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Microbial Pharmacology > Antifungal Chemotherapy > Flashcards

Antifungal Chemotherapy Flashcards

1
Q

What are the Dimorphic Fungi?

A

Histoplasma Capsulatum, Blastomyces dermatiditus,

Coccioides immitis, Sporothrix schenckii

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2
Q

What are the opportunisic fungi?

A

Candida, aspergillus, cryptococcus

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3
Q

What are the Cutaneous/subcutaneous fungi?

A

Sporothrix schenckii,

Dermadophytes: ringworm, athletes foot, onchomycosis

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4
Q

What fungi are included in dermatophytes?

A

Trychophytan, Epidermophytan, Microsporum

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5
Q

What are the unique targets of antifungal chemotherapy?

A

Fungal cell membrane(ergosterol and ergo synth),

Fungal cell walls (Glucan synth)

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6
Q

What are the shared targets of antifungals?

A

DNA/RNA synthesis, Cell division

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7
Q

What are the different classes of antifungals?

A

Polyenes, Azoles, Nucleoside analogs, echinocandins, allylamines, and microtubule inhibitors

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8
Q

Which drug has the broadest spectrum of antifungal activity?

A

Amphotericin B.

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9
Q

Why is Ampho B not used as much anymore?

A

Too many side effects. Replaced by azoles.

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10
Q

MOA of Ampho B?

A

Binds to Ergosterol in Fungal Cell membrane.

Alters membrane Permiability.

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11
Q

What are the main uses for Amphoteracin B?

A

Systemic diseases such as Candida and Cryptococcus (yeasts). and Aspergillus, Histoplasma, coccioides, blastomyces, sporothrix, and mucormycoses. (molds)

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12
Q

How is Ampho B administered?

A

Insoluable in Water. Complexed with a bile salt. High protein binding!

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13
Q

What are the adverse rxns of Ampho B?

A

Infusion related Rxns. Fever, chills, muscle spasms, vomiting. Decrease rate or dose of admin.
Nephrotoxicity (vasoconstrictive)

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14
Q

How is toxicity of Ampho B decreased?

A

Insertion into micelles.

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15
Q

What is the MOA of Azoles?

A

Inhibits ergosterol synthesis. Makes the cell membrane leaky.

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16
Q

What are the two groups included in Azoles?

A

Imidazoles and Triazoles

17
Q

What types of fungi do azoles work against?

A

Pathogenic yeast, Systemic mycoses, and dermatophytes.

18
Q

How does resistance develop to azoles?

A

Less ergosterol in the fungal cell membranes.

19
Q

What are the adverse reactions to Azoles?

A

GI disturbances

Interacts with P450 in liver

20
Q

What is the 1st line treatment for systemic candida, cryptococcus, and coccidiomycosis.

A

Fluconazole

21
Q

What are the benefits of Fluconazole?

A

Less adverse effects.

22
Q

What are the pros/cons of itraconazole?

A

Broader activity than fluconazole but narrow theraputic index…

23
Q

What drug has replaced Ampho B for treating aspergillosis?

A

Voriconazole

24
Q

What fungi does Posaconazole treat?

A

Candida, Aspergillus, and mucormycoses

25
Q

What antifungal inhibits protein and nucleic acid synthesis?

A

Flucytocine

26
Q

How is flucytosine used?

A

Combo therapy for cryptococcal infections.

27
Q

What is the MOA of Echinocandins?

A

Inhibit synth of Beta-Glucans. Fungal cell wall.

28
Q

What features allow echinocandins to work on only some fungi and no humans?

A

Only works if beta-glucan present.

29
Q

Why is use of echinocandins limited?

A

Very expensive. used if no others work well.

30
Q

What drugs are administered orally (systemically) for cutaneous and mucocutaneous infection.

A

Grisofulvin and Allylamines (terbafine)

31
Q

What are the special properties of Griseofulvin and allylamines?

A

You drink it and it localizes to the Keratin containing cells.

32
Q

What is the MOA of Nystatin?

A

Ergosterol synth (like ampho B)

33
Q

What is nystatin used for?

A

Candida, local infections, oral and vaginal candidiasis.

34
Q

What is the MOA of Allylamines?

A

Disrupts Ergosterol synthesis.

35
Q

What drugs are included with topical allylamines?

A

Terbinafine, Naftifine. used for? Tinea Cruris, Tinea corporis.

36
Q

What is the first line treatment for onchomycosis?

A

Terbinafine

Microbial Pharmacology (13 decks)

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