Antifungals Flashcards
Amphotericin B
Chemistry
Polyene antibiotic with conjugated double bonds
Insoluble in water
Amphotericin B
Mech
Bind to ergosterol (major fungal lipid) to form pores - leading to cell membrane leakage
Amphotericin B use
Side effects
Any severe fungal infection Flushing chills fever Anemia Respiratory stridor Decreased renal function -Azotemia (incease urea in blood)
Flucytosine
Mech
Gets converted to 5FU by cytosine deaminase (in fungi)(HUMANS CANT CONVERT THIS DRUG TO ACTIVE METABOLITES)
Then inhibits thymidilate synthase enzyme
Azoles
Mech
Inhibit 14 a deamylase enzyme (ergosterol biosynthesis)
Clotrimazole
Use
Topical agent for mucosal and cutaneous infections
- oropharyngeal candidiasis
- tinea
Miconazole
Use
Topical and parenteral
Cutaneous candidiases and vulvovaginitis
Itraconazole
Use
Suppresive therapy of histoplasmosis in HIV patients
Fluconazole
Use
Supressive therapy and primary tx for cryptococcal meningitis in AIDS ots
Tx mucosal candidiasis (better than nystatin)
Coccidioidal meningitis
Ketoconazole
Use
Side effect
Deep systemic mycosis High drug intersctions Endocrinological abnormalities (gynecomastia and galactorrhea)
Azoles
Side effects
Gynecomastia
Blunt response against ACTH
hepatotoxicity
Nystatin
Use
Candida infections
Cant be used parenterally bc too toxic to kidney
Griseofulvin
Mech
Inhibis mitosis by disrupting spindle formation
Used systemically
Nystatin
Mech
Similar to amphotericin b
Binds to ergosterol and forms pores
Echinocandins
Anidulafungin
Micafungin
Caspofungin
