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Pharmacology > Antifungal Drugs (Systemic Mycoses) > Flashcards

Antifungal Drugs (Systemic Mycoses) Flashcards

1
Q

Candidiasis, aspergillosis, cryptococosis, and mucormycosis are all ____ types of systemic mycoses infections

A

opportunistic - occur in IC patients

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2
Q

Name the non-opportunistic systemic mycoses infections

A

sporotrichosis, blasomycosis, histoplasmosis, and cocidiomycosis

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3
Q

What is the clinical use of Amphotericin B, Azoles, Echinocandins, and Fucytosine classes of drugs?

A

antifungal drugs

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4
Q

What are the adverse effects of Amphotericin B?

A

nephrotoxic - binds to cholesterol and other sterols in human membranes

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5
Q

What is the MOA for amphotericin B?

A

Amphotericin binds to ergosterol, facilitates pore formation

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6
Q

How is Amphotericin B administered?

A

IV; slowly

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7
Q

There are 3 liposomal formulations of amphotericin B that have higher therapeutic indexes than amphotericin B. Why is this?

A

liposomal formulations transfer amphotericin B to fungal membranes and less to human membranes

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8
Q

In regards to drug interactions, which drugs should amphotericin B not be used with?

A

other nephrotoxic drugs (ahminoglycosides, NSAIDS, cyclosporine)

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9
Q

Which drug should be given with amphotericin B?

A

Flucytosine - the dosage and toxicity of amphotericin B can be reduced with combination use

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10
Q

What are the two types of Azoles?

A

Imidazoles: clotrimazole, ketoconazole

Triazoles: itraconazole, fluconazole

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11
Q

How is Itraconazole (Triazole) administered?

A

orally - safer than amphotericin B

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12
Q

What are the adverse effects of Itraconazole (Triazole)?

A

liver toxicity, cardiosuppression

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13
Q

Why is ketocanzole (Imidazole) hardly ever used?

A

FDA limits due to potentially fatal liver injury and risk of adrenal gland problems

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14
Q

What is the MOA of the Azoles class of drugs?

A

inhibit ergosterol synthesis - bind to cyt P450

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15
Q

What are the adverse effects of the Azoles class of drugs?

A

toxicity depends on affinity for mammalian and fungal cyt P450

note: Triazoles tend to have fewer side effects, better absorption

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16
Q

Itraconazole (Tirazole) and Ketoconazole (Imidazole) inhibit ____ and could increase the levels of other drugs if co-administered

A

CYP3A4

17
Q

What type of drugs decrease absorption of itraconazole (Triazole)?

A

drugs that raise gastric pH, H2 antagonists, and proton pump inhibitors

18
Q

Fluconazole (Triazole) is associated with what syndrome?

A

Stevens-Johnson Syndrome

19
Q

Flucytosine is used to treat Candida in combination with _____

A

amphotericin

20
Q

What is the MOA of Flucytosine?

A

converted to 5-FU by FUNGAL cytosine deaminase - inhibits thymidylate synthetase - inhibits DNA synthesis

21
Q

What are the two types of Echinocandins?

A

Caspofungin, Micafungin

22
Q

What is the MOA of the Echinocandins?

A

Inhibit synthesis of beta-1,3-D-glucan (cell wall component)

23
Q

What would be the drug of choice for an Aspergillosis infection caused by Aspergillus species?

A

Amphotericin B

24
Q

What would be the drug of choice for a Blastomycosis infection caused by Blastomyces dermatitidis?

A

Amphotericin B or itraconazole

25
Q

What would be the drug of choice for a Candidiasis infection by the Candida species?

A

Fluconazole or Caspofungin

26
Q

What would be the drug of choice for Coccidioidomycosis infection caused by Coccidioides immitis?

A

Amphotericin B or fluconazole

27
Q

What would be the drug of choice for a cryptococcosis infection caused by cryptococcus neofromans?

A

Amphotericin B +/- flucytosine

28
Q

What would be the drug of choice for chronic suppression Histoplasmosis?

A

Fuconazole

29
Q

What would be the drug of choice for a Sporotrichosis infection?

A

amphotericin B or itraconazole

Pharmacology (7 decks)

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