Antifungal agents + Antimycobacterial

Question 1

Mycobacteria cause 2 categories of infection:

Answer 1

1. tuberculosis

2. nontuberculosis (MAC) i.e. leprosy

Question 2

Mycobacteria diseases and cause

Answer 2

tuberculosis – Mycobacteria tuberculosis

leprosy – Mycobacteria lepre (Hansen)

Question 3

Factors making mycobacteria hard to treat

Answer 3

1. replicate slowly
2. ^ resistant DORMANT state
3. intracellular (hide from antibiotics)
4. Acid-fast cell-wall–phospholipid outer cell layer
5. complex drug therapies
6. delay in dx

Question 4

prevents synthesis of MYCOLIC acids in cell wall by inhibing enzymes the cat their production

Answer 4

Isoniazid (only active against TB)

Question 5

isoniazid metabolized in liver so dangerous w/ ______. Notorious w/ ______ _______ and ________

Answer 5

alcohol,

peripheral neuropathy and hepatotoxicity (black box)

Question 6

Rifamycins used for ___. Protein syth inhibition.

Answer 6

TB – RED EYES and tears

Question 7

latent and active TB:

Active TB:

Answer 7

• Isoniazid (only one for latent)

- Rifabutin

Question 8

Prodrug w/ unknown function–bactericidal against M. tuberculosis ONLY

Answer 8

Pyrazinamide

Question 9

Broadest antimycobacterial–cell wall synth inhibitor –works for TB and MAC

Answer 9

Ethambutol (OPTIC NEURITIS)

Question 10

Antifungal:

binds to ergosterol in cell membrane of fungi–disrupting its function by forming pores

Answer 10

Polyenes (amphotericin B, nystatin)

–very high toxicities and drug interactions–“amphoterrible”

Question 11

Decrease ergosterol production– inhibits CYP450 enzymes –less ADRs than polyenes

Answer 11

Azoles (fluconazole)

Question 12

highly active against Candida

Answer 12

Fluconazole

Question 13

fungal infection? answer

Answer 13

Azole–fluconazole

Question 14

Azole ADRs

Answer 14

• decrease in steroid production–>gynecomastia

- elongated QT