Fungal infections Flashcards
What are the main drug targets for antifungals?
Ergosterols = membrane component (like fungal cholesterol)
Cell wall synth
Cell division
nucleic acid synth
What are the classes of systemic antifungals?
Azoles
Echinocandins
Other antifungals
Generally discuss the azole antifungal class
fluconazole (oldest), itraconazole, posaconazole, voriconazole
More resistance, better tolerated
target ergosterol
Generally discuss the echinocandins antifungal class
anidulafungin, caspofungin, micafungin
Broader, more toxic, used if high risk of death, used less
What antifungals belong in the “other class”?
Amphotericin = IV, no systemic exposure
Flucytosine = chem
Griseofluvin = nails
terbinafine = nails, topical cream
What are dimorphic fungi?
fungi that exist as mold form or as yeast
Generally discuss fungal infections/occurrence
Most common in immunocompromised (except dimorphic fungi and dermatophytes)
Subacute to chronic (except candidemia and mucormycosis)
Skins to skin transmission does not occur except skin infections
What factors inc risk of fungal infections?
Drugs that suppress immune syst
Invasive devices
Broad spectrum abx
malnutrition
disorders = AIDS, burns, diabetes, hodkgkins lymphoma, leukeamia
What are some superficial fungal infections?
Tinea capitis
Tinea barbae
Tinea corporis
Tinea cruris
Candida intertrigo
Tinea pedis
What are some mucocutaneous fungal infections?
Oral thrush
Esophageal candidiasis
Vulvavaginitis
When is systemic antifungal prophylaxis used?
High risk ICU patient
Organ transplant patients
Chemo patients w/ neutropenia
Stem cell patients with neutropenia
What is the treatment for systemic candidiasis?
Treat w/ echinocandin until sus/fungus identified —> then switch fluconazole
Describe cryptococcal meningitis
Type of meningitis (subacute or chronic) = fever, altered mental state, headache
C. gattii = immunocompetent patient
C. neoformans = immunocompromised patient
How is cryptococcal meningitis treated?
Done in phases
Induction = amphotericin + flucytosine (if HIV)
Consolidation = fluconazole (high dose/or standard dose if HIV)
Maintenance/eradication = fluconazole (standard dose/low dose if HIV)
How is allergic bronchipulmonary aspergillosis treated?
Occur in CF or asthma patient
Treat w/ systemic corticosteroids and/or anti-fungal treatments
