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Pharm Block 12 > Antifungals And Antiparasitics > Flashcards

Antifungals And Antiparasitics Flashcards

1
Q

What is a common ending for antifungal drugs

A

Conazole

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2
Q

Fungi are called ______

A

Mycoses

release mycotoxins

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3
Q

Systemic mycoses

A

Life threatening and increasing due to the number if immunosupresed patients

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4
Q

What are systemic mycoses that infect immunosupressed patients called

A

Opportunistic

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5
Q

What are the main opportunistic mycoses

A

Cryptococcal meningitis and aspergillosis

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6
Q

Two major types of mycoses

A

Yeasts and molds

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7
Q

Common yeast infection

A

Candida

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8
Q

Dermatophytoses

A

Ringworm, athletes foot, jock itch

Moist skin

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9
Q

Mycotic infections of the skin

A

Dermatopohytes

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10
Q

Cryptococcosis

A

Invasive fungal infection

Meningitis

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11
Q

People receiving broad spectrum Abx are at the greatest risk of this infection

A

Candida

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12
Q

MOA of amphotericin B

A

Binds to ergosterol in the fungal cell membrane and forms pores that allow electrolytes and small molecules to leak from the fungal cell, resulting in cell death
-pokes holes in the membranes

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13
Q

When do you use amphotericin B

A

In serious systemic infections, especially cryptococcus

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14
Q

Adverse effects of amphotericin B

A

Flushing and muscle spasms during IV infusion due to histamine, pretreat with steroid or antihistamine

  • dose limiting decrease in GFR and renal tubular acidosis
  • bone marrow suppression

amphoTERRIBLE
Pretty much never use unless absolutely necessary

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15
Q

Which antifungal is very damaging to the kidneys

A

Amphotericin B

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16
Q

Synergy in antifungal

A

Amphotericin B + flucytosine

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17
Q

MOA of flucytosine

A

Converts cytosine delaminase to 5-fluorouracil (5-FU), a cancer drug; 5-FU is converted to 5-FdUMP which inhibits thymidylate synthase

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18
Q

What might you use if you have fungal meningitis and it’s really bad

A

Amphotericin B + flucytosine

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19
Q

Antifungal spectrum of flucytosine (5-FC)

A

Used only in combination with amphotericin B for cryptococcus neoformans

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20
Q

When you use flucytosine, why does the fungus die?

A

Inhibits thymidilate synthase which causes DNA to stop, cant make thymidine

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21
Q

Azole antofungals MOA

A

Inhibit the synthesis of ergosterol by blocking the enzyme C-14 a-demthylase

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22
Q

Adverse effects of azole antifungal

A

Ketoconazole is a major P450 inhibitor and is not used much

-affects the synthesis of cortisol and androgens

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23
Q

What are the azole antifungals to know

A

Fluconazole

Voriconazole

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24
Q

Drug of choice for candidiasis and cryptococcal meningitis

A

Fluconazole

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25
Q

What is the only azole to penetrate CNS

A

Fluconazole

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26
Q

What is a good way to treat a very serious infection of cryptococcal meningitis

A

Start with amphoterocin B + flucytosine to knock it down and then switch to fluconazole to get rid of it

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27
Q

Why can’t you use azoles with amperotericin B?

A

Amphotericin B binds ergosterol, Azoles inhibit ergosterol, limiting the targets that ampho B can bind to

28
Q

Drug used for invasive aspergillosis

A

Voriconazole

29
Q

When do you see invasive aspergillosis

A

Damages the kings in immunosupressed

-HIV or organ transplant, or increase dose of steroids

30
Q

MOA of caspofungin

A

Inhibits the synthesis of B-1,2 glucagon, a critical components of fungal cell walls

31
Q

Antifungal spectrum of caspofungin

A

Candida and aspergillus

32
Q

Adverse effects of caspofungins

A

Fevers, chills, rash, and flushing due to histamine release

33
Q

Which antifungals cause a histamine release

A

Fungins and amphoterocin B

34
Q

Systemic drugs for superficial fungal infections

A

Griseofulvin

Terbinafine

35
Q

MOA of griseofulvin

A

Inhibits mitosis
Superficial fungal infection
Rarely used

36
Q

MOA of terbinafine

A

Inhibits squalene epoxidase which normally converts squalene to squalene epoxide; accumulation of squalene is toxic, this is an early step in ergosterol synthesis

37
Q

Antifungal spectrum of terbinafine

A
  • Dermatophytic infections like atheletes foot

- onchomycosis (nails)

38
Q

What drug is better to use than grisofulvin

A

Terbinafine

39
Q

Do caspofungins work on the cell wall or cell membrane of fungi

A

Cell wall

40
Q

Which drugs work on the fungal cell membrane

A

Amphotericin , azoles

41
Q

What are the two plasmodium (malaria) species we are most concerned with

A

P. Falciparum, P. Vivax

42
Q

____ accounts for 80% of all malaria cases

A

P. Vivax

43
Q

_____ only accounts for 15% of malaria causes, but it is a much more serious infection

A

P. Falciparum

44
Q

Tissue schizonticides

A

Primaquine

45
Q

Blood schizonticdes

A

Chloroquine

46
Q

Which malaria treatments work best for vivax

A

Chloroquine

Primaquine

47
Q

Which drugs work best for P. Falciparum

A

Quinine

Mefloquine

48
Q

MOA of chloroquine

A

Blood schizonticide

-intracellular heme accumulation, which is toxic to the parasite

49
Q

What is the drug of choice for acute attacks of nonfalciparum (vivax) malaria?

A

Chloroquine

-also used as prophylaxis in sensitive regions

50
Q

Side effects of chloroquine

A

Hearing and vision impairment (cinchonism), just Like quinidine

51
Q

MOA of quinidine

A

Blood schizonticide

52
Q

Clinical use of quinine

A

P. Falciparum, most commonly given with doxy

53
Q

Side effects of quinine

A

Cinchonism

54
Q

Which drugs can cause cinchonism (hearing and vision impairment)

A

Chloroquine, quinine, quinidine

55
Q

What is mefloquine used for

A

Prophylaxis for P. Falciparum

56
Q

What is the only tissue schizonticide used to treat malaria

A

Primaquine

57
Q

MOA of primaquine

A

Tissue schizonticide, forms quinolone-quinone metabolites which are oxidative stress, damaging the organism

58
Q

Clinical use of primaquine

A

Eradicates liver stages of vivax

59
Q

Quinidine

A

Can be used for anti malaria

60
Q

Treatment for giardia

A

Metronidazole

61
Q

MOA of metronidazole

A

Don’t know really, free radical

62
Q

DOC of giardia

A

Metronidazole

63
Q

Side effects of metronidazole

A

Metallic taste in the mouth; disulfiram like effect if taken with alcohol (severe hangover)

64
Q

Treatment of amebiasis (E. Hystalitica)

A

Metronidazole

65
Q

Treatment of toxoplasmosis

A

Antifoalte drigs: pyrimethamine + sulfadiazine

  • pyrimethamine: works like trimethaprim and blocks dihydrofolate reductase
  • Sulfadiazine: blocks synthetase

Pharm Block 12 (7 decks)

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