Antifungals II

Question 1

echinocandins: mechanism

Answer 1

inhibit glucan synthesis (cell wall)

Question 2

echinocandins: three examples

Answer 2

caspofungin, anidulafungin, micafungin

Question 3

echinocandin: spectrum of activity

Answer 3

active against candida and aspergillus.

Question 4

echinocandins: side effects

Answer 4

few - some hepatotoxicity, mild, no interactions

Question 5

limitation of echinocandins

Answer 5

no penetration info CNS/eye. low urinary conc

Question 6

echinocandins: indications

Answer 6

first line treatment for candidemia. invasive candidiasis, aspergillosis.

Question 7

allylamines: mechanism?

Answer 7

ergosterol synthesis

Question 8

allylamine: example? used for?

Answer 8

terbinafine - for onychomycosis aka fungal nail infections. tinea aka superficial skin enfections

Question 9

allylamines: side effects?

Answer 9

well tolerated, rare hepatotoxicity

Question 10

class: other - example? mechanism?

Answer 10

5 fluocytosine - metabolite inhibits DNA synthesis

Question 11

5 fluocytosine: indication

Answer 11

against cryptococcus, used in combination with amphotericin B

Question 12

5 fluocytosine: side effects

Answer 12

toxic to mammalian cells esp rapid dividing ones. photosensitivity. GI, hematologic, hepatotoxic effects

Question 13

first line treatment for: dermatophytosis

Answer 13

topical or systemic terbinafine

Question 14

first line treatment for: skin/mucosal candidiasis

Answer 14

fluconazole

Question 15

first line treatment for: candidemia

Answer 15

echinocandins

Question 16

first line treatment for: aspergillosis

Answer 16

voriconazole

Question 17

first line treatment for: mucormycosis

Answer 17

amphotericin B

Question 18

first line treatment for: cryptococcal meningitis

Answer 18

ampho B + 5 - flucytosine

Question 19

first line treatment for: prophylaxis in HSCT

Answer 19

prosaconazole, fluconazole

Question 20

first line treatment for: endemic fungi

Answer 20

amphotericin B or itraconazole