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PCOL2 > Antifungals > Flashcards

Antifungals Flashcards

1
Q

Name the three pathogenic fungi mentioned in the lecture.

Prompt: antibiotic chrysanthemum, fumigate Vincen’ts house, thrush

A

Penicillium chrysogenum
Aspergillus fumagatum
Candida albicans

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2
Q

What’s the THM about the threat of fungal infection?

A

Generally it represents ore of a nuisance than a threat, BUT if they gain systemic access and propagate it can be fatal. With antibiotics and HIV, opportunistic infections like this are rising.

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3
Q

X affects skin nails and hair, Y affects superfical mucous membranes (when not systemic aka ‘diseminated’)

A

Dermatomycosis; candidiasis

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4
Q

A and B are natural, whereas C and D are synthetic

A

Echinocandins and polyenes; fluoronated pyrimidines and azoles (you aren’t born an asshole, you’re made one).

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5
Q

Four pathogenic fungi
It’s hard to encapsulate a mnenomic for this.
Keanu Reeves is a men’s rights activist.
Fumigate Vincent’s house.

A

Cryptococcus neoformans, aspergillus fumagatum, candida albicans, histoplasma capsulatum.

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6
Q

Four pathogenic fungi (no prompts)

A

Cryptococcus neoformans, aspergillus fumagatum, candida albicans, histoplasma capsulatum.

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7
Q

Which fungi in this lecture is a yeast?

A

Cryptococcus neoformans

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8
Q

Which fungi in this lecture is yeast-like with myecilium-like structures

A

Candida albicans

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9
Q

Which fungi is dimorphic?

A

Histoplasma capsulatum

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10
Q

Which fungi is dimorphic?

A

Histoplasma capsulatum

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11
Q

What are risk factors for [superficial] candidosis? (no prompts)

A

Diabetes, immunosupressants, corticosteroids, antibiotics

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12
Q

What are risk factors for [superficial] candidosis? (no prompts)

A

Diabetes, immunosupressants, corticosteroids, antibiotics

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13
Q

What are three filamentous fungi other than Aspergillus fumagatum?
Small spores are likely to land on your skin. Frustrates me so much I wanna get my fight on and I don’t wanna fall in any holes in case there’s fungi down there.

A

trychophyton (jock itch - tinea of the jock)
epidermaphyton,
microsporum

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14
Q

What are three filamentous fungi other than Aspergillus fumagatum?
(No prompts)

A

trychophyton (jock itch - tinea of the jock)
epidermaphyton
microsporum

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15
Q

Name for types of tinea - jock, foot, body, scalp.

Recall it can accrue in ya jock.

A

Cruris, pedis, capitis, corporis

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16
Q

Tinea isn’t a type of fungi. It’s…

A

… the word for any time of skin infection.

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17
Q

What is the precursor to ergosterol?

A

Lanosterol.

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18
Q

Ergesterol depletion stops fungi from replicating. What’s a bonus effect?

A

Stops candidal hyphae from growing.

19
Q

What pharmacologically relevant effect foes ergosterol depletion have?

A

Reduces amphotericin binding.

20
Q

What enzyme do azoles inhibit?

A

Cytochrome P450 3A aka 14α-demethylase.

21
Q

Are azoles fungistatic or fungicidal?

A

Fungistatic.

22
Q

What two primary drugs are used for systemic infections?

A

Azoles and amphotericin.

Amphotericin is the gold standard but requires close medical supervision.

23
Q

Amphotericin components are structurally Gs, which are categorically a type of J.

A

polyenes; macrolide

24
Q

What’s the significance of ergosterol to amphotericin therapy?

A

Amphotericin binds with great avidity to ergosterol molecules in fungal cell membranes.

25
Q

What should you combine with amphotericin therapy - flucytosine or azoles?

A

FLUCYTOSINE - famously good synergistic effect. Absolutely do NOT combine it with azoles.

26
Q

Why is amphotericin often delivered in liposomes?

A

Because otherwise it’s so pharmacokinetically stubborn. The liposome formulation also reduces side effects.

27
Q

What are the five main headings for amphotericin unwanted effects?

A 
Nephrotoxicity 
Hypokalaemia
Bone marrow suppression
Neurotoxicity
Amphoterrible effects
28
Q

What is the name of the two other polyenes?

I hate nyan cat.

A

Nyastatin and griseofulvin

29
Q

Cons of nyastatin as opposed to amphotericin?

A

Not absorbed through skin or mucous membranes.
Limited to mycoses of the skin, mucous membranes or GI tract.
Only kills candida (but is quite good at it).

30
Q

Think mitotic interference through microtubule binding, think…

A

Griseofulvin

31
Q

When do we use griseofulvin?

A

When local treatment doesn’t work. BUT has to be very prolonged.

32
Q

What is 1,3-β-glucan and what fucks up it synthesis?

A

It’s a fungal cell wall polymeric component whose synthesis is fucked up by echinocandins.

33
Q

How is flucytosine selective for fungi?

A

Only in fungal cells can it be converted into the antimetabolite 5-fluorouracil. Therefore it can disrupt DNA synthesis in fungal cells, but not human ones.

34
Q

What are the gentlest drugs/drug in this lecture in terms of side effects?

A

Flucytosine. Makes it easier to combine with for sure.

35
Q

Which antifungal has problems with resistance development?

A

Flucytosine.

36
Q

What are the big three side effects of ketoconazole? (biggest first)

A

Hepatotoxicity
Gynaecomastia
Interactions with metabolising enzymes

37
Q

Name the three specific azoles in this lecture

A

Ketoconazole
Fluconazole
Itraconazole

38
Q

What is basically the opposite of amphotericin when it comes to pharmacokinetics?

A

FLUCONAZOLE
Well absorbed orally
Even fungicidal concentrations reached in CNS, superficial mucous membranes, even skin and nails.

39
Q

Are fluconazole side effects mild?

A

Yes. Drug interactions tho.

Bonus: nausea, vomiting, rash

40
Q

Caspofungin is a …

A

echinocandin

41
Q 
Think...
combination with amphotericin
really poor absorption
very gentle side effects
problems with resistance,
think...
A

flucytosine

42
Q

nystatin’s sort of similar to saquinavir (viral protease inhibitor) in its side effects. What are they?

A

Nausea, vomiting, diarrhoea.

43
Q

3 griseoflulvin side effects. It’s like the sun is travelling through my eyes burning my skull and sliding down into my GI tract and I need Gris the real person to use his massive body to block it out.

A

GI, photophobia, headache

44
Q

What are the two drugs in this lecture with potential liver toxicity?

A

Ketonazole, itraconozole.

PCOL2 (24 decks)

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