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PAS 506 > Exam 8 Pharm > Flashcards

Exam 8 Pharm Flashcards

1
Q

Enterics (enterobacteriaceae)

A

In GI tract
Also causes UTI and aspiration pneumonia

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2
Q

H. influenza

A

Upper respiratory tract
Meningitis
Pneumonia in elderly

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3
Q

Examples of G- in respiratory and GU tract

A

N. meningitidis, N. gonorrhea

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4
Q

Common anaerobic bactera

A

Bacteroids fragils
C. diff
Fusobacterium
C. botulinum
C. tetani
Smell bad

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5
Q

Human ribosomes subunits

A

60s
40s

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6
Q

Bacteria ribosome subunits

A

50s
30s
We can target this difference with drugs

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7
Q

Bacteria DNA

A

Single, circular
Single DNA polymerase
Single RNA polymerase
Make own food.
We can target all these differences with drugs

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8
Q

Beta lactams ABx

A

Cell wall inhibitor
only active against rapidly dividing bacteria
All have beta lactam ring with different R groups that makes each drug unique

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9
Q

Examples of beta lactams

A

Penicillins
Cephalosporins
Monobactam
Carbapenems

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10
Q

Penicillin structure

A

Thiazolidine ring attached to beta-lactam ring
Some bacteria have beta-lactamases that break beta-lactam ring deactivating drug.
Side chains determine susceptibility to beta-lactamase

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11
Q

Penicillin mechanism

A

Covalently binds PBP to to inhibit transpeptidase from cross linking peptidoglycan layers
This causes rupture of cell wall

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12
Q

Favorable characterisitics of penicillin

A

Small, hydrophillic to get through the porin of the outer membrane

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13
Q

Natural penicillin

A

Penicillin G (IV preferred)
Penicillin V
Narrow spectrum
Work best against G- cocci, G+, non-beta lactamase producing anaerobes.

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14
Q

Narrow spectrum penicillin

A

Nafcillin, dicloxacillin, oxacillin, methicillin
Antistaph/strep
Methicillin not used because of resistance, only used to identify resistant strains

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15
Q

Extended spectrum penicilin

A

Aminopenicillins, Ureidopenicillins
More hydrophilic so can enter G- porins of outer membrain
Work on G- cocci, G+, non-beta-lactamase-producing, Works some in G- rods

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16
Q

Aminopenicillins

A

Ampicillin, amoxicillin
Extended spectrum penicillin.
Amoxicillin good for oral
most active oral beta-lactams for pneumococci.
Ampicillin best for shigellosis

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17
Q

Ureidopenicillins

A

Piperacillin
Extended spectrum penicillin
Active against G- bacilli
Antipseudomonal
Combined with beta-lactamase inhibitor tazobactam

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18
Q

Penicillin adverse effects

A

N/V/D
Rash
hypersensitivity
Nafcillin causes neutropenia adn interstitial nephritis
Oxacillin causes hepatitis
Ampicillin cuases pseudomembranous colitis

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19
Q

Beta lactamase inhibtors

A

Clavulanate, sulbactam, tazobactam, avibactam
Prevent destruction of beta-lactam ABx
Combined with certain beta-lactams
Little intrinsic antibacterial activity alone

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20
Q

Cephlasporin mechanism

A

Bind to pBP to interfere with crosslinking of peptidoglycan.
Could be cross reactive for penicillin (don’t give to someone allergic to penicillin)

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21
Q

Cephlasporin

A

Five generations
Start with Ceph
Less susceptible to beta-lactamase than penicillin

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22
Q

First gen cephalosporins

A

Cefadroxil (oral)
Cefazolin (parenternal) - surgical prophylaxis
Cephalexin (oral)
G+ cocci
Some G-
UTI

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23
Q

Second gen cephalosporins

A

Cefaclor (oral)
Cefotetan (parenternal)
Cefoxitin (parenternal)
Cefprozil (oral)
Cefuroxime(oral)
Treat sinusitis, otitis media, lower respiratory infection
G+
more G- coverage

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24
Q

Third gen cephalosporins

A

Cefdinir
Cefditoren
Cefixime
Cefotaxime
Cefpodoxime
Ceftazidime
Ceftriaxone
G+
Even more G- coverage
Some cross BBB
NO enterobacteria use
Penetrate body fluid and tissues well
Cefixime good for UTI
Ceftriaxone excreted through bile

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25
Q

Cephtriaxone

A

Third gen cephalosporin
Treats meningitis

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26
Q

Fourth gen cephalosporins

A

Cefepime
Parenternal
Goood against pseudomonas, enterobacteria, MSSA, Strep pneumoniae, Haemophilus, Neisseria
Crosses into CSF
Cleared renally

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27
Q

Fifth gen (advanced cephalosporins

A

Ceftaroline
Parenternal
Increases binding to PBP2a so greater affinity for MRSA.
Used in skin and soft tissue infections and pneumonia.
Renally excreted

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28
Q

Cephalosporin adverse effects

A

Cross sensitivity in those allergic to penicillin in early generations.
Irritation after IM injection
Thrombophlebitis after IV injection
Cefotetan can cause hypoprothrombinemia and bleeding disorders so avoid alcohol.

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29
Q

Monobactam

A

Aztreonam
Monocyclic beta-lactam ring
G- aerobic
Penetrates CNS
IM or IV
accumulation possible in renal failure
Mostly nontoxic
Caution with pts allergic to ceftazidime

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30
Q

Carbapenems

A

Ertapenem, imipenem, meropenem
Hard hitters (not used every day)
Penetrate tissues and fluids well
Used for organisms resistant to other drugs

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31
Q

IMipenem

A

Carbapenem
Wides spectrum against G+, G- rods, anaerobes
REsistant to some beta-lactamases

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32
Q

Carbapenems adverse effects

A

AE more common with impenem
NVD
rashes
seizures
cross sensitivity in less than 1% of pts allergic to penicillin

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33
Q

Vancomycin

A

Glycopeptide
Inhibits bacterial cell wall synthesis
Binds side chain to prevent elongation of peptidoglycan and cross linking
G+

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34
Q

Vancomycin pharmacokinetic

A

Renally cleared
Poorly absorbed in intestinal tract
Orally - C. diff colitis
Parenteral - MRSA

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35
Q

Vancomycin uses

A

Infections and endocarditis caused by MRSA
Used with gentamicin for endocarditis if pt has penicillin allergy
Used with cefotaxime, ceftriaxone, or rifampin for meningitis caused by penicillin resistant pneumococcus

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36
Q

Vancomycin adverse reaction

A

Phlebitis
Flushing syndrome (red man syndrome) from release of histamine

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37
Q

Lipoglycopeptide ABx

A

Telavancin, oritavancin, dalbavancin
Bactericidal
Conc dependent
G+

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38
Q

Telavancin

A

Lipoglycopeptide
G+
Inhibits wall synthesis OR disrupts bacterial cell membrane.
Can cause nephrotoxicity
Potentially tetratogenic

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39
Q

Oritavancin and Dalbavancin

A

Lipoglycopeptide
Long half life
Interfere with phosphollipid reagents used in asssessing coagulation.
Alternative therapy with heparin use

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40
Q

Daptomycin

A

Lipopeptide
G+
Inserts tail into cell membrain via Ca insertion. Tails agreagater forming hole and Potassium efflux then death
Treats vancomycin resistant stuff

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41
Q

Fosfomycin

A

Lipopeptide
Inhibits enolpyruvate transferase blocking first step in making peptidoglycan
Cross resistance unlikely because of unique structure
Single 3g dose for simple UTI in female

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42
Q

Bacitracin

A

Cyclic peptide mixture
G+
TOPICAL
Inhibits recycling of carrier that transports cell wall precursors across plasma membrane

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43
Q

What drugs bind to 50S ribosomal unit inhibiting protein synthesis

A

Chloramphenicol
Macrolides
Lincosamides
Oxazolidinones

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44
Q

What drugs bind to 30S ribosomal unit impairing proofreading

A

Aminoglycosides

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45
Q

What drugs bind to 30S ribosomal subunit blocking tRNA

A

Tetracycline

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46
Q

Three methods of bacterial resistance against protein synthesis inhibitors

A

Impaired influx or increased efflux
Ribosome protection intefering tetracycline binding
Enzymatic inactivation
Most use efflux pump

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47
Q

Aminoglycosides

A

Amikacin, gentamicin, neomycin, streptomycin, tobramycin.
Aerobic G- bacilli
Used in combo with other agents for drug-resistant organisms.
Used with beta-lactams for Enterococcus faecalis
Very toxic
Mean girl

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48
Q

Aminoglycoside mechanism

A

Bind to 30S subunit to distort structure so 50S can’t bind.
Can also misread/miscode mRNA making non-functional proteins
Irreversible effects

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49
Q

Aminoglycoside pharmacokinetics

A

Long post antibiotic effect.
Poor gut absorption so given parenternally.
Neomycin is topical bc of nephrotoxicity

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50
Q

Aminoglycoside adverse effects

A

Ototoxicity
Nephrotoxicity
NEOMYCIN with loop diuretics (fluerosemide/Lasix) causes nephrotoxicity.
Neuromuscular paralysis

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51
Q

Tetracycline

A

Doxycycline, minocycline, demeclocycline
Four rings
Variable R segments
Broad spectrum
G+, G-, protozoa, spirochetes, mycobacteria
bacteriostatic
Chelate devalent metal ions (calcium)
Goes into CSF

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52
Q

Tetracycline mechanism

A

Enter bacteria through passive diffusion or energy dependent transport.
Reversibly bind to 30S subunit
Stops addition of amino acid to peptides

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53
Q

Tetracycline absorption

A

Tetra and demeclocycline given on empty stomach
Dairy inhibits absorption

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54
Q

Tigecycline

A

Tetracycline with very long half life (36hrs)

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55
Q

Tetracycline clinical use

A

Used for rickettsia, Borrelia, H. pylory
Chlamydia
Acne
Doxycycline used for secondary syphylis in pts allergic to penicillin

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56
Q

Tetracycline adverse effects

A

Stains teeth and stunts growth from calcium effects(don’t give to kids)
Phototoxicity (burn fast)
Hepatotoxicity
Don’t use in pregnant or breastfeeding women

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57
Q

Macrolides

A

Erythromycin, Clarithromycin, Azithromyxin
Macrocyclc lactone ring to one or more doxy sugars
G+ bacilli, G- rods

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58
Q

Macrolides mechanism

A

Irreversibly bins to 50S subunit inhibiting translocation of protein synthesis.

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59
Q

Macrolide uses

A

Mycoplasma
Chlamydia (with azithromycin or doxycycline)

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60
Q

Erythromycin

A

Macrolide
Need enteric coating to protect from stomach acid
Food effects absorption
Alternative for penicillin

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61
Q

Clarithromycin

A

Macrolide
Improved acid stability
Great against intracellular

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62
Q

Azithromycin

A

Macrolide
Less active against strep and staph.
Moree active against respiratory pathogens
Great for chlamydia
Very long 1/2 life (3 days)
Does not inactivate CYP450

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63
Q

Macrolide adverse effects

A

GI disturbances
Jaundice
Ototoxicity
QT prolongation bc of effect on K channels
Erythromycin and azithromycin bad for liver.
Erythromycin and clarithromycin inhibit metabolism of other drugs

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64
Q

Clindamycin method of action

A

Lincosamide
Interferes with translocation reactions binding to 50S subunit

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65
Q

Clindamycin uses

A

G+ and anaerobic including MRSA
Skin and soft tissue infection.
Used with pen G for treating toxic shock or necrotizing fasciitis from group A strep
Dental procedures if allergic to penicillin

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66
Q

CLindamycin adverse effects

A

C. diff

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67
Q

Clindamycin pharmacokinetics

A

Distributes well into body fluids but not CSF
Penetrates well into abscesses

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68
Q

Oxazolidinone mecahnism

A

Linezolid, Tedizolid
Binds to 50S subunit to block formation of 70S ribosome.

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69
Q

Oxazolidinone uses

A

G+
Bacteriostatic
Bacteriocidal against strep
Good against TB
Treat infections caused by dreg resistanc G+

70
Q

Oxazolidinone adverse effects

A

Gi effects.
Thrombocytopenia
Anemia
Neutropenia

71
Q

Tedizolid

A

Oxazolidinone
Increased potency against staff
Highly active against G+

72
Q

Chloramphenicol

A

Only used in life threatening situations.
Reversibly binds to bacterial 50S.
Inhibits peptidyl transferase
Prevents formation of peptide bonds

73
Q

Chloramphenicol uses

A

Bacteriostatic
Sometimes bactericidal
Broad spectrum
G+, G-
Only life threatening

74
Q

Chloramphenicol adverse effects

A

Anemia
Gray baby syndrome (babies can’t break it down so drug accumulates)

75
Q

Metronidazole mechanism

A

Reduced to free radical metabolites in anaerobic bacteria
Forms concentration gradient
Increased uptake of metronidazole
Free radicals destroy DNA

76
Q

Metronidazole uses

A

ANAEROBIC bacteria and some protozoa
Vaginitis
Intraabdodminal infections (C. diff)
Brain abscess

77
Q

What drugs to use with anaerobes

A

Clidamycin
Metronidazole

78
Q

Metronidazole adverse effects

A

GI
Metallic taste
Stomatitis
Peripheral neuropathy
Disulfiram-like effect with alcohol (No alcohol when taking drug)
Seizures

79
Q

Fluoroquinolones

A

Act on type II topoisomerase enzymes.
Effecting way DNA is twisted
DNA gyrase in G- relax supercoiled DNA
Topoisomerase IV in G+ Separating daughter chromosomes

80
Q

Fluoroquinolones mechanism

A

Bind DNA gyrase and topoisomerase IV
Interfere with DNA ligation
Generate lots of double stranded breaks.
Cell lysis
Death

81
Q

Ciprofloxacin

A

Fluoroquinolone used for traveler’s diarrhea
G-

82
Q

Levofloxacin

A

Respiratory Fluorquinolone
Used for S pneumonia and CAP

83
Q

Moxifloxacin

A

Respiratory fluoroquinolone
G+ and G-
Mycobacterium
CAP

84
Q

Gemifloxacin

A

Respiratory Fluoroquinolone
Oral

85
Q

Respiratory Fluoroquinolones examples

A

Levofloxacin
Moxifloxacin
Gemifloxacin

86
Q

Delafloxacin

A

Fluoroquinonlone
G+
Skin infections
IV or PO

87
Q

Fluoroquinolones pharmacokinetics

A

Good absorption in GI
Calcium containing foods are bad for absorption
High concentrations in bone, urine kidney, prostate, lungs

88
Q

Fluoroquinolone adverse effects

A

Tendonitis
Tendon rupture
Worsening of myasthnia gravis
Irreversible peripheral neuropathy
CNS effects
Phototoxicity
Blood glucose imbalance
QT prolongation
C. diff risk
Saved for emergencies

89
Q

Folate

A

Coenzyme needed in RNA and DNA synthesis.
Bacteria make their own.

90
Q

Sulfonamides

A

Folate inhibitor
Competes with PABA inhibiting dihydropteroate synthsis.
Inhibits dihydrofolic acid formation

91
Q

Sulfonamide uses

A

Rarely single agent
Can be topical

92
Q

Sulfonamides adverse effects

A

Crystalluria
Hypersensitivity
Hemolytic anemia in pts with G6PD deficiency
Granulocytopenia and thrombocytopenia
Kernicterus

93
Q

Sulfonamids contradiction

A

Don’t give to infant under 2 months
Pregnant women
Methenamine

94
Q

Trimethroprim

A

Folate inhiitor
Inhibits dihydrofolate reductase
Used with sulfamethoxazole for UTI.

95
Q

Trimethoprim adverse effects

A

Hyperkalemia
Folic acid deficiency megoblastic anemia, leukopenia, granulocytopenia

96
Q

Bactrim

A

Combonation of sulfamethoxazole and trimethoprim
Stronger than the drugs on their own.
Inhibits tetrahydrofolate synthesis
Used in UTI
Used in skin and soft tissue.
Works on MRSA

97
Q

Nucleoside

A

Nucleotide without phosphate group

98
Q

Antiviral drug target

A

Different stages of viral life cycle.
Attachment, entry, transcription, translation, replication, release

99
Q

Virustatic

A

Only active against replicating virus.
Don’t effect latent virus.
Monotherapy for acute
Combo therapy for chronic
Might harm host cell
Start treatment immediately after symptoms

100
Q

HSV-1

A

Herpes labilais
Cold sores
Fevers
Blisters

101
Q

HSV2

A

Genital herpes

102
Q

Varicella zoster virus (VZV)

A

Blister like rash
Spreads via direct contact with blister fluid.
Itching
Fever

103
Q

Varicella zoster virus reactivation

A

Herpes zoster
aka Shingles
Follows nerve (dermatome)
PAIN, tingling, fever, sensitivity to light
Post herpetic neuralgia most common

104
Q

Herpes family viruses

A

Herpes simplex virus (HSV-1+2)
Varicella zoster virus (varicella and herpes zoster)

105
Q

Herpes family antiviral agents

A

Guanosine analogs.
(Acyclovir and Valacyclovir)

106
Q

Acyclovir and valacyclovir mechanism against herpes family

A

Triphosphorylated
Competes with dGTP for viral DNA polymerase.
No viral replication

107
Q

What is antiherpes more effetive against

A

More effective against anogenital than labialis

108
Q

Varicella Zoster Virus treatment

A

High doses of antiherpes against
IV acyclovir for serious infections

109
Q

Valacyclovir

A

Herpes/VZV
Guanosine analog
Prodrug
Better bioavailability than acyclovir

110
Q

Acyclovir

A

Herpes/VZV
Guanosine anolog
Given IV or oral
Oral NVD
IV renal toxicity, neuro effects, neutropenia

111
Q

Penciclovir

A

Herpes/VZV
Nucleoside analog
Poor bioavailability
Topical

112
Q

Famciclovir

A

Herpes/VZV
Nucleoside analog
Oral prodrug of penciclovir
Better bioavailability

113
Q

Docosanol

A

Over the counter cream
Herpes labialis
No benefit for genital herpes
Stabilizeds host cell membrane to prevent viral fusion with host cell

114
Q

Cytomegalovirus (CMV)

A

Common in immunocompromised
Spread via body fluid.
CAUSE INFECTIOUS BIRTH DEFECTS

115
Q

Ganciclovir and Valgancyclovir

A

CMV
Guanosine analogs
Require triple phosphorilation.
Inhibit DNA polymerase so no DNA elongation
Ganciclovir IV for systemic
Valgancyclovir ophthalmic gel for acute herpetic keratitis

116
Q

Ganciclovir adverse effects

A

NVD
HA
Insomnia
Neutropenia
Myelosuppression
Carcinogenic
Teratogenic

117
Q

Valganciclovir

A

CMV
Oral prodrug with better bioavailability

118
Q

Cidofovir

A

CMV
Cytosine nucleotide
Phosphorylation via host enzymes.
Active against kinase-deficient or altered CMV or HSV.
Diphosphate is active form
Inhibits and distracts DNA polymerase.
INcorperates into viral DNA

119
Q

Cidofovir adverse effects

A

Cross resistance with ganciclovir.
Need aggressive hydration to prevent nephrotoxicity.
Gonadotoxic
Embryotoxic

120
Q

Foscarnet

A

CMV
Direct viral enzyme inhibitor
DOES NOT REQ PHOSPHORYLATION
Blocks pyrophosphate binding site on herpevirus DNA/RNA polymerase
Used when things are very bad (organ failure)

121
Q

Foscarnet adverse effects

A

Nephrotoxicity
Serum creatinine increase
Metabolic abnormalities

122
Q

Adamantanes

A

Amantadine and rimantadine
Anti-flu A
Inhiit uncoating step of RNA to prevent replication
Tetratogenic
Dose reduction for renal impairment in elderly

123
Q

Neuramidase inhibitor examples

A

Oseltamivir (tamiflu),
Zanamivir,
Peramivir
Cover influenza A and B

124
Q

Neuraminidase inhibitors method of action

A

Inhibit viral neuraminidase
Stops cleavage of new virion from host cell membrane
Clumping of virions to each other and infected host cell membrane.
Block virion release

125
Q

When to give nuraminidase inhibitors

A

within 48 hours of symptoms

126
Q

Neuraminidase inhibitor adverse reactions

A

NVD
HA
Take with food to avoid GI upset
Skin allergic rxns
Don’t give to person who had LAIV two weeks before.
Don’t give to person with ESRD without dialysis

127
Q

Oseltamivir

A

Anti-flu A and B (neruaminidase inhibitor)
Tablet or suspension
13 yo+ give 75mg BID for 5 days or QD for 10 days
Peds based on weight

128
Q

Zanamivir

A

Anti-flu A and B (neruaminidase inhibitor)
Dry powder inhaler or parenteral infusion.
2 puffs Q12 hrs for 5 days or Q24 for 7 days

129
Q

Zanamivir adverse effects

A

Bronchospasm, reversible. decrease in pulmonary function, transient nasal and throat discomfort

130
Q

Peramivir

A

Anti-flu A and B (neuraminidase inhibitor)
Single IV dose for adults with uncomplicated flu.
Up to five days of IV

131
Q

Baloxavir

A

Flu
Endonuclease inhibitor
Inhibits viral replication
Used for uncomplicated flu in 5yo+ or 12 yo+ at high risk of complications
Single dose good for the whole sickness (long half life)

132
Q

Baloxavir dosing

A

<20 kg = 2mg/kg/dose suspension
20-79kg = 40mg single tablet
>80kg = 80 mg single tablet

133
Q

Nirmatrelvir/ritonavir (Paxlovid) mechonism

A

Protease inhibitor
N blocks MPRO cleaving two viral proteins in budding process.
R is a CYP3A4 inhibitor to delay metabolism (prolong half-life)

134
Q

Nirmatrelvir/ritonavir (Paxlovid) dosing

A

Q12hrs x 5 days
Within five days of symptom onset

135
Q

Nirmatrelvir/ritonavir (paxlovid) adverse effects

A

Metallic taste
Diarrhea
Elevated serum aminotransferases
Covid rebound between 2-8 days after recovery

136
Q

Molnupiravir

A

EUA for adults with mild-moderate Covid.
Prodrug of NHC (nucleoside)
Triphosphorylated and incorporated into RNA causing mutations and inhibition of viral replication

137
Q

Molnupiravir dosing

A

Q12 hrs x 5 days
Treatment within 5 days of symptom onset.
Not for <18 yo

138
Q

Remdesivir

A

Adenoside analog
Broad spectrum antiviral
All ages
hospitalized pts with moderate-severe covid.
IV infusion for at least five days.
Loading dose needed
Competes for incorporation into RNA chains by viral RNA polymerase causing chain termination

139
Q

Remdisivir adverse effects

A

Nausea, bradycardia, hypotension.
Dont give to children, pregnant, lactating, hepatic or renal imparement

140
Q

Ribavarin

A

Guanaside analog
Used for RSV and HCV
Inhibits synthesis of GTP decreasing GTP available to cap mRNA.
INcorporates into viral RNA
Inhibits RNA polymerase

141
Q

Ribavirin adverse effects

A

Anemia, Pruritis, Upper respiratory symptoms.
Tetratogenic.
Women taking or men must use two forms of contraceptive

142
Q

Three most common overgrown dermatophytes in cutaneous mycosis

A

Trichophyton
Microsporum
Epidermophyton
Cause Tinea infections

143
Q

Tiniea corporis

A

Ring worm

144
Q

Tinea pedis

A

Athletes foot

145
Q

Tinea cruris

A

Jock itch

146
Q

Tinea capitis

A

Scalp ringworm

147
Q

Tiniea unguium

A

Onchomycoses.
Discoloratoin, thickening, separation of nail from nailbed

148
Q

Amphotericin B

A

Very toxic
Only give for life threatening mycoses.
IV for systemic
Rarely used topically
Broadest spectrum of antifungals

149
Q

What all is Amphotericin B effective against

A

Candida albicans
Histoplasma capsulatum
Cryptococcus neoformans
Coccidioides immitis
Blastomyces dermatidis
Aspergillus strains

150
Q

Amphotericin B mechanism

A

Bind to ergosterol in fungal membrane.
Form pores in membrane.
Cell death

151
Q

Amphotericin B dosing

A

IV for systemic
PO for GI fungi only

152
Q

Amphotericin B adverse effectes

A

Fever, chills
1-3 hrs after starting IV
Renal damage
Hypotension with hypokalemia

153
Q

Flucytosine

A

Oral
Pyrimidine analog
Used with Amphotericin B
INcreases permiability of fungal cell

154
Q

Systemic azoles mechanism

A

Inhibit CYP450 3A4 enzymes
Reduces ergosterol synthesis.
Disrupts fungal membrane structure and funciton
Blocking fungal cell growth and causing death

155
Q

Systemic azoles spectrum

A

Very broad.
Candida, C neoformans, endemic mycoses, dermatophytes.
Some azoles effective against aspergillus

156
Q

Ketonazole

A

First oral azole
Less selectivve for fungal P450
Topical form (shampoo) against dermatotyphosis

157
Q

Fluconazole

A

First triazole antifungal.
PO and IV
SIngle dose therapy for vulvovaginal cadidiasis
Excreted unchanged in urine

158
Q

Osteconazole

A

Works against most candida
Used in recurrent vulvovaginal candidiasis
Lower affinity for CYP enzymes

159
Q

Echinocandins

A

-fungin
Available for slow IV once daily
Work against aspergillus and candida

160
Q

Echinocandins mechanism

A

Inhibit glucan synthesis necessary to make fungal cell wall

161
Q

Terbinafine mechanism

A

Allylamine
inhibits fungal enzyme squalene epoxidase
Increases membrane permeability

162
Q

Ibrexafungerp

A

Cidal
Vulvovaginal candidiasis adn recurrent vulvovaginal candidiasis.
NOT for preg women

163
Q

Grisofulvin

A

Oral.
Absorption increased with fatty foods.
Disrupts mitotic spindle inhibiting fungal mitosis
2-6 wks for skin and hair infections.
6-12 months for onychomycosis

164
Q

Nystatin

A

Orally used against thrush
Polyene macrolide
Candida infections

165
Q

Efinaconazole (Jublia)

A

Solution painted onto nails’
Onychomycosis fo toenails
Highest cure rate for topical onychomycosis (15-18%)

166
Q

Ketoconazole

A

Topical cream for dermatophytosis, candidias.
Shampoo or foam for seborrheic dermatitis

167
Q

Naftifine and Terbinafine

A

Allylamines usd against dermatophytes.
Effecteive for tinea cruris and tinea corporis

168
Q

Butenafine

A

Benzylamine related to allylamines
Inhibits epoxidatoin of squalene blocking ergosterol synthesis stopping cell wall synthesis.
Good for superficial dermatophytosis

169
Q

Tolnaftate

A

Effective dermatophyte infections
Not active against candida

170
Q

Ciclopirox

A

Inhibits DNA and RNA synthesis.
Painted on nail

171
Q

Tavaborole

A

Topical antifungal for toenail onchomycosis

PAS 506 (9 decks)

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