins

A

well tolerated

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16
Q

Drug of choice for aspergillosis

A

Voriconazole

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17
Q

Drug of choice for mild to moderate blastomycosis

A

Itraconazole

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18
Q

Drug of choice for mod to severe blastromycosis

A

amphotericin B followed by itraconazole

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19
Q

What are the 3 options for vaginal candiasis?

A

1) intravaginal azole - clotrimazole, miconazole
2) Intravaginal nystatin
3) Fluconazole (oral)

20
Q

What are the 3 options for oropharyngeal candiasis?

A

1) clotrimazole or miconazole lozenges
2) nystatin oral suspension
3) fluconazole

21
Q

Esophageal candiasis

A

fluconazole

22
Q

Systemic candiasis

A

fluconazole or echinocandin

23
Q

Coccidioidomycosis

A

fluconazole or itraconazole

24
Q

Cryptococcosis

A

amphotericin B + flucytosine, followed by fluconazole

25
Q

Prophylaxis for cryptococcosis for HIV pts

A

fluconazole

26
Q

Histoplasmosis

A

amphotericin B followed by itraconazole

27
Q

Prophylaxis for histoplasmosis for HIV pts

A

Itraconazole

28
Q

Mucormycosis

A

amphotericin B

29
Q

Cutaneous sporotrichosis

A

itraconazole

30
Q

Extracutaneous sporotrichosis

A

amphotericin B followed by itraconazole

31
Q

Dermatomycosis

A

Topical azole or topical terbinafine

32
Q

Onychomycosis

A

Terbinafine (oral) or itraconzaole (oral)

33
Q

Candida

Cryptococcus

A

Yeast

34
Q 
Aspergillus
Histoplasma
Coccidioides
Blastomyces
Sporothrix
Mucormycoses
A

Mold

35
Q

Systemic infections (4)

A

Histoplasma
Blastomyces
Coccidioides
Sporothrix

36
Q

Opportunistic infections (3)

A

Candida
Aspergillus
Cryptococcus

37
Q

Cutaneous/Spontaneous (2)

A

Sporothrix

Dermatophytes

38
Q

Voriconazole

A

Aspergillosis

39
Q

Itraconazole (5)

A

1) mild to mod blastomycosis
- mod to severe, follows amphotericin B
2) coccidioidomycosis
3) histoplasmosis - follows amphotericin B
- prophylaxis
4) cutaneous sporotrichiosis
5) onchomycosis

40
Q

Fluconazole (3)

A

1) candidiasis (all forms)
2) coccidioidomycosis
3) cryptococcus - follows amphotericin B
- prophylaxis

41
Q

Amphotericin B (5)

A

1) mod to severe blastomycosis
2) cryptococcosis
3) histoplasmosis
4) mucormycosis
5) extracutaneous sporotrichosis

42
Q

Topical azoles

A

1) vaginal and oropharyngeal candidiasis

2) dermatomycosis

43
Q

Echinocandin

A

systemic candidiasis

44
Q

Nystatin

A

topical for vaginal, oral suspension for oropharnygeal candidiasis

45
Q

Terbinafine (oral)

A

oral - onchomycosis

topical - dermatomycosis

Pharm 4 (10 decks)

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