Antifungals

Question 1

Superficial fungal infections generally treated with

Answer 1

Topical drugs

Question 2

Primary drugs for anti fungals

Answer 2

Azoles, amphotericin B/nystatin, echinocandins

Question 3

Amphotericin B

Answer 3

Widest spectrum anti fungal but very toxic
Nystatin used topically
Binds to ergosterol in fungal cell membrane causing pores

Question 4

Administration of Amphotericin

Answer 4

Oral has poor absorption so IV is best
No CNS entry
Long 1/2 life of 2 weeks

Question 5

Adverse effects of Amphotericin B

Answer 5

Nephrotoxicity

Combination with azoles to reduce toxicity

Question 6

Azoles

Answer 6

Inhibit CYP450 enzymes–many drug interactions
Fungistatic mostly but can be fungicidal in higher doses
Broad spectrum
All effective orally or IV

Question 7

Fluconazole

Answer 7

Can enter CSF: Can treat fungal meningitis

Question 8

Flucytosine

Answer 8

Disrupts RNA and DNA synthesis
Also used as anti cancer drug
Used orally–able to enter the CSF
Can cause bone marrow suppression