Fungal drugs Flashcards
What is the cell wall of fungi made of?
Manoprotein
Glucan
Chitin
What is the cell membrane of fungi made of?
ergosterol
How do azoles work?
They target the ergosterol in the fungal membrane
How do polyenes work?
Target ergosterol
How does flucytosine work?
It’s a pyramidine interferes with replication machinery
How do echinocandins (-fungin) work?
They target the cell wall
GIve an example of a polyene
Ampho B
What are the benefits of fluconazole?
Available oral and Iv
- -Good GI absorption and CNS penetration
- -Doesn’t react with many other drugs
What is the first choice drug for candida?
Fluconazole.
What are the side effects of gluconazole?
hepatitis, rash, alopecia, anorexia.
–Overall, few drug interactions
What is the drug of choice for histoplasma?
itraconazole
how does itraconazole compare with fluconazole?
Itraconazole has poorer GI absorption and poorer CNS penetration
–Lots of drug interactions
What are the side effects of itraconazole?
hypokalemia, adrenal insufficiency, hepatitis
What is the drug of choice for aspergillosis?
voriconazole
What is the drug of choice for zygomycosis?
Posaconazole
What are the side effects for posaconazole?
hepatitis, some nausea/headache
What are the side effects of ampho B?
Nephrotoxic!
Also anemia
–>lipid based amphos have fewer adverse rxns but need higher dosing
How do echinocandins work?
They inhibit the 1/3 D glucan synthesis, weakening cell wall
–Effective against candida and aspergillus
In what formulation does caspofungin come?
IV only
What are the side effects of caspofungin?
hepatitis/fever/rash
When might you use caspofungin?
For candida if you can’t give azoles
