Chapter 35 (micro 50): Anti-fungals Flashcards
What is the mechanism of action of polymers
Bind to ergosterol causing disruption of cell membrane
What is the mechanism of action of allylamines
Block ergosterol synthesis in cell membrane
What is the mechanism of action of azoles
Block ergosterol synthesis in cell membrane
What is the mechanism of action of echinocnadins
Inhibit cell wall synthesis
What is the mechanism of action of pyrimidine inhibitor
Inhibits DNA and protein synthesis
What pathogens does flucytosine treat mostly
Cryptococcus, candida
What pathogens does echinocgandins mostly treat
Candida, aspergillosis
What pathogens does terbinafine usually treat
Dermatophytes
What pathogens does fluconazole mostly treat
Candida, cryptococcus
What inherent toxicities are associated with amphotericin B (micro)
Nephrotoxicity, anemia, infusion reactions
What activity does terbinafine inhibit
Squareness epoxidase acitvity
What is potassium iodide used against
Cutaneous sporotrichosis
What are some side effects of potassium iodide
Metallic taste, thyroid dysfunction, rash, salivary swelling
describe the mechanism of action of flucytosine
converted in several steps to 5-FdUMP, which inhibits thymidylate synthase and thereby interferes with DNA synthesis
what are the clinical applications of flucytosine
candidiasis, cryptococcosis, chromomycosis
what are some adverse effects with flucytosine
bone marrow suppression, cardiotoxicity, GI disturbance
what is a contraindication to flucytosine
pregnancy
what accounts for resistant to flucytosine
mutations in cytosine permeate or cytosine deaminase
who should flucytosine be use with caution in
patients with renal impairment
what is the mechanism of action of griseofulvin
binds to tubular and a microtubule-associated protein, thereby disrupting assembly of the mitotic spindle
what is the clinical application of griseofulvin
fungal infection of skin, hair or nail to trichophyton, microsporum, or epidermophyton
what levels can griseofulvin increase
protoporphyrin levels
what are some adverse effects seen with griseofulvin
vertigo, blurred vision, hepatotoxicity, serum sickness
what are some contraindication to griseofulvin use
pregnancy, porphyria and hepatic failure
at what interval is griseofulvin taken
6 hour intervals
what is the mechanism of action of terbinafine, naftifine, butenafine
inhibit conversion of squalene to lanosterol by inhibiting squalene epoxidase
what is the main clinical application of terbinafine, naftifine, butenafine
tinea infections
what drugs can alter plasma levels of terbinafine
cimetidine increases it and rifampin decreases it
what is the mechanism of action of the imidazole antifungals
inhibiting 14-alpha-sterol demethylase which inhibits conversion of lanosterol to ergosterol
what are some adverse effects seen with ketoconazole
GI disturbance, hepatic dysfunction, gynecomastia, decreased libido, menstrual irregularities
what is the mechanism of action of amphotericin B
bind to ergosterol and form pores that alter fungal membrane permeability and stability
what are some adverse effects seen with amphotericin B
renal toxicity, cytokine storm, anemia, weight loss, GI disturbance
what is the clinical application of nystatin
mucocutaneous candidiasis
what is the mechanism of action of echincandins
non competitively inhibit synthesis of beta-(1,3)-D-glucans, which leads to disruption of cell wall integrity
what is the clinical application of anidulafungin
esophageal candidiasis, candidermia
what organ systems is amphotericin primarily used for
severe systemic fungal infections
what does amphotericin toxicity result form
non-selective binding to mammalian cholesterol membranes
what type of amphotericin administration is needed for fungal CNS infections
intrathecal administration
what is the biggest amphotericin toxicity
renal tubular acidosis type 1 (renal damage)
what fungi does itraconazole treat
systemic infections with dimorphic fungi (histoplasmosis, blastomycosis, coccidioidomycosis, sporothrix)
what does ketonazole inhibit
17,20-desmolase, the first step of steroid synthesis of cholesterol
