Fungal Pharm

Question 1

What are the four different types of fungal infections?

Answer 1

• Superficial (skin/hair/nails)
• subQ (muscle, CT)
• Systemic/invasive (internal organs, primary vs opportunistic)
• allergic (affect lungs or sinuses)

Question 2

3 things that antifungals target (general)

Answer 2

cell MB
DNA synthesis
Cell wall

Question 3

three classes of “Azole” antifunglas

Answer 3

imidazole
triazoles
2nd gen triazoles

Question 4

Azoles block what type of enzyme? Why is this important for drug interactions, specifically with the human body’s function

Answer 4

Steroid converting enzymes

-they could effect mammalian relevant steroid-like molecule production

Question 5

spectrum of ketoconazole?

Answer 5

yeasts and molds

-generally used for topical/mucosal infections d/t poor absorption

Question 6

pharacodynamics of ketoconazole (4)

Answer 6

• variable absorption (depends on pH)
• half life =7-10 hours
• protein binding >99%
• hepatic, bile and kidney elimination

Question 7

adverse effects of ketoconazole (~4)

Answer 7

Nausea (worse w/ higher doses)
vomiting “ “
hepatoxic (2-8%)
dec testosterone (libido, sperm and enlarged breast tissue in males (Gynecomastia))

Question 8

2 major drug interactions to worry about with Ketoconazole

Answer 8

wafarin

Antacids

Question 9

3 advantages of fluconazole

Answer 9

well tolerated
IV/PO formulations
favorable pharmokinetics

Question 10

5 disadvantages of fluconazole

Answer 10

fungistatic
resistance
narrow spectrum
drug interactions
Adverse effects (N/V, rash)

Question 11

spectrum of activity for fluconazole

Answer 11

C. albicans

cryptococcus neoformans

Question 12

in which patients do you see primary resistance of fluconazole?
secondary?

Answer 12

Primary= severely immunocomp

Secondary=AIDS pt who have received fluconazole for reoccurring oropharyngeal candidiasis

Question 13

2 drug interactions for fluconazole

Answer 13

may increase warfarin

rifampin reduces levels to half