Antifungal Flashcards

Question

Clotrimazole

Answer 1

Pyrimidine analogue

Answer 2

Echinocandins

Answer 3

Topical preparation

Answer 4

Strong affinity for ergosterol | Binding to it causes disruption to fungal cell membrane

Answer 5

Oral IV Intraarticular

Answer 6

Topical (creams ointment suppositories)

Answer 7

Infusion rxn (shake and bake syndrome; fever and chills ) Thrombophlebitis Nephrotoxic Bone marrow suppression

Answer 8

It is not absorbed to a significant degree from skin, mucous membranes, or the gastrointestinal tract. As a result, nystatin has little toxicity.

Answer 9

1. aminoglycosides, | 2. vancomycin, 3. NSAIDs, 4. cyclosporine All will increase nephrotoxic potential.

Answer 10

Inhibit ergosterol synthesis, by inhibiting α- demethylase, which demethylates lanosterol to ergosterol

Answer 11

Topical | Cream lotion powder pessary

Answer 12

Cream powder | Oral gel 2%

Answer 13

Topical | Shampoo

Answer 14

Oral only | best absorb with food

Answer 15

Oral (>90% absorb) | IV

Answer 16

Invasive aspergillosis Histoplasmosis Systemic candidiasis

Answer 17

Vaginal candidiasis

Answer 18

Amphotercin B for treating different systemic fungal infection

Answer 19

Clotrimazole - skin and vulvovaginal infections caused by a wide variety of fungi, including Candida.

Answer 20

Miconazole - tineal infections and vulvovaginal candidiasis; oral gel for thrush (alternative to nystatin)

Answer 21

Itraconazole

Answer 22

Itraconazole - Trichophyton infections, Histoplasmosis,

Answer 23

Fluconazole - Cryptococcosis, candidiasis in AIDS patients, vaginal candidiasis

Answer 24

Voriconazole - Candidaemia; invasive aspergillosis (alternative to amphotericin B)

Answer 25

GIT disturbance Mild rash May have SJS 1. Headache Serious side effects: 2. cardiac suppression (due to negative inotropic action on cardiac muscle) 3. hepatotoxicity

Answer 26

GIT disturbance Mild rash May have SJS

Answer 27

GIT disturbance Mild rash May have SJS 1. hepatitis, 2. visual disturbances: -colour perception defect, -reduced visual acuity, -photophobia.

Answer 28

Warfarin Sulphonylurea Digoxin (Both anole inhibit hepatic CYP450 enzyme) PPI Antacid H2RA (Reduce anole absorption)

Answer 29

Carbamazepine Erythromycin Voriconazole is both a substrate and inhibitor of CYP450 enzymes. Avoid concomitant use of potent CYP450 inducers, like carbamazepine, and inhibitors, like erythromycin.

Answer 30

Disrupt synthesis of fungal RNA and DNA

Answer 31

Inhibit the synthesis of β(1–3)- glucan =>disruption of the fungal cell wall and cell death.

Answer 32

Squalene accumulates in the cell and Inhibits squalene epoxidase which is involved in the synthesis of ergosterol from squalene.

Answer 33

Topical - 1% cream: for treatment of dermatophytic infections. Oral – not commonly prescribed.

Answer 34

Effective against systemic yeast infections if given orally. Systemic Candidiasis and Cryptococcal meningitis (combined with amphotericin B). Combination allows use of amphotericin B at a lower dose, thus reducing the risk of nephrotoxicity. Combine with itraconazole for chromoblastomycosis

Answer 35

Mucocutaneous candidiasis and candidaemia, usually in immuno-compromised patients Salvage therapy in patients with invasive aspergillosis (failed response to amphotericin B)

Answer 36

Against dermatophytic infection of the skin and nails (“keratophilic”).

Answer 37

1. Bone marrow suppression is most serious. Monitor leucocytes and platelets weekly. 2. Hepatotoxicity - mild and reversible damage is common; monitor liver enzymes (ALT and AST weekly.

Answer 38

1. GIT-related symptoms, fever, histamine-like facial flushing rash, pruritus 2. thrombophlebitis 3. Foetal toxicity (Category C) - Avoid use in pregnancy.

Answer 39

Erythema, dry skin. (These can be avoided by not using > 4 weeks).

Answer 40

Quinidine Causes dysthymia

Answer 41

1. rifampicin 2. Carbamazepine 3. cyclosporine (1), (2) are CYP 450 inducers; reduce caspofungin plasma levels Risk of hepatotoxicity