Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ECVIM 2024 > Antifungals > Flashcards

Antifungals Flashcards

1
Q

Indications:

A

■ Blastomyces dermatitidis
■ Histoplasma capsulatum
■ Coccidioides immitis
■ Cryptococcus neoformans
■ Candida spp.
■ Aspergillus (may have resistance/high MIC)
■ Leishmania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Mechanism of Action:

A

■ Fungistatic
■ Steroid (primarily ergosterol) binding in cell membrane
■ Altered permeability leading to leakage of K and other cellular
constituents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pharmacokinetics:

A

■ Poor GI absorption (IV or SC administration)
■ Highly protein-bound (>90%)
■ Does not penetrate well to CNS, bone, joints, pancreas, muscle, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

○ Adverse Effects:

A

■ AKI (common)
■ Vomiting
■ Tremor
■ Pyrexia
■ Anorexia
■ Calcinosis cutis
■ CK elevations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Comments:

A

■ Liposomal formulation is more selective and less toxic
■ Different formulations: deoxycholate, lipid complex, cholesteryl sulfate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Indications:

A

■ Yeast, systemic fungi, dermatophytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

○ Mechanism of Action:

A

■ CYP450 inhibition
■ Inhibition of ergosterol formation
■ Weakens fungal cell membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pharmacokinetics:

A

■ Good PO absorption but variable bioavailability
■ Acidic environment enhances absorption
■ Variable tissue distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Adverse Effects:

A

■ GI issues
■ Hepatotoxicity
■ Altered metabolism of other drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Comments:

A

■ Hepatotoxicity more common in cats
■ Not usually used in cats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Indications:

A

■ Systemic and cutaneous mycosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Mechanism of Action:

A

■ Similar to other azoles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

○ Pharmacokinetics:

A

■ Bioavailability influenced by pH and food
■ High protein binding, very lipophilic
■ Many drug interactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Adverse Effects:

A

■ Idiosyncratic hepatotoxicity in cats
■ Hepatopathy in 10% of dogs
■ Vasculitis, skin lesions, thrombocytopenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

○ Comments:

A

■ More potent than ketoconazole
■ Available in capsules and suspension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications:

A

■ Effective against Cryptococcus and coccidiosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Pharmacokinetics:

A

■ High PO absorption
■ Low protein binding, high distribution
■ Elimination through kidneys

18
Q

Indications:

A

■ Variety of fungal infections, particularly Blasto, Crypto, and Aspergillus

19
Q

Mechanism of Action:

A

■ Similar to other azoles

20
Q

Pharmacokinetics:

A

■ High bioavailability
■ Can cross the CNS
■ Liver metabolism with main metabolite

21
Q

Comments:

A

■ Cats seem prone to adverse reactions
■ Complex elimination

22
Q

○ Indications:

A

■ Systemic or severe fungal infections

23
Q

Mechanism of Action:

A

■ Similar to other azoles

24
Q

Pharmacokinetics:

A

■ Adequate bioavailability
■ Moderate protein binding

25
Q

Adverse Effects:

A

■ GI issues, ALT elevation, PLTpenia

26
Q

○ Comments:

A

■ Second-generation triazole
■ Cost prohibitive

27
Q

Amphotericin B (Fungizone):

A

○ Indications: Blastomyces dermatitidis, Histoplasma capsulatum, Coccidioides
immitis, Cryptococcus neoformans, Candida spp., Aspergillus, Leishmania
○ Mechanism of Action: Fungistatic, binds primarily to ergosterol in cell
membrane
○ Pharmacokinetics: Poor GI absorption, highly protein-bound (>90%), limited
penetration to various tissues
○ Adverse Effects: AKI, vomiting, tremor, pyrexia, anorexia, calcinosis cutis, CK
elevations
○ Comments: Liposomal formulation for more selectivity, different formulations
available

28
Q

Ketoconazole:

A

○ Indications: Yeast, systemic fungi, dermatophytes
○ Mechanism of Action: CYP450 inhibition, weakens fungal cell membrane,
anti-inflammatory
○ Pharmacokinetics: Good PO absorption, variable bioavailability, metabolized
in the liver
○ Adverse Effects: GI disturbances, hepatotoxicity, altered metabolism of other
drugs
○ Comments: Hepatotoxicity more common in cats, not typically used in cats

29
Q

Itraconazole (Sporanox):

A

○ Indications: Systemic and cutaneous mycosis
○ Mechanism of Action: Similar to other azoles
○ Pharmacokinetics: Bioavailability influenced by pH and food, high protein
binding, many drug interactions
○ Adverse Effects: Idiosyncratic hepatotoxicity in cats, hepatopathy in dogs,
skin reactions, thrombocytopenia
○ Comments: More potent than ketoconazole, available in capsules and
suspension

30
Q

Fluconazole:

A

○ Indications: Effective against cryptococcus and coccidiosis
○ Pharmacokinetics: High PO absorption, low protein binding, elimination
through kidneys

31
Q

Voriconazole:

A

○ Indications: Variety of fungal infections, particularly Blasto, Crypto, and
Aspergillus
○ Mechanism of Action: Similar to other azoles
○ Pharmacokinetics: High bioavailability, can cross CNS, liver metabolism
○ Comments: Cats prone to adverse reactions, complex elimination

32
Q

Posaconazole:

A

○ Indications: Systemic or severe fungal infections
○ Pharmacokinetics: Adequate bioavailability, moderate protein binding
○ Adverse Effects: GI issues, ALT elevation, PLTpenia
○ Comments: Second-generation triazole, cost prohibitive

33
Q

Amphotericin B - Mechanism of Action:

A

○ Binds primarily to ergosterol in the fungal cell membrane
○ Induces altered permeability, leading to leakage of cellular constituents

34
Q

Itraconazole - Adverse Effects:

A

○ Idiosyncratic hepatotoxicity in cats
○ Hepatopathy in 10% of dogs, skin lesions, thrombocytopenia

35
Q

Posaconazole - Pharmacokinetics:

A

○ Adequate bioavailability with moderate protein binding
○ Prolonged t1/2 in cats, associated with GI issues and ALT elevation

36
Q

Voriconazole - Mechanism of Action:

A

Inhibition of 24-methylene dehydrolanosterol demethylation in molds,
resulting in increased antifungal activity

37
Q

Fluconazole - Pharmacokinetics:

A

○ High PO absorption, low protein binding, significant elimination through
kidneys

38
Q

Ketoconazole - Pharmacokinetics:

A

○ Good PO absorption, variable bioavailability, extensive liver metabolism

39
Q

Itraconazole - Comments:

A

○ More potent than ketoconazole
○ Available in both capsules and suspension formulations

40
Q

Posaconazole - Adverse Effects:

A

○ GI issues, ALT elevation, platelet abnormalities identified in dogs
○ Considered a second-generation triazole with a cost-prohibitive profile

ECVIM 2024 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions