Antifungal Drugs Flashcards
What are fungal infections also known as?
Mycoses
What are the four general types of mycotic infections?
Systemic, cutaneous, Subcutaneous and superficial
What part of the body do the cutaneous, subcutaneous and superficial fungal infections affect?
Integumentary system (Skin, hair, nails)
Fungi that cause integumentary infections are known as ____________
Dermatophytes
What are infections of the integumentary system called?
Dermatomycoses
How do yeasts reproduce?
Budding
Yeasts are ____________ and Moulds are _______
Single-celled; multicellular
What can the use of antibiotics, antineoplastics and immunosuppressants cause?
Colonization by candida albicans
What is an infection of candida albicans in mouth called?
Oral candidiasis or thrush
Who is more at risk for vaginal candidiasis?
Pregnant women, women with diabetes and women taking oral contraceptives
What are two types of systemic antifungal drugs?
Terbinafine and Voriconazole
What are the 4 major groups of antifungal frugs and give examples?
Triazoles: Fluconazole, Ketoconazole, Voriconazole
Echinocandins: Caspofungin
Imidazole: Ketoconazole
Polyenes: Amphotericin B, Nystatin
What is the MOA of Amphotericin B and nystatin?
They bind to sterols in the cell membrane lining and result in fungal cell death
They do not bind to human cell membranes.
What are considerations when administering nystatin orally (mouthwash)?
Swish and swallow.
No food for 30 minutes afterwards
T/F: Do not stop nystatin cream therapy during menstruation
True
Why do polyenes not bind to human cell membranes?
Human cell membranes have cholesterol instead of ergosterol.
Polyenes have a strong affinity for ergosterol
What is the MOA of Imidazoles and triazoles?
They inhibit fungal cell cytochrome P450 enzymes, resulting in cell membrane leaking
What is the MOA echinocandins?
They prevent the synthesis of glucans which are essential components of fungal cell walls resulting in fungal cell death.
What is the drug of choice for severe systemic fungal infections and what are other parameters when choosing a drug?
Amphotericin B
Type and location of infection
What is an indication of fluconazole?
Cryptococcal meningitis because it passes into the CSF and inhibits the growth of cryptococcal fungi
What medication is used to treat onychomycosis?
Terbinafine
It is used for finger and toe nail fungal infections
What are the contraindications of antifungal drugs?
Drug allergy
Liver failure
Kidney failure
Porphyria (Abnormal metabolization of Hb)
What is a contraindication of voriconazole?
Can cause fetal harm in pregnant women
What are the adverse effects of amphotericin B ?
Cardiac dysrhythmias
Neurotoxicity, tinnitus, visual disturbances, paresthesia, convulsions
Kidney toxicity, K loss, Hypomagnesemia
Pulmonary infiltrates
Fever, chills, headache, nausea, hypotension, GI upset, anemia
