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IDMM > Antifungal Therapy > Flashcards

Antifungal Therapy Flashcards

1
Q

What is the MOA of polyenes?

A

Binds ergosterol (part of cm) –> disrupts CW perm –> fungicidal

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2
Q

Name the 2 polyenes

A
  1. Amphotericin B IV

2. Nystatin many forms

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3
Q

What is the DOC for Aspergillus?

A

Amphotericin

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4
Q

What is the DOC for Cryptococcal meningitis?

A

Amphotericin

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5
Q

How does the spectrum of activity differ for Amphotericin and Nystatin?

A

Nystatin = candida only

Amphotericin = candida, aspergillus, cryptococcus and dimorphic fungi

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6
Q

What is the DOC of oropharyngeal adn vaginal candidiasis?

A

Nystatin

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7
Q

What is the MOA of azoles? What is of note for azole metabolism?

A

Inhibit lanosterol C14-demethylase –> inhibit ergosterol synthesis

Potent CYP3A4 inhibitors –> affect many drugs

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8
Q

Name the 4 azoles

A
  1. Fluconazole IV/PO
  2. Itraconazole PO
  3. Voriconazoel IV/PO
  4. Posaconazole PO
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9
Q

What is the DOC for invasive Candida albicans?

A

Fluconazole (excellent bioavailability)

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10
Q

What is the SOA of fluconazole?

A

Candida (C. albicans ONLY), Cryptococcus, dimorphic fungi

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11
Q

Which azole acts as an oral stepdown for treatment of dimorphic fungi?

A

Itraconazole PO

I-tra to step down yo

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12
Q

Which azole is an alternative treatment for Candida and Aspergillus? Why is it NOT the DOC?

A

Itraconazole; poor bioavailability

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13
Q

Which azole has excellent bioavailability (vitral and CSF penetration), is broad spectrum and reserved for drug-resistant fungal infections?

A

Voriconazole IV/PO

Full activity against Aspergillus

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14
Q

Which is the broadest spectrum azole?

A

Posaconazole PO

Pos-eidon is all mighty!!!!! —-E

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15
Q

Name the 3 echinocandins

A
  1. Anidulafungin IV
  2. Caspofungin IV
  3. Micafungin IV
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16
Q

What is the MOA of echinocandins?

A

Inhibit production of D-glucan –> inhibit cell wall synthesis

*IV only

17
Q

What is the spectrum of activity of echinocandins?

A

Aspergillus (not first line) and candida

18
Q

What is the DOC for serious non-albicans Candida infections?

A

Echinocandins

19
Q

What is the MOA of allylamines?

A

Inhibit squalene epoxidase –> inhibit ergosterol synthesis

20
Q

Name 1 allylamine

A

Terbinafine PO, cream

Distributes mainly to sebum and skin

CYP2D6 inhibitor

21
Q

What are allylamines mainly used for?

A

Dermatophytes

PO: tinea of nail and scalp
Cream: tinea of foot, ring worm, groin

22
Q

Name 3 topical antifungals and their MOAs

A
  1. Clotrimazole - inhibit ergosterol syn
  2. Ciclopirox - inhibit transport of essential substrates into fungal cell
  3. Tolnaftate - inhibit squalene epoxidase (ergosterol synthesis)
23
Q

Which topical antifungal is not effective against Candida?

A

Tolnaftate

IDMM (6 decks)

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