Antifungals

Question 1

What types of antifungals disrupt cell membrane & cell wall structure

Answer 1

Polyenes

Candins

Question 2

What antifungals target and inhibit ergosterol biosynthesis

Answer 2

Azoles

Question 3

What antifungal binds to ergosterol in fungal cell membranes leading to pore formation and permeability and eventually cell death?

Answer 3

Amphotericin B

Question 4

What are the toxicities of Amphotericin B?

Answer 4

 Patients will rigor (shake and tremor) and have a high burning temperature, due to TNF-a and IL-6 release, much like a flu.

Nephrotoxicity, leads to clamping down blood flow into kidney, while simultaneously binding and accumulating in the kidney.

Question 5

What are the formulations of Amphotericin B?

Answer 5

LFAP (lipid formulations of Amphotericin B)
FWAB
Bacontericin B

Question 6

Which drugs disrupt ergosterol biosynthesis by inhibiting cytochrome P450 Lanosterol 14-a demethylase?

Answer 6

Azole Antifungals

Question 7

Are Azole antifungals considered fungicides or fungistatic?

Answer 7

Static

Question 8

What is the major concern with use of ALL Azole antifungal drugs?

Answer 8

Drug Drug interactions and P450 metabolism.

Question 9

What is the most commonly used systemic antifungal?

Answer 9

Fluconazole

Question 10

What are the advantages of Fluconazole?

Answer 10

High oral bioavailability, extreme efficacy against Candida Albicans

Question 11

What are the differences between lipid formulations of Ampho B and regular Ampho B?

Answer 11

Not much, decreases toxicity slightly and DELAYS nephrotoxicity (still occurs over time)