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HLSC 220 Pharmacotherapeutics for Health Professionals 💊 > Antifungal Drugs - Ch. 92 > Flashcards

Antifungal Drugs - Ch. 92 Flashcards

1
Q

Fungi

A

-Large and diverse group of micro-organisms
-Broken down into yeasts and moulds

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2
Q

What is the term used for fungal infections?

A

Mycoses

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3
Q

Where can fungal infections develop?

A

Normal flora of the skin, mouth, intestines, vagina (just like bacteria)

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4
Q

There is a rise in which kind of fungal infections?

A

Opportunistic
-Broad-spectrum antibiotics causing less competition

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5
Q

How are Mycotic (fungal) infections classified?

A

Superficial
Systemic

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6
Q

Where do superficial mycotic (fungal) infections occur?

A

Integumentary
Mucous membranes

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7
Q

What are systemic mycotic infections?

A

Can be life-threatening
May require prolonged drug therapy that can be toxic
Occur in immunocompromised hosts

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8
Q

What is Candida albicans?

A

Common yeast

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9
Q

Why are immunocompromised patients more likely to get a candida infection?

A

Antibacterial therapy, antineoplastics or immunosuppressents increase their risk

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10
Q

What can result from a Candida albicans infection in an immunocompromised patient?

A

May result in overgrowth and systemic infections

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11
Q

What are some parts of the body Candida albicans infects?

A

Mouth mucous membranes
Vagina

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12
Q

What is is called when there is an infection of candida in the mouth?

A

Oral candidiasis or thrush

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13
Q

What is it called when there is vaginal candidiasis?

A

Yeast infection

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14
Q

What things can make you more susceptible to Candida infections?

A

Pregnancy
Diabetes Mellitus
Oral contraceptives

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15
Q

What are dermatomycoses?

A

Tinea/ringworm
-Affects skin, nails and hair

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16
Q

What are the main subgroups of antifungals?

A

Naturally occuring
Synthetic

17
Q

Which antifungals belong to the naturally occurring group?

A

Polyenes
Echinocandins

18
Q

Which antifungals belong to the synthetic group?

A

Azoles
Pyrimidines

19
Q

Examples of Polyenes?

A

Amphotericin B
nystatin

20
Q

Examples of Azoles?

A

Fluconazole
-miconazole, clotrimazole, ketoconazole,
itraconazole

21
Q

What can be used to treat systemic fungal infections?

A

Amphotericin B
Fluconazole, ketoconazole, itraconazole

22
Q

How is Amphotericin B administered?

A

SLOW IV injection
Lipid and non-lipid preparations

23
Q

How is Fluconazole, ketoconazole, itraconazole administered?

A

Multiple administration routes

24
Q

What is used to treat superficial fungal infections?

A

Nystatin
Azoles like fluconazole, ketoconazole, clotrimazole,
miconazole

25
Q

What find of superficial infections are treated via Nystatin?

A

Oral infections

26
Q

How is Nystatin administered?

A

Suspension should be swished in the mouth as long as possible before swallowing

27
Q

How is azoles for superficial infections administered?

A

PO/topical
for vaginal candidiasis, skin infections (tinea)

28
Q

What is the mechanism of action of Polyenes: amphotericin B and nystatin?

A

Binds to sterols in cell membrane
Makes hole sin fungi cell membranes
Fungal cell death (mostly)

29
Q

What do higher concentrations of Polyenes do?

A

Bind to cholesterol of human cells to cause toxicities

30
Q

What is the mechanism of action of Azoles: fluconazole, ketoconazole, miconazole, clotrimazole?

A

Inhibit sterol-altering enzyme
-Cyp P450 enzymes which cause less ergosterol in fungi membranes

Leads to altered cell membrane
Inhibits growth/kills cells

31
Q

What is the antifungal agent of choice for the treatment of severe systemic mycoses?

A

Amphotericin B
-Azoles = alternative

32
Q

Amphotericin has many what?

A

Many adverse effects

33
Q

What are the main concerns (adverse effects) of amphotericin B?

A

Renal toxicity (K+ loss)
Impairs hepatic functions

34
Q

Assess which functions before amphotericin B administration.

A

Liver and kidney functions

35
Q

What are the other adverse effects of Amphotericin B?

A

fever
headache
malaise
hypotension
muscle and joint pain
chills
dysrhythmias
Nausea and vomiting
Anorexia

36
Q

What is a patient pretreated with to reduce the severity of the amphotericin B infusion-related reactions?

A

Antipyretic (acetaminophen)
Antihistamines (diphenhydramine)
anti-emetics

-test dose is given to assess the reaction

37
Q

Many azoles inhibit which enzymes?

A

Hepatic CYP enzymes

38
Q

What may the co-administration of two drugs metabolized by the hepatic system result in?

A

Competition for hepatic CYP enzymes
-Higher levels of one of the drugs

HLSC 220 Pharmacotherapeutics for Health Professionals 💊 (15 decks)

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