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Principles of Disease > Antifungals > Flashcards

Antifungals Flashcards

1
Q

Amphotericin B MOA and use

A 
Binds ergosterol
creates pore, K+ leakage
serious infections
Poor CSF penetration – intrathecal
lipid complexes less nephrotoxic, equal efficacy
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2
Q

Amphotericin B Tox

A

nephrotoxicity

shaking and chills - avoid with NSAIDS

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3
Q

Flucytosine MOA and use

A

Penetrates fungal cell - 5-fluorouracil
serious infections
Synergistic with amphotericin B for Cryptococcal meningitis

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4
Q

Flucytosine Tox

A

bone marrow hypoplasia

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5
Q

Azole Antifungal Agents MOA

A

Inhibits CYP P450 enzyme that converts lanosterol to ergosterol
Triazoles increased affinity for fungal CYP

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6
Q

Azole Antifungal Agents Tox

A

Dose dependent depression of testosterone and ACTH

Gynecomastia, impotence, decreased libido

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7
Q

Azole Antifungal Agents interaction

A

Antacids, H2 antagonists – decreased absorption
Warfarin – decrease dose
Azoles inhibit CYP2C9, 2C19, 3A4

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8
Q

What can treat Cushings Disease

A

Ketoconazole

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9
Q

Drug of choice for mild to moderate meningitis

A

Fluconazole

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10
Q

Voriconazole interaction

A

Decreased absorption by high fat meals

Rifampin increases metabolism of drug so it is ineffective

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11
Q

What anti fungal causes visual disturbances

A

Voriconazole

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12
Q

What inhibits CYP3A4 only

A

Posaconazole, Itraconazole

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13
Q

Caspofungin Acetate MOA and Tox

A

Blocks cell wall synthesis – glucan synthesis inhibitor

Phlebitis, increased serum creatinine

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14
Q

Griseofulvin MOA and Use

A

Disrupts cells mitotic spindle structure arrests in metaphase
Oral administration for Dermatophytosis

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15
Q

What do you have to do with Warfarin dose when taking Griseofulvin?

A

CYP450 inducer – increase warfarin dose

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16
Q

Terbinafine MOA and use

A

Inhibits squalene epoxidase – blocks sterol synthesis

Onychomycosis – cosmetic problem

17
Q

Terbinafine contraindications

A

Not recommended for liver or renal dysfunction

Contraindicated in pregnancy

18
Q

Azoles inhibit what CYPs?

A

Azoles inhibit CYP2C9, 2C19, 3A4

19
Q

What anti fungal is CYP450 inducer that requires increasing warfarin dose

A

Griseofulvin

20
Q

Posaconazole inhibits what CYP?

A

CYP3A4

21
Q

What causes depression of testosterone and ACTH

Gynecomastia, impotence, decreased libido

A

Azoles

22
Q

What anti fungal causes bone marrow hypoplasia

A

Flucytosine

23
Q

What anti fungal is synergistic with amphotericin B for Cryptococcal meningitis

A

Flucytosine

Principles of Disease (8 decks)

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