Antimicrobials: Antifungal Medications Flashcards

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1
Q

Amphotericin is an

A

anti-fungal

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2
Q

Fungal cell membranes are composed of ________ not your usual cholesterol

A

ergosterol

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3
Q

amphotericin and nystatin bind

A

amphotericin and nystatin bind ergosterol to form holes in the fungal cell membrane

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4
Q

amphotericin treats

A

severe systemic fungal infections

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5
Q

IV administration of amphotericin is used for

A

treatment of severe systemic fungal infections

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6
Q

What decreases amphotericin toxicity

A

liposomal formulations of amphotericin prevent binding to human cholesterol membranes (decreased toxicity)

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7
Q

amphotericin toxicity results from

A

amphotericin toxicity results from non-selective binding to mammalian cholesterol membranes

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8
Q

What are immediate infusion-related toxicities of amphotericin

A
  1. hypotension
  2. headache
  3. fever
  4. chills
  5. thrombophlebitis
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9
Q

intrathecal administration of amphotericin to treat

A

fungal CNS infections

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10
Q

intrathecal administration of amphotericin can cause

A

seizure and other CNS side effects

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11
Q

______ is a cumulative toxicity of amphotericin

A

renal tubular acidosis (RTA) type 1

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12
Q

RTA type 1 is associated with

A

hypokalemia

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13
Q

amphotericin can cause

A

hypomagnesemia (due to renal magnesium wasting)

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14
Q

amphotericin can cause hypomagnesemia due to

A

renal magnesium wasting

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15
Q

volume expansion with IV normal saline before amphotericin administration prevents

A

kidney damage

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16
Q

___________ with IV normal saline before amphotericin administration prevents kidney damage

A

volume expansion

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17
Q

amphotericin induced damage to renal tubular cells can cause

A

anemia

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18
Q

amphotericin induced damage to renal tubular cells can cause anemia due to

A

decreased erythropoietin production

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19
Q

flucytosine is an

A

anti-fungal

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20
Q

cytosine deaminase in fungal cells converts

A

cytosine deaminase in fungal cells converts flucytosine (a fluorinated cytosine) into 5-fluorouracil (5-FU)

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21
Q

flucytosine halts

A

flucytosine halts fungal DNA and RNA synthesis

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22
Q

flucytosine and amphotericin combo treats

A

Cryptococcus infections (e.g. cryptococcal meningitis)

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23
Q

___________ combo treats cryptococcal meningitis

A

flucytosine and amphotericin combo treats cryptococcal meningitis

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24
Q

nystatin mechanism

A

nyastatin has the same mechanism of action as amphotericin

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25
Q

nystatin treats

A

Candida infections (candidiasis)

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26
Q

topical nystatin treats

A

mucocutaneous candidiasis (e.g. vaginal candidiasis)

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27
Q

oral nystatin rinse treats

A

oropharyngeal candidiasis

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28
Q

Cone-azole antifungals include

A
  1. voriconazole
  2. fluconazole
  3. itraconazole
  4. clotrimazole
  5. miconazole
  6. ketoconazole
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29
Q

_______ comprises the fungal cell membrane

A

ergosterol

30
Q

_______ antifungals inhibit the synthesis of ergosterol

A

azole

31
Q

azole antifungals inhibit the synthesis of

A

ergosterol

32
Q

azole antifungals inhibit the conversion of

A

lanosterol to ergosterol

33
Q

azole antifungals inhibit

A
  1. the synthesis of ergosterol
  2. conversion of lanosterol to ergosterol
  3. fungal cytochrome P-450
34
Q

Voriconazole inhibits

A

mammalian cytochrome P-450

35
Q

voriconazole side effects

A
  1. blurry vision of flashes of light

2. cause changes in color vision

36
Q

voriconazole treats

A
  1. invasive aspergillosis (caused by Aspergillus fumigatus)
  2. Candida infections (e.g. esophageal candidiasis)
  3. Cryptococcus infections (e.g. cryptococcal meningitis)
37
Q

fluconazole treats

A

Candida infections (e.g. mucocutaneous candidiasis)

38
Q

fluconazole treats what type of candida infection

A

mucocutaneous candidiasis

39
Q

voriconazole treats what type of candida infection

A

esophageal candidiasis

40
Q

one-time oral dose of fluconazole treats

A

vaginal candidiasis

41
Q

_______ treats vaginal candidiasis

A

one-time oral dose of fluconazole treats vaginal candidiasis

42
Q

systemic fluconazole treats

A

esophageal candidiasis

43
Q

fluconazole has high levels of

A

fluconazole has high levels of CNS penetration (treats cryptococcal meningitis)

44
Q

itraconazole is an

A

azole antifungal

45
Q

itraconazole treats

A
  1. systemic infections with dimorphic fungi (e.g. histoplasmosis, blastomycosis, coccidioidomycosis, sporothrix)
  2. onychomycosis and dermatophytosis
46
Q

itraconazole treats systemic infections with

A

dimorphic fungi (e.g. histoplasmosis, blastomycosis, coccidioidomycosis, sporothrix)

47
Q

itraconazole treats what diseases

A

onychomycosis and dermatophytosis

48
Q

Dermatophytes are

A

tinea

49
Q

What drugs are used to treat tinea infections (dermatophytosis)

A
  1. topical miconazole

2. topical clotrimazole

50
Q

clotrimazole and miconazole treat

A

vaginal candidiasis

51
Q

topical ketoconazole treats

A

dermatophytosis(e.g. tinea corporis)

52
Q

ketoconazole inhibits

A
  1. 17,20-desmolase (the first step of steroid hormone synthesis from cholesterol)
  2. production of androgens and estrogens
    3.
53
Q

Ketoconazole can cause

A

anti-androgenic side effects (e.g. gynecomastia)

54
Q

dermatophytes include

A

tinea corporis, tinea pedis, and tinea cruris

55
Q

griseofulvin is an

A

antifungal agent

56
Q

oral griseofulvin treats

A

dermatophytosis

57
Q

oral griseofulvin and terbinafine are first line therapy for

A

tinea capitis in children

58
Q

griseofulvin binds

A

griseofulvin binds fungal cell microtubules, halting mitosis

59
Q

griseofulvin activates

A

cytochrome P-450

60
Q

terbinafine is an

A

anti-fungal agent

61
Q

topical terbinafine is used to treat

A

tinea infections (e.g. dermatophytosis)

62
Q

oral terbinafine treats

A

onychomycosis

63
Q

terbinafine inhibits

A

terbinafine inhibits fungal squalene epoxidase causing accumulation of squalene

64
Q

Terbinfine side effects

A
  1. GI side effects

2. hepatotoxicity

65
Q

echinocandins are

A

caspofungin, micafungin, anidulafungin

66
Q

echinocandins act at the

A

echinocandins act at the fungal cell wall

67
Q

echinocandins inhibit

A

echinocandins inhibit the synthesis of beta-1-3-glucan in the fungal cell wall

68
Q

echinocandins have excellent activity against

A

Candida infections (e.g. mucocutaneous candidiasis)

69
Q

echinocandins are delivered IV for

A

systemic Candida infections (e.g. candidemia)

70
Q

echinocandins are delivered

A

IV for systemic Candida infections (e.g. candidemia)

71
Q

echinocandins treat

A
  1. esophageal candidiasis

2. invasive aspergillosis (caused by Aspergillus fumigatus)