Antifungals Flashcards
Name the Polyenes
Amphoteracin B
Nystatin
Name the Triazoles
Fluconazole
Itraconazole
Voriconazole
Posaconazole
Name the Echinocandins
Caspofungin
Micafungin
Anidulafingin
What are the four classes of anti fungal agents
Triazole
Polyenes
Echinocandins
Flucytosine
Triazole MOA
Impede ergosterol synthesis through direct inhibition of CP450 dependent enzyme 14-alpha-sterol-demethylase (ergosterol is essential for the fungus cell membrane)
Cannot kill already present fungi but stops growth
*CYP450 drug interactions
Triazole SE
GI
Liver enzyme abnormalities
Visual disturbances with voriconazole
Spectrum of activity of Triazoles
Posaconozole>voriconazole, itraconazole>fluconazole
What drug is used for prophylaxis of aspergillosis and candidiasis in immunocompromised patients?
Posaconazole
What drug is used for invasive aspergillosis?
Voriconazole
What drug is used for histoplasmosis?
Itraconazole
What polyene macrolide inhibits ergosterol and punches holes in fungal cell membranes?
Amp B
Broad spectrum but poor tolerability
SE Amp B
Nephrotoxic
Acute infusion reaction
Electrolyte abnormalities
*lipid formulas help with tolerability
Echinocandin - are they well tolerated?
Very few SE
Few drug interactions
IV only
What does Echinocandins have activity against?
Excellent against candida
Refractory aspergillosis
Candidiasis
Empiric therapy for febrile neutropenic patients
MOA Echinocandins
Non-competitively inhibit beta 1,3 D Glucan synthase enzyme complex in susceptible fungi to disturb fungal cell Glucan synthesis -> prevents resistance against osmotic forces
