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ID > Antifungals > Flashcards

Antifungals Flashcards

1
Q

What is the mechanism of Amphotericin B?

A

Binds to ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes.

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2
Q

What are the clinical uses of Amphotericin B?

A

Serious, systemic mycoses. Cryptococcus, blastomyces, coccidioides, histoplasma, candida, mucor. Intrathecally for fungal meningitis. Supplement K and Mg because of altered renal tubule permeability.

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3
Q

What is the mechanism of Nystatin?

A

Same as amphotericin B. - topical because too toxic for systemic use.

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4
Q

What are the toxicities we should be aware of for Amphotericin B?

A

Fever/chills
hypotension
nephrotoxicity
arrhythmias

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5
Q

What are the clinical uses of Nystatin?

A

“Swish and swallow” for oral candidiasis and topical for vaginal candidiasis or diaper rash

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6
Q

What are the azoles?

A

Fluconazole
ketoconazole
clotrimazole
miconazole

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7
Q

What is the mechanism of the azoles?

A

Inhibit fungal sterol (ergosterol) synthesis, by inhibiting te P-450 enzyme that converts lanosterol to ergosterol.

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8
Q

What are the clinical uses of the azoles?

A

Local and less serious systemic mycoses. Fluconazole for chronic suppression of cryptococcal meningitis in AIDS patients and candidal infections of all types.

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9
Q

What are the toxicities we should look out for with azoles?

A

Testosterone synthesis inhibition

liver dysfunction

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10
Q

What is the mechanism of Flucytosine?

A

Inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase.

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11
Q

What are the clinical uses of Flucytosine?

A

Used in systemic fungal infections in combination with amphotericin B.

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12
Q

What are the toxicities we should look out for with Flucytosine?

A

Bone marrow suppression.

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13
Q

What are the mechanisms for Caspofungin and micafungin?

A

Inhibit cell wall synthesis by inhibiting synthesis of Beta-glucan

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14
Q

What are the toxicities we should look out for with caspofungin and micafungin?

A

GI upset

flushing

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15
Q

What are the clinical uses of caspofungin and micafungin?

A

Invasive aspergillosis, Candida

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16
Q

What is the mechanism for Terbinafine?

A

Inhibits the fungal enzyme squalene epoxidase.

17
Q

What are the clinical uses for Terbinadine?

A

Used to treat dermatophytoses

18
Q

What are the toxicities we should look out for with Terbinafine?

A

Abnormal LFTs, visual disturbances

19
Q

What is the mechanism of Griseofulvin?

A

Interferes with microtuble function; disrupts mitosis. Deposits in keratin-contain tissues

20
Q

What are the clinical uses of Griseofulvin?

A

Oral treatment of superficial infections; inhibits growth of dermatophytes (tine, ringworm)

21
Q

What are the toxicities we should look out for with Griseofulvin?

A 
Teratogenic
cacinogenic
confusion
headaches
upregulaion of P450 and war fin metabolism

ID (8 decks)

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