Antifungals and Antivirals

Question 1

What is in the plasma membrane of fungi instead of cholesterol?

Answer 1

ergosterol

Question 2

What are the cell wall of fungi made out of?

Answer 2

chitin and contain beta-glucan

Question 3

What are the three types of fungi?

Answer 3

1. mold (multicellular, branching filaments)
2. yeasts (single celled, budding reproduction)
3. dimorphic (switch between 2)

Question 4

Which antifungal agent is used most often?

Answer 4

azole antifungals

Question 5

Which azole antifungal has side effect that can cause visual disturbances and hallucinations?

Answer 5

voriconazole

Question 6

What are some side effects of azole antifungals?

Answer 6

• QT prolongation and arrhythmias
• hepatotoxicity
• nausea, gastric intolerance

Question 7

Which antifungal do you not want to prescribe if patient has renal problems?

Answer 7

voriconazole

Question 8

Which antifungal is used to treat fungal skin or nail infections?

Answer 8

terbinafine

Question 9

What is the mechanism of action of terbinafine?

Answer 9

cell membrane disruptor, stops precursor of ergosterol

Question 10

What are some side effects of terbinafine?

Answer 10

• hepatotoxicity
• gastric intolerance
• headache

Question 11

What is a broad-spectrum antifungal that exerts its action by forming a ring that punches through cell membrane?

Answer 11

polyenes

Question 12

What are some side effects associated with polyenes?

Answer 12

• nephrotoxicity
• hepatotoxicity
• infusion related reaction
• electrolyte abnormalities

Question 13

What is the mechanism of action for cell wall agents?

Answer 13

inhibit B-glucan synthesis, stopping production of B-glucan that is needed for the cell wall

Question 14

what are cell wall agents typically prescribed for?

Answer 14

more invasive diseases such as candida and aspergillus

Question 15

Which cell wall agent drug is not processed by the liver or kidneys so can be given to patients with severe problems there?

Answer 15

Anidulafungin

Question 16

What are the side effects associated with cell wall agents?

Answer 16

• hepatotoxicity

- infusion reaction

Question 17

Are cell wall agents able to get through biofilms?

Answer 17

yes

Question 18

What is the mechanism of action of Oseltamivir and Zanamivir (neuraminidase inhibitors)?

Answer 18

Competitively inhibits neuraminidase, stopping the release of the virion from the infected cell

Question 19

WHat is used for the treatment and prevention of influenza A and B?

Answer 19

Neuraminidase Inhibitors (Oseltamivir, Zanamivir)

Question 20

What side effect does Zanamivir (neuraminidase inhibitor) cause?

Answer 20

bronchospasm

Question 21

What neuraminidase inhibitor drug should not be used for patients with COPD and asthma?

Answer 21

Zanamivir (due to the bronchospasm)

Question 22

What antiviral is used for treatment or prophylaxis of HSV and VZV?

Answer 22

narrow spectrum HHV antivirals

Question 23

What class of drugs do acyclovir, valacyclovir and famciclovir belong to?

Answer 23

narrow spectrum HHV antivirals

Question 24

What are the side effects associated with narrow spectrum HHV antivirals?

Answer 24

• headache, nausea and vomiting

- nephrotoxicity

Question 25

What narrow spectrum HHV antiviral drug can be given for disseminated HSV?

Answer 25

Acyclovir

Question 26

What two drugs belong to broad spectrum HHV antivirals?

Answer 26

ganciclovir and valganciclovir

Question 27

When are broad spectrum HHV antivirals used?

Answer 27

treatment or prophylaxis of CMV, HSV, VZV

Question 28

What are the side effects associated with broad spectrum HHV antivirals?

Answer 28

• nephrotoxicity, thrombocytopenia and neutropenia