Antifungals Flashcards
Fungal infections most commonly occur where?
Most commonly superficial involving the skin (cutaneous mycoses), but when systemic are very severe and life-threatening
Fungal infections are most common in what patients?
Immunocompromised - chronic immune suppression, undergoing chemo, HIV/AIDS
What is the most common target of antifungal drugs?
Cellular membranes
What is the MOA of Amphotericin B?
Lipophilic rod-like molecule binds to ergosterol and then forms pores in the membrane causing K+ to leak out and cause cell death
What are the indications for Amphotericin B?
Treatment of severe invasive fungal infections, widest spectrum of activity of all the antifungals.
What is the PK of Amphotericin B?
Onset is rapid; not dependent on organisms growth rate
Metabolism is poorly understood, poor PO absorption so used IV- wide tissue distribution (intrathecal occasionally)
Little CSF penetration
Low TI
What labs need to be monitored with Amphotericin B treatment?
Need to monitor K+, Mg2+
What are the adverse reaction associated with Ampotericin B?
Infusion reactions, nephrotoxicity, bone marrow suppression, N/V, anemia, phlebitis
What are the contraindications of Amphotericin B?
Contra in renal insufficiency, combo use w other nephrotoxic agents
How can nephrotoxicity risk with treatment of Amphotericin B be avoided?
Nephrotoxicity decreased by saline loading and increased infusion time
What is used in combination with Amphotericin B (synergistic) for treatment of systemic mycoses and meningitis caused by cyrptococcus and candida spp.?
Flucytosine (5-FC)
What is the MOA of Griseofluvin?
Binds to microtubules and inhibits mitosis
What are the indications for use of Griseofluvin?
Superficial mycoses, Dermatophytic infections of the skin, hair, and nails (tinea)
It accumulates in keratin
What is the PK of griseofluvin?
Oral, 6-12 months of treatment
What should be avoided while being treated with griseofluvin?
Avoid ETOH
