Antifungals

Question 1

Amphotericin B MOA

Answer 1

Amphipathic molecule that bind Ergosterol and punches holes in the fungal membrane to allow leakage of electrolytes

Question 2

Amphotericin B Toxicity

Answer 2

Fever/Chills (“Shake and Bake”)

hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis

Question 3

Nystatin MOA and Use

Answer 3

Same MOA as Amphotericin B (only topical application) used in oral thrush Candidiasis

Question 4

Flucytosine MOA

Answer 4

Converted to 5-FU (pyrimidine analog) by cytosine deaminase and inhibits DNA and RNA biosynthesis

Question 5

Flucytosine Toxicity

Answer 5

Bone marrow suppression: Anemia, Leukopenia, Thrombocytopenia, increased liver enzymes

Question 6

Azole drugs MOA

Answer 6

Inhibits the CYP-450 enzyme that converts Lanosterol to Ergosterol, which prevents wall formation

Question 7

Azole Toxicity

Answer 7

Testosterone synthesis inhibition (gynecomastia), Liver dysfunction due to CYP-450 inhibition

Question 8

Terbinafine MOA

Answer 8

Inhibits the fungal enzyme Squalene Epoxidase

Question 9

Terbinafine Toxicity

Answer 9

GI upset, headaches, hepatotoxicity, taste disturbance

Question 10

Echinocandins (“-fungin”) MOA

Answer 10

Inhibits synthesis of B-Glucan, which inhibits cell wall synthesis

Question 11

Griseofulvan MOA

Answer 11

Interferes with microtubule function, disrupts mitosis and deposits in keratin containing tissues

Question 12

Griseofulvan Toxicity

Answer 12

Teratogenic, carcinogenic, confusion and headaches, increased CYP-450 and Warfarin metabolism