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Pharm 4 > Antifungals > Flashcards

Antifungals Flashcards

1
Q

Polyenes

A

Amphotericin B

Nystatin

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2
Q

Polyenes - mechanism

A

artificial pores in membrane

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3
Q

Azoles - mechanism

A

block ergosterol synthesis

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4
Q

azoles - TOX

A

teratogenic

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5
Q

Echinocandins - mechanism

A

block cell wall synthesis

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6
Q

echinocandins - TOX

A

embryotoxic

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7
Q

Amphotericin B - mechinism

A

binds ergosterol, creates pores in membrane

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8
Q

Amphotericin B - administration

A

IV (no PO) - liposomal formulation, excreted slowly (can accumulate), intrathecal necessary

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9
Q

Amphotericin B - TOX

A 
infusion (chills, fever, spasms, HA, vomit, hypotension) - infuse slowly, give Benadryl+Tylenol, sodium
Renal damage (1st rev, 2nd irrev) - <2 gm cumulative
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10
Q

Amphotericin B - in pregnancy

A

B, but preferred

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11
Q

Nystatin - administration

A

NOT PO (creams, loc inf)

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12
Q

Azoles (imidazoles) - administration

A

topical

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13
Q

Azoles (Triazoles) - administration

A

systemic

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14
Q

Azoles - special

A

Pseudallescheria boydii

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15
Q

Azoles - mechanism

A

inhibit fungal cytochrome P450 - decrease synthesis of ergosterol

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16
Q

Fluconazole - administration

A

PO/IV

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17
Q

Fluconazole - special

A

best azole for CSF

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18
Q

Fluconazol - disposition

A

highest bioavailability +TI + water solubility + renal excretion

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19
Q

Fluconazol - indication

A

cryptococcal meningitis, prophylaxis for imm comp

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20
Q

Fluconazol - TOX

A

rash, SJS, nausea, alopecia, teratogenic

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21
Q

Fluconazol - drug drug rx

A

Inhibits CYP2C9 (incr phenytoin/warfarin)

22
Q

Itraconazole - administration

A

PO

23
Q

Itraconazole - penetration

A

poor CNS

24
Q

Itraconazole - drug drug rx

A

PPI/H2 decrease absorption
+Rifampin - decrease bioavailability
inhibits CYP3A4 - (not with statins, midazolam, triazolam)

25
Q

Itraconazole - indications

A

dimorphic histoplasma, blastomyces, sporothrix, dermatophytes

26
Q

Itraconazole - TOX

A

CH

27
Q

Voriconazole - administration

A

PO/IV

28
Q

Voriconazole - special

A

broadest spectrum

29
Q

Voriconazole - indication

A 
invasive aspergillosis (less tox than Ampho B)
also candida, dimorphic
30
Q

Voriconazole - TOX

A

visual disturbances in 1st 30 mins (blur, color, bright)

31
Q

Voriconazole - drug drug rx

A

inhibits CYPs

32
Q

Capsofungin - mechanism

A

inhibits synthesis of b(1-3)glucan

33
Q

Capsofungin - origin

A

ehinocandin (candida)

34
Q

Capsofungin - administration

A

IV! (PO is bad) (water soluble)

35
Q

Capsofungin - indication

A

aspergillus (resistant) + candida

36
Q

Capsofungin - TOX

A

GI, flush, hepatic tox (+cyclosporin)

37
Q

Capsofungin - in pregnanacy

A

NO

38
Q

Griseofulvin - administration

A

PO (insoluble microcrystals)

39
Q

Griseofulvin - mechanism

A

mitotic inhibition (fungistatic), stop microtubule assembly, inserts into growing keratin

40
Q

Griseofulvin - indication

A

dermatophytosis only (fingernails 6-9 months) (toenails 1 year)

41
Q

Griseofulvin - TOX

A

CNS, serum sick, hepatic tox, GI

42
Q

Griseofulvin - drug drug rx

A

P450 inducer (decr warfarin/pheno)

43
Q

Terbinafine - administration

A

PO

44
Q

Terbinafine - mechanism

A

inhibits squalene epoxidase (increase squalene which is toxi)

45
Q

Terbinafine - indications

A

dermatophytosis (keratophilic and fungicidal) - 3 months

46
Q

Terbinafine - TOX

A

NO P450 dxdx, GI +HA, Preg B

47
Q

Flucytosine - mechanicsm

A

anti-metabolite (cytosine permease takes up, converts to 5FU and block DNA/RNA synthesis)

48
Q

Flucytosine - administration

A

PO

49
Q

Flucytosine - excretion

A

Renal unchanged

50
Q

Flucytosine - TOX

A 
narrow TI (only in combo)
gut flora converts - hematotox
51
Q

Flucytosine - indication

A

+Amphob B for cryptococcus

+Itraconazole for chromoblastomycosis

Pharm 4 (5 decks)

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