Antifungals Flashcards
Nystatin
Mechanism
Binds ergosterol -> forms pores -> K+ leaks
Azoles
Mechanism
Inhibits ergosterol synth via CYP450 dependent enzyme lanosterol 14- alpha-demethylase
Flucytosine
Mechanism
Inhibits DNA and RNA synth
Caspofungin
Mechanism
Inhibits cell wall synthesis by blocking beta glucan synth
Terbinafine
Mechanism
Inhibits fungal enzyme squalene epoxidase
Griseofulvin
Mechanism
Interferes with microtubule function
Amphotericin B
Clinical use
Systemic of local candidemia
Aspergillus
Nystatin
Clinical Use
Oral Candida albicans (mouth wash) Vaginal candidiasis (cream)
Azoles
Clinical Use
Fluconazole- Cryptococcal meningitis in AIDS and c albicans
Ketoconazole- systemic, or topical therapy
Clotrimazole & Miconazole - topical
Vorconizole- 1st line for aspergillosis
Flucytosine
Clinical Use
Systemic fungal infections
Caspofungin
Clinical Use
Fungicidal candida species and invasevie aspergillosis
Terbinafine
Clinical Use
Dermatophytes (onychomycosis), mucocutaneous fungal infections
Griseofulvin
Clinical Use
Inhibits growth of dermatophytes
Amphotericin B
Toxicity
Fever and chills
Hypotension
Nephrotoxicity
Neurotoxicity
Nystatin
Toxicity
Headache
Metallic taste
Disulfiram like reaction
(Too toxic to give orally)
Azoles
Toxicity
Gynecomastia
Hypercortisolism
Liver dysfunction
Fever chills
Flucytosine
Toxicity
Nausea
Vomiting
Diarrhea
Bone Marrow Suppression
Caspofungin
Toxicity
GI upset
Flushing
Terbinafine
Toxicity
Hepatotoxicity
Visual Disturbance
Hematologic disorders
Cellulitis
Griseofulvin
Toxicity
Teratogenic
Carcinogenic
Headaches
Which two antifungals are synergistic and what are they used in combo for?
Amphotericin B and Flucytosine for cryptococcal meningitis
Which antifungal induces CYP450 warfarin metabolism and which inhibits CYP450?
Griseofulvin induce and azoles inhibit
Amphotericin B
Mechanism
Binds ergosterol -> forms pores -> K+ leaks
