Fungal and Protazoa

Question 1

Antifungal MOI

Answer 1

interacts w/ or inhibits the synthesis of ERGOSTEROL (unique to fungal membranes)

targets the cell membrane/cell wall

Question 2

**Amphotericin B: MOI

Answer 2

binds to ergosterol –> leaky pores

Question 3

Amphotericin B: clinical applications

Answer 3

candidemia
aspergillus
blastomyces
cryptococcus
histoplasma
coccidiodes

Question 4

**Amphotericin B: ADEs

Answer 4

nephrotoxicity

infusion reactions (chills, fever, muscle spasms, hypotension)

Question 5

**Flucytosine: MOI

Answer 5

interferes w/ RNA and DNA synthesis selectively in fungi

Question 6

Flucytosine: clinical applications

Answer 6

cryptococcus

chromoblastomycosis infxn

Question 7

**Flucytosine: ADEs

Answer 7

renal excretions

myelosuppression

Question 8

Azoles: agents

Answer 8

ketoconazole
fluconazole
itraconazole
posaconazole
voriconazole

Question 9

**Azoles: MOI

Answer 9

inhibits P450 enzymes –> blocking ergosterol synthesis

long term use –>resistance

Question 10

Azoles: clinical applications

Answer 10

asperillosis - voriconazole

blastomycosis - itraconazole, fluconazole

mucormycosis - posaconazole

Question 11

What form of azoles do we use to treat dermatophytoses?

Answer 11

oral/topical

Question 12

**Azoles: ADEs

Answer 12

GI upset
rash

voriconazole

• visual disturbances
• pregnancy cat D

Question 13

**Terbafine: MOI

Answer 13

inhibits epoxidation of squalene

Question 14

Terbafine: clinical applications

Answer 14

mucocutaneous fungal infections
-accumulates in keratin

used for toenail infections

Question 15

**Terbafine: ADEs

Answer 15

GI upset

HA

Question 16

What is the MC drug of 1st choice?
What is the exception?
What is the 2nd line?

Answer 16

1st choice: Amphotericin B

Exception: voriconazole for Aspergillus

2nd choice: azoles

Question 17

What is a unique ADE of voriconazole?

Answer 17

rash, photosensitivity (vori-malignancy)

• visual disturbances
• pregnancy cat D

Question 18

What is a common ADE for systemic antifungal agents?

Answer 18

inc hepatic transaminases

Question 19

What diseases are caused by protozoa?

Answer 19

malaria
giardia
trichomoniasis

Question 20

What are the antimalarial drugs?

Answer 20

mefloquine
chloroquine
proguanil w/ atovaquone
doxycycline

Question 21

**Antimalarial Agents: MOI

Answer 21

kill/inhibit growth/life cycle

used to treat AND prevent

Question 22

What determines the choice of antimalarial drug?

Answer 22

destination (where you are traveling to)

Question 23

**What is the first line treatment for systemic fungal infections?

Answer 23

maybe?

Amphotericin B

Except Voriconazole w/ Aspergillus

Question 24

**What is the first line treatment for mucocutaneous fungal infections?

Answer 24

Terbinafine

Question 25

**What is the first line treatment for malaria?

Answer 25

i think it is CHLOROQUINE but she didnt specifically say mefloquine chloroquine proquanil w/ atovaquone doxycycline

Question 26

**What is the first line treatment for lice and scabies?

Answer 26

maybe PERMETHRIN but who really knows

Question 27

Which azole is eliminated in urine unchanged?

Answer 27

fluconazole

Question 28

*What resource would you use to determine which drugs to use for the prevention of malaria in travelers?

Answer 28

the CDC website

Question 29

**Mefloquine: ADEs, precautions

Answer 29

``` n/v dyspepsia abdominal pain diarrhea dizziness, ha INSOMNIA, VIVID DREAMS ``` caution in pts w/: - epilepsy, seizures - depression, other mental health problems - severe heart or liver problems

Question 30

**Chloroquine: ADEs, precautions

Answer 30

``` GI disturbance HA hypotension convulsions visual disturbances depigmentation/hair loss rash, pruritus ``` caution in pts w/: - neurologic disorders - myasthenia gravis - G6PD deficiency - liver and renal problems

Question 31

**Proguanil w/ Atovaquone: ADEs, precautions

Answer 31

``` n/v abdominal pain diarrhea ha, dizziness insomnia, abnormal dreams DEPRESSION rash ``` contraindications: - pregnant/breastfeeding women - severe kidney problems

Question 32

**Doxycycline: ADEs, precautions

Answer 32

n/v/d yellow teeth and disfigurement - not for pregnant/breastfeeding women and children <8yo - avoid taking w/ antacids, milk, Ca or Mg salts - photosensitivity may occur