antifungal meds Flashcards
1
Q
nystatin
A
polyene like amphotoxin B but only topical tx oral candida bitter taste too toxic for systemic use
2
Q
griseofalvin
A
fungistatic blocks microtubule polymerization only use: oral tx for systemic dermatophytosis CYP interaction -warfarin -oral contraceptives -affects sperm production
3
Q
flucytosine (5fu)
A
analog, prodrug defective RNA> decreased protein synthesis bacteriostatic used with amphotericin B good CNS penetration tx Systemic candida and cryptococcus AE -GI -decreased BM -anemia -leukopenia -thrombocytopenia
4
Q
ketoconazole
A
imidazole fungistatic local and systemic inhibit ergosterol synthesis (CYP) broad spectrum numerous drug interaction limited AE hepatitis
5
Q
miconazole
A
imidazole fungistatic local only inhibit ergosterol synthesis (CYP) broad spectrum numerous drug interaction limited tx jock itch and tropical candida
6
Q
clotrimazole
A
imidazole fungistatic local and systemic inhibit ergosterol synthesis (CYP) broad spectrum numerous drug interaction limited Tx: thrush prophylactic for AIDS patients
7
Q
itraconazole
A
triazole broader spectrum than fluconazole absorbed well and iv (long half life) tx -aspergilla -fluconazole resistant candida (esophageal)
8
Q
fluconazole
A
triazole more selective than imidazoles better CNS penetration Tx -cryptococcal meningitis -first line for invasive candida and mucocutaneous -prophylactic tx in immunocompromized Resistance -intristic to C. Krusei -C alabrata -molds
9
Q
voriconazole
A
triazole same spectrum as itraconazole but more potent oral and iv TX -invasive mold in immunocompromised> aspergillosis -fusarum -fluconazole resistant candida Low toxicity (transient) -skin rash -^LFT -drug interactions
10
Q
posaconazole
A
triazole spectrum like voriconazole -> also tx zygomycoses tx: BMT GVHD prophylaxis AE -skin rash -^LFT -drug interactions
11
Q
Efinaconazole
A
triazole
newest
tx orychomycosis topical
safe
12
Q
terbinafine
A
allylamine blocks ergosterol synthesis >squalene epoxide accumulates -> fungicidal oral, liver metabolized tx -dermpatophytosis -> similar specturm to griseofulvin but less toxic -phythium insidiosum (ling treatment time)
13
Q
caspofungin, micafungin, anidulafungin
A
newest class antifungals inhibit glucan synthesis > causes lysis 2ndary to osmotic shock tx -aspergillus -azole resistant candida
14
Q
amphotericin B
A
polyene antifungal binds ergosterol and forms pores broadest spectrum Tx -first line for life threatening systemic fungal infections >candida (rare resistance) >apergilla >crytpococcus cidal but affected by (pH, concentration, organisms) topical or IV (slow infusion), long 1/2 life (15 days) AE: deoxycholate toxicity (lipid formulations much less toxic) -hypokalemia > digitalis toxicity -azoles >antagonism -increased tox with other nephrotox --aminoglycosides --cyclosporine
