Antifungals

Question 1

5 classes of antifungal agents

Answer 1

polyenes. azoles. echinocandins. allylamines. others.

Question 2

2 examples of polyenes.

Answer 2

amphotericin B. istatin.

Question 3

how do polyenes work

Answer 3

binds ergosterol in cell membrane = increases permeability, pore formation

Question 4

amphotericin: fungicidal? spectrum of activity

Answer 4

fungicidal. broad: candida, cryptococcus, aspergillus, mucor, endemic BUT no activity against aspergillus terreus

Question 5

side effects of amphotericin B

Answer 5

dose dependent nephrotoxicity. infusion related side effects like chills, fever, tachypnea

Question 6

nistatin: antifungal that is administered how, and for what?

Answer 6

topical or oral - to prevent mucosal infections

Question 7

indications for nistatin

Answer 7

oral gargles for prophylaxis of oral candidiasis in HIV infected pts. intravaginal to treat candida vaginitis

Question 8

nistatin side effects

Answer 8

no clinical effects/interactions bc no GI absoprtion

Question 9

azoles: mechanism

Answer 9

block ergosterol synthesis so affects cell membrane

Question 10

azoles: 5 examples

Answer 10

fluconazole. itraconazole. voriconazole. posaconazole. isavuconazole.

Question 11

fluconazole: used for?

Answer 11

treatment of choice for candida. no effect on filamentous fungi

Question 12

fluconazole: side effects?

Answer 12

well tolerated - some liver toxicity

Question 13

voriconazole: treatment of choice for?

Answer 13

aspergillus. prophylaxis + treatment.

Question 14

voriconazole: side effects

Answer 14

worst: liver toxicity, interactions, hallucinations, periostitis

Question 15

posaconazole: use for?

Answer 15

invasive aspergillus. usually for prevention, not treatment

Question 16

isavuconaole used for?

Answer 16

mucor