Antifungals

Question 1

What is an ideal antifungal?

Answer 1

Selectively eliminates fungal pathogens from a host with minimal toxicity to the host

Question 2

What are the three targets of antifungals?

Answer 2

Cell wall, Cell membrane, cytoplasm

Question 3

Used if refractory to other agents

Answer 3

Echinocandins

Question 4

Site of action of griseofulvin?

Answer 4

binds to microtubules

Question 5

site of action of echinocandins?

Answer 5

cell wall

Question 6

Polyenes are products of _______ species

Answer 6

Streptomyces

Question 7

What organisms are resistant to Amphotericin?

Answer 7

Pseudallescheria boydii, Fusarium spp., Trichosporon spp., certain isolates of Candida lusitaniae & Candida guilliermondii

Question 8

T or F. Dose adjustment is required for Amphotericin B.

Answer 8

F. Hepatic and renal impairment, and dialysis have little impact on drug concentrations

Question 9

Adverse effects of Amphotericin B

Answer 9

Elevation of LFT?s, anemia (reduced erythropoietin production), impaired hepatic function

Question 10

List three imidazoles

Answer 10

ketoconazole, miconazole (topical), and clotrimazole (topical)

Question 11

List three triazole

Answer 11

itraconzaole, fluconazole (prototype) and voriconazole

Question 12

Excretion of itraconazole

Answer 12

Fecal

Question 13

Does Amphotericin B cross the blood-brain barrier?

Answer 13

Yes. Kaya intrathecal yung administration for cryptococcal meningitis.

Question 14

most significant toxic reaction for Amphotericin B

Answer 14

Renal damage causes K+ bicarbonate wasting

Question 15

MOA of Azoles

Answer 15

Inhibits 14-?-demethylase during ergosterol synthesis from lanosterol

Question 16

Fungistatic or Fungicidal? Azole

Answer 16

Fungistatic

Question 17

Resistant to Amphotericin B

Answer 17

Pseudallescheria boydii, Fusarium spp., Trichosporon spp., certain isolates of Candida lusitaniae & Candida guilliermondii

Question 18

Most common AE for Azoles

Answer 18

relatively minor gastrointestinal upset

Question 19

Interferes with synthesis of adrenal hormones

Answer 19

Ketoconazole

Question 20

resistant to fluconazole

Answer 20

Candida glabrata and Candida krusei

Question 21

Most commonly used for the treatment of mucocutaneous candidiasis

Answer 21

Fluconazole

Question 22

Used extensively in the treatment of dermatophytoses and onychomycosis

Answer 22

Itraconazole

Question 23

May cause Stevens-Johnson Syndrome

Answer 23

Itraconazole

Question 24

Azole of choice for aspergillosis

Answer 24

Voriconazole

Question 25

Little interaction at CYP450

Answer 25

Voriconazole

Question 26

Inhibits CYP3A4

Answer 26

Posaconazole

Question 27

Taken up by fungal cells via enzyme cytosine permease

Answer 27

Flucytosine

Question 28

Does Flucytosine penetrate CNS?

Answer 28

Yes.

Question 29

Fungistatic or Fungicidal? Flucystosine

Answer 29

Fungistatic

Question 30

Most common AE?s for Flucytosine

Answer 30

Bone marrow toxicity with anemia, leukopenia, and thrombocytopenia

Question 31

Mechanism of Action of Echinocandins

Answer 31

Act at the level of the fungal cell wall by inhibiting beta (1-3) gucan synthase

Question 32

Fungistatic or Fungicidal? Echinocandins

Answer 32

Fungicidal

Question 33

histamine release may occur during IV infusion

Answer 33

Anidulafungin

Question 34

For disseminated and mucocutaneous candida infections

Answer 34

Caspofungin

Question 35

licensed for mucocutaneous candidiasis and prophylaxis of candida infections in BM transplant patients

Answer 35

Micafungin

Question 36

approved for use in esophageal candidiasis and invasive candidiasis, including septicemia

Answer 36

Anidulafungin

Question 37

Antifungal derived from species of Penicilium

Answer 37

Griseofulvin

Question 38

orally administered in crystalline form

Answer 38

Griseofulvin

Question 39

MOA of Griseofulvin

Answer 39

Binds to microtubules comprising the spindles and inhibits mitosis

Question 40

Drug of choice for onychomycosis

Answer 40

Terbinafine

Question 41

MOA of Terbinafine

Answer 41

Inhibits squalene 2, 3- epoxidase

Question 42

Used in the ICU for vaginal candidiasis

Answer 42

Nystatin

Question 43

pleasant- tasting alternative to nystatin

Answer 43

Clotrimazole, Miconazole

Question 44

used to treat cutaneous and lymphocutaneous sporotrichosis

Answer 44

Potassium Iodide