Antifungals

Question 1

what do echinocandins target

Answer 1

B-1,3-glucan synthase (part of the cell wall)

Question 2

give some examples of echinocandins and state side effects

Answer 2

end in FUNGIN
micafungin
caspofungin
anidulafungin
minimal side effects

Question 3

what are echinocandins used for

Answer 3

aspergillus
candida
not certain moulds like Cryptococcus
parenteral administration for systemic infections

Question 4

what do polyenes target

Answer 4

directly target ergosterol in the cell membrane

form an association–> pore like molecular aggregates –> potassium leakage and death

Question 5

give 2 types of polyenes

Answer 5

amphotericin B and nystatin

Question 6

what is nystatin used for

Answer 6

only superficial not systemic (as toxic)

oral/ vaginal candidiasis

Question 7

what is amphotericin B used for

Answer 7

v. broad spectrum
systemic infections such as crypotoccus, aspergillus, candida
parenteral not oral administration

Question 8

how is amphotericin B often given

Answer 8

as lipid associated Amphotericin B formulations to decrease nephrotoxicity

Question 9

what are the negatives of amphotericin B

Answer 9

nephrotoxicity and allergic reactions

Question 10

what is the target of allylamines

Answer 10

squalene epoxidase –> needed for formation of ergosterol in cell membrane

Question 11

what are the uses of allylamines

Answer 11

dermatophyte infections

Question 12

give an example of an allylamine

Answer 12

terbinafine

Question 13

which infections is terbinafine administered topically for

Answer 13

tinea corporis
tinea pedis
tinea cruris

Question 14

which infections is terbinafine administered orally

Answer 14

onychomycosis

tinea capitis

Question 15

what do azoles target

Answer 15

lanosterol 14a demethylase

Question 16

what are the 2 types of azole

Answer 16

imidazoles (2n) and triazoles (3n)

Question 17

what are the main side effects of allyamines

Answer 17

hepatotoxicity

jaundice hepatitis

Question 18

what are the main side effects of azoles

Answer 18

hepatotoxicity

Question 19

what are the drug interactions of azoles

Answer 19

inhibit CP450 enzymes

Question 20

name some imidazoles

Answer 20

clotrimazole
miconazole
ketoconazole

Question 21

what are imidazoles used to treat

Answer 21

rarely systemic infections

superficial infections e.g. candidiasis, dermatophyte infections

Question 22

name some triazoles

Answer 22

fluconazole
itraconazole
voriconazole
posaconazole
isavuconazole

Question 23

what is the spectumof fluconazole

Answer 23

yeasts not aspergillus

Question 24

what is the spectrum of itraconazole and voriconazole

Answer 24

yeasts and aspergillus

Question 25

what is the spectrum of posaonaole and isavuconazole

Answer 25

yeasts aspergillus mucoraceous moulds

Question 26

which antifungals need therapeutic drug monitoring

Answer 26

itraconaole
coriconazole
5-fluorocytosine

Question 27

what is 5-fluorocytosine

Answer 27

developed as an anti-cancer drug
targets DNA synthesis (and RNA/ protein synthesis)
cytosine permease uptake means selective toxicity

Question 28

what is the negative of 5-fluorocytosine

Answer 28

BM suppression

Question 29

what is 5-flurocytosine used for

Answer 29

only yeasts such as candida and cryptococcus

Question 30

what is used to treat cryptococcal meningitis

Answer 30

5-fluorocytosine and amphotericin B

Question 31

what targets mitosis

Answer 31

griseofulvin

Question 32

what side effects does griseofulvin have

Answer 32

minimal side effects

Question 33

what is griseofulvin used for

Answer 33

dermatophyte infections in children requiring systemic treatment
kerion (fungal abscess)
onychomycosis