Antifungals - pyrimidines and polyenes Flashcards

1
Q

example of pyrimidine antifungal

A

5-fluorocytosine

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2
Q

how does 5-fluorocytosine work, 2 ways

A
  1. disruption of DNA synthesis

2. disruption of translation

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3
Q

what is 5-fluorocytosine active against

A

crytococcus neoformans and candida species + some moulds

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4
Q

is 5-fluorocytosine used on its own or as combo therapy? And why is it used this way?

A

combo with Amp or fluconazole. Less resistance experienced with combo therapy

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5
Q

What is 5-fluorocytosine used generally for?

A

treatment of systemic fungal infections and mainly for crypt. meningitis

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6
Q

What is the patient at risk of if 5-fluorocytosine is used for more than two weeks at >100mg/L?

A

Bone marrow supression

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7
Q

What toxicity does 5-fluorocytosine present?

A

liver toxicity

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8
Q

what does 5-fluorocytosine interact with?

A

Brivudine

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9
Q

2 Examples of polyene?

A

Nystatin and Amphotericin

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10
Q

Another name for Amphotericin

A

Ambiosome

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11
Q

What can Amphotericin be used for

A

most yeasts and moulds

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12
Q

Is Amphotericin broad or narrow spectrum?

A

Broad

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13
Q

How is 5-fluorocytosine given?

A

IV

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14
Q

How is Nystatin and Amphotericin given?

A

IV but occasionally given topically

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15
Q

What type of therapy can Amphotericin be used for?

A

Empiric therapy (based on past experience)

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16
Q

What toxicity do patients experience with Amphotericin

A

Nephrotoxicity

17
Q

Are most yeasts sensitive to Nystatin?

A

yes

18
Q

How is Nystatin given?

A

Topical

19
Q

why is Nystatin given topically?

A

too toxic

20
Q

What is Nystatin used to treat?

A

oral/vaginal candidosis