Antifungal Drugs

Question 1

Fungi

Answer 1

-Large and diverse group of microorganisms
-broken into yeasts and moulds

Question 2

Mycoses is a

Answer 2

fungal infection

Question 3

Fungal infections are

Answer 3

Normal flora of the skin, mouth, intestines, or vagina
-rise in opportunistic infections

Question 4

what is part of the reason normal flora increases

Answer 4

broad spectrum antibiotics cause less competition

Question 5

Normal flora

Answer 5

natural body bacteria

Question 6

Fungal (mycotic) infection classifications

Answer 6

-superficial
-Systemic

Question 7

Superficial fungal infection

Answer 7

-integumentary
-mucous membranes

Question 8

Systemic fungal infections

Answer 8

-Can be life threatening
-ma require prolonged therapy
-usually occur in immunocompromised hosts

Question 9

Whats the issue with systemic treatments

Answer 9

treatment drugs frequently prove toxic

Question 10

Candida albicans

Answer 10

-in immunocompromised
-common yeast
-due to antibiotic therapy, antineoplastics, or immunosuppressants

Question 11

Types of Candida albicans

Answer 11

-Oral candidiasis
-Vaginal Candidiasis
-Dermatomycoses

Question 12

Oral Candidiasis

Answer 12

thrush of mucous membranes

Question 13

Vaginal Candidisis

Answer 13

-Yeast infection
-Pregnancy, diabetes mellites, oral contraceptives

Question 14

Dermatomycoses

Answer 14

-Skin (tinea/ringworm)
-Nails
-Hair

Question 15

Antifungal drugs are split into

Answer 15

-Naturally Occurring
-Synthetic

Question 16

Naturally Occuring

Answer 16

-Polyenes
-Echinocandins

Question 17

Synthetic

Answer 17

-Azoles
-Pyrimidines

Question 18

Polyenes

Answer 18

-Amphotericin B
-Nystatin

Question 19

Azoles

Answer 19

-Fluconazole
-Miconazole
-Ketoconazole
-Itraconazole

Question 20

Systemic Infections are treated with

Answer 20

-Amphotericin B (polyene/natural)
-Fluconazole, Ketoconazole, Itraconazole (Azoles/synthetic)

Question 21

Amphotericin B (Polyene/natural) administration

Answer 21

-Slow IV injection
-Lipid/Non-lipid preparations

Question 22

Fluconazole, Ketoconazole, Itraconazole (Azole/synthetic) administration

Answer 22

multiple administration routes

Question 23

Superficial infections are treated with

Answer 23

Nystatin

Question 24

Nystatin (polyene/natural) administration

Answer 24

-Oral infections- suspension should be swished thoroughly in the mouth as long as possible before swallowing
-Polytypical azoles

Question 25

Polytypical Nystatin

Answer 25

-Vaginal candidiasis, skin infections (tineal) -Fluconazole, ketoconazole, clotrimazole, miconazole

Question 26

Polyenes mechanism of action (Amphotericin B + Nyststin)

Answer 26

-Bind to sterols in cell membrane lining -Makes holes in cell membranes -Fungal cell death (mostly)

Question 27

What's the danger of polyenes in high concentration

Answer 27

bind to cholesterol of human cells causing toxicities

Question 28

Azoles mechanism of action (Fluconazole, Ketoconazole, Miconazole, Clotrimazole)

Answer 28

-Inhibit sterol altering enzyme (CYP 450 enzymes, ergosterol in membranes) -lead to altered cell membrane -Inhibit growth/kills cells

Question 29

Indications of Antifungal drugs

Answer 29

-Systemic + Superficial infections -Agent of choice for the treatment of severe systemic mycosis

Question 30

Agent of choice for the treatment of severe systemic mycosis

Answer 30

-Amphotericin B -Azoles as alternative

Question 31

Amphotericin B adverse effects

Answer 31

Many adverse effects nontribally: -Renal toxicity -Impaired hepatic functions

Question 32

What should to assess when administering Amphotericin B

Answer 32

-Kidney and liver functions

Question 33

Other effects of Amphotericin B

Answer 33

-Fever -Headache -Dysrhythmias -Malaise -Hypotension -Nausea + Vomiting -Muscle +Joint pain -Chills -Anorexia

Question 34

How to reduce the severity of infusion related reaction of Amphotericin B

Answer 34

Pre-treat with -Antipyretic (acetaminophen) -Antihistamines (diphenhydramine) -Anti-emetics -Use a test dose

Question 35

Drug Interactions

Answer 35

-many azoles inhibit hepatic CYP enzymes -Co-administration of 2-drugs that are metabolized by this system result in competition with the enzymes -leading to higher levels of one of the drugs