antifungal

Question 1

topical:

Answer 1

Terbinafine, and imidazoles (micon-azol, clotrim-azol, ketocon-azol)

Question 2

Terbinafine:

Answer 2

also called lotrimine, tenia pedis, curis, toe nail fungus, nothing more than a cosmetic anamoly trichofiten

Question 3

trichofiten:

Answer 3

tenia pedis, curis, topical treatment, terbinafine, onchomichosis

Question 4

systemic:

Answer 4

amphotericin b works by binding ergosterol in cell membrane, increases cell membrane permeability, disrupts the continuity of the fungi, works against fungi and molds`

Question 5

amphotericin mechanism

Answer 5

not well understood

Question 6

amphotericin is used for:

Answer 6

deep seeded fungi infections, often people with immunocompromised, or transplants, candida, yeast, dimorhphic fungi, cocci, used in molds: aspergillus

Question 7

cocci:

Answer 7

sw, phoenix, dust, earthquakes, amphotereic

Question 8

ampho

Answer 8

only available iv

Question 9

ampho packaged with

Answer 9

lipid particle, delivered deeper, lessens fever, much more expensive,

Question 10

flucytosine

Answer 10

pyramadine analoge, doesn’t work well by itself, used with amphotericin b, synthe, one cell wall, one rna dna, ampho and flucyt work better together, aids patients, limit combo therapy 2 weeks, induction phase

Question 11

azoles

Answer 11

remember them all as azoles, spectrum braodens, newer more broad, interfere with memberane via p450 ergosterol

Question 12

amph and imidazole?

Answer 12

antagonistic, azoles decrease synthesis of ergosterol, and amph B binds to ergosterol and increases its permeability, they’re not used to together

Question 13

problem with ampho

Answer 13

eventually they will all get kidney problems, renal issues, this may cause full kidney failure, rizapus, used when azoles don’t work or when there’s no other option

Question 14

fluconazole

Answer 14

candida and cryptococcus, same level as iv, imidazole drug, iv or oral

Question 15

fluconazole excellent at:

Answer 15

penetrating csf, ideal for: cryptococcal meningitis

Question 16

ideal treatment for crypto:

Answer 16

induction 2 weeks with ampho b and flucytosine, then switch to fluconazole

Question 17

fluconazole resistance?

Answer 17

canada krusei, starting to see acquired resistance via candida albicans

Question 18

fluconazole used in?

Answer 18

most systemic candidiasis, bladder, vag, don’t use in catheter where it might build up but is necessary

Question 19

itraconazole

Answer 19

doesn’t cross blood brain barrier, some activity over mold (low yield)

Question 20

voriconazole

Answer 20

increases mold action, aspergillus, adds activity against mold vs flu and iconazole

Question 21

posaconazole and isavuconazole

Answer 21

increased spectrum for complex molds, rhizopus and mucor

Question 22

increased spectrum of iconazoles

Answer 22

flucon, itracon, voricon, (posacon and isavucon)

Question 23

candida that is resistant to flucanazole:

Answer 23

echinocandins

Question 24

all echinocandins ends in

Answer 24

fungin

Question 25

echinocandins work against___ and not ____

Answer 25

candida, aspergillu, not crypto

Question 26

candida krusei drugs

Answer 26

only 2: amphotericin, echinocandin (fungin)

Question 27

echinacandin used in

Answer 27

systemic candida in blood

Question 28

terbinafine:

Answer 28

topical or oral

Question 29

terbinafine

Answer 29

mainly used for trichophytin, topical dermatophyte

Question 30

terbinafine

Answer 30

inhibits ergosterol synthesis but not p450 like azoles

Question 31

trichophytin can occasionally be deep seeded infecetion and you need:

Answer 31

oral terbinafine

Question 32

terbinafine

Answer 32

lamisol: occasional liver toxicity, toe nail fungus, not important, too expensive, etc