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BBDA Spring (Exam 7) > Antifungals > Flashcards

Antifungals Flashcards

1
Q

Amphotericin B

A

Broad spectrum, limited b/c of toxitcity, standard of treatment for most serious mycoses

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2
Q

Mucocutaneous

A

Yeast infection in mouth, Thrush

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3
Q

Fungi MOR

A

Efflux pumps, impaired ergosterol binding, reduced permeabilty of cell membrane, alter P450 enzymes, overproduction of enzymes

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4
Q

Amphotericin B available products

A

Funigizone, Abelcet, Amphotec, AmBisome

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5
Q

Amphotericin B

A

fungicidal, ergosterol (cholesterol in fungus membrane), causes cell to be very leaky and die

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6
Q

Amp-B Spectrum of coverage

A

Yeasts, Molds, resistance shown with some species as well.

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7
Q

Amp-B ADR

A

Infusion related rxn’s or toxicity. (fever, chills, muscle spasms, vomiting, HA and hypotension) premedicate ADR symptoms to reduce ADR, slow infusion, give via central line (minimal-anemia/neurotoxic)

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8
Q

Amp-B

A

risk increases with increased dose, give 1-2 grams, give w/ NS

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9
Q

L-AmB (lipid version)

A

least nephrotoxicity, least infusion rxn’s

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10
Q

Flucytosine

A

taken up by cell, converted to 5-FU and other metabolites, oral, inhibits DNA and RNA synthesis

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11
Q

Flucytosine

A

rarely used, Cryptococcal meningitis and Chromoblastomycosis, NOT as a mono-therapy

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12
Q

Flucytosine ARD

A

Bone marrow toxicity w/ anemia, leukopenia, thrombocytopenia (decrease in platelets), incr. LFT, enterocolitis

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13
Q

Diflucan

A

Fluconazole

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14
Q

Sporanox

A

Itraconazole

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15
Q

Nizoral

A

Ketoconazole

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16
Q

Vfend

A

Voriconazole

17
Q

Noxafil

A

Posaconazole

18
Q

Imidazoles

A

ketoconazole, miconazole, clotrimazole, older, more drug-drug interactions

19
Q

Triazoles

A

Fluconazole, voriconazole, posaconazole, itraconazole

20
Q

Azole MOA

A

inhibit enzyme that eventually leads to ergosterol synthesis, inhibits fungal P450 enzymes

21
Q

Azole Spectrum of Activity

A

Broad, Candida, Aspergillus, Dermatophytes

22
Q

Azole ADR

A

NVD

23
Q

Ketoconazole

A

shampoo for dandruff, absorption is pH dependent, metabolized in liver, increase LFT, excreted in bile

24
Q

Ketoconazole

A

IMPOTENCE, rash, pruritis, alopecia, menstrual irregularities,

25
Q

Itraconzaole

A

pH dependent, oral, WF that is acidic, for onychomycosis

26
Q

Itraconazole Drug Interactions

A

antacids, H2 blockers, PPI’s, rifampin decreases itraconazole

27
Q

Fluzonazole

A

Candida, absorption NOT pH dependent, good CSF penetration (60-80%), NOT for aspergilius

28
Q

Fluconazole ADR

A

less of the common ADR 100-800mg daily

29
Q

Vfend

A

treatment of choice for Aspergillosis, on empty stomach, 30% GET VISUAL DISTURBANCES W/IN 30MIN, LASTS FOR 30 MIN

30
Q

Vfend ADR

A

QTc prolongation, more interactions than other newer azoles, Loading dose required

31
Q

Poscanazole

A

broadest spectrum of all, suspension, tablet, IV, give w/ full high fat meal

32
Q

Poscanazole

A

broadest spectrum of all, suspension, tablet, IV, give w/ full high fat meal

33
Q

Miconazole/Clotrimazoel

A

for thrush, dermatophytic infections (Tinea corporis, pedis, cruris)

34
Q

Know MOA for all

A

Echinocandins- inhibit component of cell wall

35
Q

Echinocandins

A

overall well tolerated w/ minor GI side effects and flushing

36
Q

Candidas

A

Capsofungin, for neutropenic therapy, slow rate of infusion and pre-medicate with antihistamine, DOES NOT INHIBIT CYP450, load w/ 70mg then continue w/ 50mg daily

37
Q

Mycamine

A

(Micafungin), similar to Candidas, 150mg daily for esophageal candidiasis, 50mg prophylaxis

38
Q

Eraxis

A

(anidulafungin), invasive or deep-tissue candidiasis, NO SIGNIFICANT DRUG INTERACTIONS, IV

39
Q

Others

A

Griseofulvin (must use for 2-6 weeks), Terbinafine (Lamisil) for at least 12 weeks, Nystatin- for oral thrush

BBDA Spring (Exam 7) (6 decks)

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