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MAD Exam 2 > Antifungals > Flashcards

Antifungals Flashcards

1
Q

topical antifungals - uses

A

*superficial mycoses
*vulvovaginal candiasis
*thrush

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2
Q

topical antifungals - benefits

A

*safe and generally effective

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3
Q

amphotericin B - mechanism of action

A

*binds to ergosterol in the cell membrane of yeasts and some molds, increasing cell permeability

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4
Q

amphotericin B - overveiw

A

*IV only
*broad spectrum of activity

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5
Q

amphotericin B - indications

A

deep-seated or systemic fungal infections
-yeasts (candida, cryptococcus)
-dimorphic fungi
-aspergillus

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6
Q

amphotericin B - problems

A

*NEPHROTOXICITY (dysfunction of PCT of kidney)
*infusional toxicity

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7
Q

flucytosine - overview

A

*pyrimidine analog
*given orally
*ALWAYS given WITH AMPHOTERICIN

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8
Q

flucytosine - mechanism of action

A

*inhibits RNA and DNA synthesis (b/c its a pyrimidine analog)

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9
Q

flucytosine - indications

A

*cryptococcal infections (given w/ amphotericin, esp in HIV patients)

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10
Q

azole class - mechanism of action

A

*interferes with synthesis and permeability of fungal cell membranes through inhibiting fungal p450 and synthesis of ergosterole

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11
Q

fluconazole - spectrum

A

*YEASTS only (candida, cryptococcus, coccidioidomycosis)
*NOT C. krusei (resistant)

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12
Q

fluconazole - benefits

A

*EXCELLENT penetration into CSF for fungal infections (crypto meningitis)
*IV and oral

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13
Q

fluconazole - resistance to what organisms

A

*intrinsic: ALL C. krusei, many C. glabrata
*acquired: C. albicans

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14
Q

itraconazole - indications

A

*mostly the dimorphic fungi
*activity against molds

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15
Q

voriconazole - indications

A

*yeasts AND molds (especially ASPERGILLUS)

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16
Q

voriconazole - side effects

A

rash, hepatitis, visual disturbances, heart dysrhythmia

17
Q

posaconazole - indications

A

*yeasts AND molds, including mucormycosis

17
Q

isavuconazole - indications

A

*yeasts and molds, especially good for mucormycosis

18
Q

echinocandins - examples of drugs

A
  1. caspofungin
  2. micafungin
19
Q

echinocandins - mechanism of action

A

*inhibits 1,3-beta-glucan synthetase (key cell wall component)

20
Q

echinocandins - indications

A

*activity against candida and aspergillus
*NO activity against crypto
*drug of choice against resistant candida infections

21
Q

terbinafine - mechanism of action

A

*an analymine, which inhibits SQUALENE EPOXIDASE, thereby inhibiting ergosterol synthesis for the fungal cell membrane

22
Q

terbinafine - indications

A

onchomycosis of toenails/fingernails (must be given for a long time)

23
Q

therapy for pneumocystis jirovecii

A

primary therapy = TMP/SXT (trimethoprim/sulfa) NOT ANTIFUNGAL

24
Q

do we use antifungals for pneumocystis jirovecii

A

NO, we actually use an antibacterial

MAD Exam 2 (37 decks)

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