Antifungals: Polyenes and Antimetabolites Flashcards

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1
Q

what are the polyenes?

A

amphotericin B

nystatin

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2
Q

what is the antimetabolite

A

flucytosine

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3
Q

MOA amphotericin B

A

bind to ergosterol and increase cell permeability, create pores in cells that allow leakage of intracellualr ions and macromolecules

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4
Q

spectrum of amphotericin B

A

broad spectrum, clinically significant yeasts (candida, cryptococcus neoformans), endemic mycosis (histoplasma, blastomyces, coccidioides), ASPERGILLUS

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5
Q

kinetics of amphotericin B

A

IV only, cleared renally, highly protein bound so need large amounts or directly administered for CNS

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6
Q

what form of amphotericin B is safest

A

liposomal formulations

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7
Q

ADE amphotericin B

A

TOXIC, losing electrolytes, may have decreased LFT, creatinine levels. renal impairment occurs in nearly all patients.

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8
Q

MOA nystatin

A

bind to ergosterol and increased cell permeability, create pores to allow leakage

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9
Q

how is nystatin used?

A

only topically, so little SE.

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10
Q

spectrum of nystatin

A

most candida species

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11
Q

MOA flucytosine

A

pyrimidine analog related to 5-fluorouracil that penetrates fungal cells and is converted to fluorouracil which competes with uracil. interferes with funal RNA and protein synthesis

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12
Q

kinetics of flucytosine

A

poorly protein bound so penetrates all body compartments including CSF

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13
Q

spectrum of flucytosine

A

some candida, cryptococcus neoformans

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14
Q

use of flucytosine

A

combination with cryptococcal meningitis

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15
Q

ADE flucytosine

A

resistance seen at subtherapeutic doses, bone marrow toxicity with anemia, leukopenia, and thrombocytopenia

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