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Pharm main > AntiFungals > Flashcards

AntiFungals Flashcards

1
Q

Polyenes

A

Ampthotercin B, Nystatin

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2
Q

Ampho B- MOA

A

Binds egosterol to disrupt fungal membrane

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3
Q

Ampho-B role of deoxycholate

A

Must be compexed to deoxycholate for solubitliy

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4
Q

Ampo- B- admin

A

IV, Intrathecally, bladder wash

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5
Q

Ampo B - uses

A

Systemic fungal infections

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6
Q

Ampo-B-AE

A

Attacks renal cells and RBC’s, K, Mg, HCO3 wasting- hydrate and monitor, Infusion related- fever, chills, riggor, hypotenstion, myalgia, arthralgia, HA- premedicate with APAP, NSAIDS and others Thrombophlebitis- prevent with heparin. Amenia- suppresses EPO

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7
Q

Ampho-B- newer preps

A

Better formulations dec nephrotoxicity and allow larger doses BUT don’t do anything for rigor and infusion rxnmuch more expensive

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8
Q

Nystatin- MOA

A

binds to ergosterol and disrupts membrane

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9
Q

Nystatin- Uses

A

oral, vaginal, skin candidiasis

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10
Q

Nystatin- Admin

A

topical swish and swallow not orally absorbed

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11
Q

Nystatin- AE

A

not many

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12
Q

Pyrimidines

A

Flucytosine

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13
Q

Flucytosine- MOA

A

Flucytosine –> 5- Flurouridylic acid via cytosine deaminase–> inhibits translation, 5- Flurodeoxyuridylic acid –> inhibits thymylate synthase –> inhibits DNA synthesis

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14
Q

Flucytosine- Uses

A

used with Amphoteracin B for cryptococcal meningitis, Never use alone, resistance develops to quickly

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15
Q

Flucytosinse- administration

A

Oral

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16
Q

Flucytosine- distribution

A

well absorbed orally

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17
Q

Flucytosine- 1/2 life

A

3-6 hrs

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18
Q

Flucytosine- Excretion

A

Renal

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19
Q

Flucytosine- AE

A

Bone marrow suppression GI- N/V/D. Livertoxicity- reversible

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20
Q

Echinocandins

A

Caspofugin, Micafugin, Andidafugin

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21
Q

Echinocandins- MOA

A

inhibit beta 1,3 glucan synthesis- inhibit cell wall production

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22
Q

Echinocandins- Admin

A

IV

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23
Q

Echninocandins- uses

A

systemic Candida or Apergillus infections

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24
Q

Echinocandins - drug interactions

A

Cyclosporine inc blood levels of Caspofugin

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25
Q

Echinocandins- Protein binding

A

Highly protein bound

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26
Q

Echinocandins- CNS penetration

A

Minimal

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27
Q

Echinocandins- AE

A

Histamine related rxns- warmth, swelling, rash, Headache, Hepatotoxicity

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28
Q

Griseofluvin- MOA

A

Inhibits mitotic spindle formation. Binds to human keratin which prevents invasion of fungus. Infected cells slough off eventually non-infected keratinocytes at the basal layer eventually replace

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29
Q

Griseofluvin- Admin

A

Oral- best with fatty foods

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30
Q

Griseofluvin- uses

A

Fungal infections of: Hair, skin, and nails

31
Q

Griseofluvin- 1/2 life

32
Q

Griseofluvin- Excretion

33
Q

Griseofluvin- AE

A

Headache, Hepatotoxicity, Neuro/leuckopenia, basophilia, photosensitivity, GI, Rash

34
Q

Griseofluvin- Effect on enzymes

35
Q

Griseofluvin- Drug interactions

A

Inc metabolism of Warfarin and Oral contraceptives

36
Q

Terbinafine- MOA

A

binds squalene epoxidase –> inhibits ergosterol synthesis

37
Q

Terbinafine- Admin

38
Q

Terbinafine- Uses

A

Mycoses of nails, drug accumulates in the nail beds

39
Q

Terbinafine- T 1/2

A

400 hrs b/c accumulates in hair, skin, and fat and slowly releases

40
Q

Terbinafine- Protein binding

41
Q

Terbinafine- AE

A

Well tolerated. Uncommon AE- GI, hepatatoxicity, stevents Johnson syndrome

42
Q

Terbinafine- drug interactions

A

Cimetidine- increases levels of Terbinafine

43
Q

Azoles- Types

A

Imidazoles, Triazoles

44
Q

Imidazoles

A

Ketoconazole, Clotrimazole, Miconazole, Econazole, Butoconazole, Oxiconazole

45
Q

Imidazoles- Admin

A

All topical except Ketoconazole which is for systemic

46
Q

Triazoles

A

Terconazole, Itraconazole, Fluconazole, Voriconazole, Poscanzole

47
Q

Triazoles- Admin

A

All systemic except for Terconazole which is topical

48
Q

Azoles- MOA

A

bind 14 alpha demethylase –> inhibit ergosterol synthesis

49
Q

Azoles- CYP450

A

inhibitors

50
Q

Azoles- Uses

A

Mostly, topical, but some systemic. Superficial infections- ringworm, candidiasis, tinea versicolor/ nigra, fungal keratitis. NOT FOR NAIL/HAIR-THOSE REQ SYSTEMIC

51
Q

Ketoconazole- Admin

A

Oral. Require acidic environment for absorption. Drugs that inhibit acidity in the stomach dec absorption (Histamine2 and PPI)

52
Q

Ketoconazole- CYP450

A

Inhibitor Inc levels of other drugs

53
Q

Ketoconazole- AE- hormonal effects

A

Hormonal due to CYP450 inhib- dec libido, gynecomastia, menstral irregularities. Blocks androgen, cortisol, aldosterone syntehsis and adronergic receptor antagonist

54
Q

Ketoconazole- AE- non hormonal

A

GI- dose dependent rash, hepatotoxicity

55
Q

Itracanazole- Admin

56
Q

Itraconazole- Uses

A

Candida, Aspergillus

57
Q

Itraconazole- absorption

A

GI absorption- empty stomach and acid

58
Q

Iraconazole- AE

A

GI, Rash, LFTs. hypoTG, Hypokalemia

59
Q

Itraconazole- drug interactions

A

Fatal arrhythmia if given with cisapride or quinidine

60
Q

Intriconazole- Liver enzyme

A

Potent CYP3A4 inhibitor

61
Q

Fluconazole- Admin

62
Q

Fluconazole- Use

63
Q

Fluconazole- absorption

A

not affected by food

64
Q

Fluconazole- AE

A

Reversible alopecia, GI, Rash, LFTs

65
Q

Fluconazole- Contraindications

A

Pregnancy- results in fatal skeletal and cardiac muscle deformities

66
Q

Voricaonazole- Admin

67
Q

Voriconazole- Uses

A

Candida, Aspergillus

68
Q

Voriconazole- t1/2

A

variable- dependson drug concentration, non linear kinetics

69
Q

Voriconazole- liver enzymes

A

Potent CYP3A4 inhibitor–> drug interactions

70
Q

Voriconazole- AE

A

Visual changes, Cardiovascular, CNS, Rash, LFTs

71
Q

Posconazole- admin

A

Oral- w/full meals

72
Q

Posconazole- Uses

A

Candida, Apergillus, Zygomycetes

73
Q

Posconazole- liver enzymes

A

CYP3A4- moderate inhibitor

74
Q

Posconazole- AE

A

Cardiovacular- HTN, hpokalemia. CNS- headache, dizziness. GI, LFTs

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