Antifungals - pyrimidines and polyenes Flashcards
example of pyrimidine antifungal
5-fluorocytosine
how does 5-fluorocytosine work, 2 ways
- disruption of DNA synthesis
2. disruption of translation
what is 5-fluorocytosine active against
crytococcus neoformans and candida species + some moulds
is 5-fluorocytosine used on its own or as combo therapy? And why is it used this way?
combo with Amp or fluconazole. Less resistance experienced with combo therapy
What is 5-fluorocytosine used generally for?
treatment of systemic fungal infections and mainly for crypt. meningitis
What is the patient at risk of if 5-fluorocytosine is used for more than two weeks at >100mg/L?
Bone marrow supression
What toxicity does 5-fluorocytosine present?
liver toxicity
what does 5-fluorocytosine interact with?
Brivudine
2 Examples of polyene?
Nystatin and Amphotericin
Another name for Amphotericin
Ambiosome
What can Amphotericin be used for
most yeasts and moulds
Is Amphotericin broad or narrow spectrum?
Broad
How is 5-fluorocytosine given?
IV
How is Nystatin and Amphotericin given?
IV but occasionally given topically
What type of therapy can Amphotericin be used for?
Empiric therapy (based on past experience)