Antifungal/Malaria - EG

Question 1

What are systemic mycoses caused by pathogenic fungi?

Answer 1

Histoplasmosis, Coccidioidomycosis, cryptococcosis, blastomycosis, paracoccidioidomycosis, sporotrichosis

Question 2

What are examples of invasive opportunistic fungi?

Answer 2

candida albicans, aspergillius species, trichosporon, candida glabrate, fusarium, alternaria, mucor

Question 3

What are fungal agents MOA?

Answer 3

selectively toxic to fungi

• interacts w/ or inhibits the synthesis of ergosterol (sterol unique to fungal cell membranes)

Question 4

Almost all antifungal drugs target…

Answer 4

cell membrane or cell wall

except flucytosine and possibly griseofulvin

Question 5

What is the prototype drug of the -azoles?

Answer 5

Fluconazole

Question 6

What is the susceptibility activity?

Answer 6

candidemia, aspergillus, blastomyces, cryptococcus, coccidioides, histoplasma

Question 7

Amphotericin B MOA?

Answer 7

binds to ergosterol in fungal cell membranes, forming “leaky pores”

Question 8

What organisms does Amphotericin B treat?

Answer 8

candidemia and infx’s caused by: aspergillus, blastomyces, cryptococcus, histoplasma, coccidioides

Question 9

Amphotericin B toxicities?

Answer 9

Nephrotoxicity is dose-limiting

infusion rxns (chills, fever, muscle spasms, hypotension)

Question 10

Flucytosine MOA

Answer 10

interferes w/DNA and RNA synthesis selectively in fungi

Question 11

Flucytosine tx’s against which organisms?

Answer 11

cryptococcus and chromoblastomycosis infx’s

Question 12

Flucytosine toxicities?

Answer 12

renal excretions

myelosuppression

Question 13

Azoles MOA

ketocon-, flucon-, itracon-, posacon-, voricon-

Answer 13

inhibits fungal P450-dependent enzymes BLOCKING ERGOSTEROL SYNTHESIS

resistance w/ long-term use

Question 14

Which Azole tx’s aspergillosis

Answer 14

Voriconazole

Question 15

how do most azoles get metabolized in the body?

Answer 15

hepatic metabolism

Question 16

which azole is eliminated in urine unchanged?

Answer 16

fluconazole

Question 17

Azole toxicities

Answer 17

cause GI upsets and rash

Question 18

Voriconazole toxicity

Answer 18

visual & CNS disturbances
class D for pregnancy risk

Question 19

Terbanafine clinical applications

Answer 19

mucocutaneous fungal infx’s

accumulates in keratin

Question 20

Terbinafine toxicities

Answer 20

GI upset

headache

Question 21

What is the only antifungal with nephrotoxicity toxicity?

Answer 21

Amphoterrible B

Question 22

What adverse effect do amphotericin, azole’s, and echino antifungals all have in common?

Answer 22

increased hepatic transaminases

Question 23

What are 3 diseases caused by protazoa?

Answer 23

malaria
giardia
trichomoniasis

Question 24

How is malaria transmitted?

Answer 24

by the bite of infected mosquitoes (asexual erythrocytic stage) in tropical and subtropical areas of the world

Question 25

What are some serious consequences of malaria?

Answer 25

mental disturbances convulsions kidney disorders

Question 26

What are examples of antimalarial drugs?

Answer 26

mefloquine chloroquine proguanil w/atovaquone doxycycline

Question 27

What factors affect malaria prevention?

Answer 27

choice of drugs depends on destination visiting | risk determined by traveler behavior and health status

Question 28

Which 2 antimalarial drugs should not be given to pregnant or breastfeeding women?

Answer 28

proguanil w/atovaquone | doxycycline

Question 29

Which anti-protazoal drug is used to treat p. vivax & p. oval?

Answer 29

Primaquine

Question 30

Which drug do you use in areas w/out resistance to P. falciparum?

Answer 30

Chloroquine

Question 31

Which drug do you use in areas w/ chlorquine-resistant P. falciparum?

Answer 31

Malarone or mefloquine

Question 32

What drug do you use in areas w/ multidrug-resistant P. falciparum?

Answer 32

Doxycycline

Question 33

If you give your patient metronidazole, what do you need to educate them on?

Answer 33

Do not use w/ alcohol bc it will lead to severe vomiting