Antifungal Drugs (92)

Question 1

What are fungi?

Answer 1

A large and diverse group of microorganisms
-yeasts, models

Question 2

What is the term referred to as fungal infections s

Answer 2

Mycoses

Question 3

Superficial fungal infection

Answer 3

-integumentary
-mucus membranes

Question 4

Systemic fungal infections

Answer 4

Can be life threatening
-prolonged therapy
-use of toxic drugs
-immunocompromised host

Question 5

Candida albicans in immunocompromised patients

Answer 5

A common yeast that causes thrush or vaginal yeast infections
-naturally found on the body (bad for immunocompromised)
-may result in overgrowth and systemic infections

Question 6

Dermatomycoses

Answer 6

Infections of the hair, nails or skin caused by fungus
-tinea or ringworm

Question 7

Naturally occuring anti fungal drugs (2)

Answer 7

-polyenes
-echinocandins

Question 8

Synthetic anti fungal drugs

Answer 8

-azoles
-pyrimidines

Question 9

Two types of polyenes

Answer 9

Amphotericin B and nystatin

Question 10

One type of azoles

Answer 10

Fluconazole
-importantly they end in ZOLE

Question 11

Amphotericin B

Answer 11

Usually given for systemic infections
-slow IV injection
-lipid and non lipid preparations

Question 12

Fluconazole

Answer 12

Systemic infections
-there are multiple administration routes

Question 13

Nystatin

Answer 13

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

Question 14

PO/topical azoles would be used to target

Answer 14

Superficial infections
-vaginal candidiasis, tinea
-Fluconazole

Question 15

Ergosterol is very similar to what chemical?

Answer 15

Cholesterol

Question 16

Polyenes mechanism of action

Answer 16

Binds to sterols (Ergosterol in fungal cells) in cell membrane lining, makes holes in fungi cell membranes and causes cell death

Question 17

Higher concentrations of polyenes are at risk of what?

Answer 17

Binding to cholesterol of human cells to cause toxicities
-taking this drug daily

Question 18

Mechanisms of actions for Azoles

Answer 18

Inhibit sterol altering enzyme, leading to altered cell membrane, inhibits growth = death

Question 19

Azoles inhibit sterol altering enzyme leads to

Answer 19

Less ergosterol in membranes
-CYP P450 enzymes

Question 20

Adverse effects of amphotericin B

Answer 20

MANY :(((
-renal toxicity (K+ loss)
-impairs hepatic functions

Question 21

What needs to be assessed before delivering amphotericin B

Answer 21

You need to assess the kidney and liver functions

Question 22

Less important other adverse effects of amphotericin B

Answer 22

-fever, headache, malaise, hypotension, muscle and joint pain, chills, dysrythmias, nausea, vomiting, anorexia

Question 23

How can one reduce the severity of infusion related reaction to amphotericin B (3)

Answer 23

PROPHYLACTIC drugs
-antipyretic
-antihistamines
-antiemetics

A test dose is given to assess reaction

Question 24

Many azoles will inhibit…

Answer 24

Hepatic CYP enzymes

Question 25

Co administration of two drugs that are metabolized by this system (azoles inhibiting hepatic CYP enzymes) may result in…

Answer 25

Competition for these enzymes
-higher levels of one of the drugs

Question 26

What scenarios make you more prone to fungal infections?

Answer 26

-pregnancy
-diabetes mellitus
-oral contraceptives