Antifungals & antiprotozoans

Question 1

Binds ergosterol –> lyses membrane.
Supplement K+ and Mg+ d/t alt. renal perm.

SE: fever/chills (shake and bake), hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis

Answer 1

Amphotericin B

Question 2

Binds ergosterol –> lyses membrane. Topical only. “Swish and swallow” for thrush

Answer 2

Nystatin

Question 3

Inhibit ergosterol synthesis by inhibiting the fungal P450 that converts lanosterol to ergosterol.
SE: gynecomastia, inhibits P450

Answer 3

Azoles

Question 4

Inhibits DNA and RNA biosynthesis by conversion to 5-FU by cytosine deaminase.
CU: Cryptococcal meningitis w/ Ampho B
SE: BMS

Answer 4

Flucytosine

Question 5

Inhibits cell wall synthesis by inhibiting synthesis of beta-glucan.
CU: Invasive aspergillosis, Candida
SE: GI, flushing (histamine release)

Answer 5

Echocandins (caspofungin)

Question 6

Inhibits squalene epoxidase.
CU: dermatophytes
SE: GI, hepatotoxic, taste disturbances

Answer 6

Terbinafine

Question 7

Interferes with microtubule function. Disrupts mitosis. Deposits in keratin-containing tissues (e.g. nails).
CU: dermatophytes
SE: teratogenic, P450 inducer

Answer 7

Griseofulvin

Question 8

Tx: toxo

Answer 8

Sulfadiazene + pyrimethamine

Question 9

Tx: Trypanosoma brucei (African sleeping sickness)

Answer 9

Suramin and melarsoprol

Question 10

Tx: Tryanosoma cruzi (Chaga’s disease)

Answer 10

Nifurtimox

Question 11

Tx: Leishmaniasis

Answer 11

Sodium stibogluconate

Question 12

Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia.
SE: retinopathy, pruritis

Answer 12

Chloroquine

Question 13

Tx: helminths

Answer 13

usually mebendazole

Question 14

Tx: flukes (i.e. Schisto)

Answer 14

Praziquantel