Antifungal/Malaria - EG Flashcards
What are systemic mycoses caused by pathogenic fungi?
Histoplasmosis, Coccidioidomycosis, cryptococcosis, blastomycosis, paracoccidioidomycosis, sporotrichosis
What are examples of invasive opportunistic fungi?
candida albicans, aspergillius species, trichosporon, candida glabrate, fusarium, alternaria, mucor
What are fungal agents MOA?
selectively toxic to fungi
- interacts w/ or inhibits the synthesis of ergosterol (sterol unique to fungal cell membranes)
Almost all antifungal drugs target…
cell membrane or cell wall
except flucytosine and possibly griseofulvin
What is the prototype drug of the -azoles?
Fluconazole
What is the susceptibility activity?
candidemia, aspergillus, blastomyces, cryptococcus, coccidioides, histoplasma
Amphotericin B MOA?
binds to ergosterol in fungal cell membranes, forming “leaky pores”
What organisms does Amphotericin B treat?
candidemia and infx’s caused by: aspergillus, blastomyces, cryptococcus, histoplasma, coccidioides
Amphotericin B toxicities?
Nephrotoxicity is dose-limiting
infusion rxns (chills, fever, muscle spasms, hypotension)
Flucytosine MOA
interferes w/DNA and RNA synthesis selectively in fungi
Flucytosine tx’s against which organisms?
cryptococcus and chromoblastomycosis infx’s
Flucytosine toxicities?
renal excretions
myelosuppression
Azoles MOA
ketocon-, flucon-, itracon-, posacon-, voricon-
inhibits fungal P450-dependent enzymes BLOCKING ERGOSTEROL SYNTHESIS
resistance w/ long-term use
Which Azole tx’s aspergillosis
Voriconazole
how do most azoles get metabolized in the body?
hepatic metabolism
which azole is eliminated in urine unchanged?
fluconazole
Azole toxicities
cause GI upsets and rash
Voriconazole toxicity
visual & CNS disturbances class D for pregnancy risk
Terbanafine clinical applications
mucocutaneous fungal infx’s
accumulates in keratin
Terbinafine toxicities
GI upset
headache
What is the only antifungal with nephrotoxicity toxicity?
Amphoterrible B
What adverse effect do amphotericin, azole’s, and echino antifungals all have in common?
increased hepatic transaminases
What are 3 diseases caused by protazoa?
malaria
giardia
trichomoniasis
How is malaria transmitted?
by the bite of infected mosquitoes (asexual erythrocytic stage) in tropical and subtropical areas of the world
What are some serious consequences of malaria?
mental disturbances
convulsions
kidney disorders
What are examples of antimalarial drugs?
mefloquine
chloroquine
proguanil w/atovaquone
doxycycline
What factors affect malaria prevention?
choice of drugs depends on destination visiting
risk determined by traveler behavior and health status
Which 2 antimalarial drugs should not be given to pregnant or breastfeeding women?
proguanil w/atovaquone
doxycycline
Which anti-protazoal drug is used to treat p. vivax & p. oval?
Primaquine
Which drug do you use in areas w/out resistance to P. falciparum?
Chloroquine
Which drug do you use in areas w/ chlorquine-resistant P. falciparum?
Malarone or mefloquine
What drug do you use in areas w/ multidrug-resistant P. falciparum?
Doxycycline
If you give your patient metronidazole, what do you need to educate them on?
Do not use w/ alcohol bc it will lead to severe vomiting
