General + Polyene drugs Flashcards
Polyene antibiotics (3 drugs)
Amphotericin B
Natamycin
Nystatin
Polyene drugs - MOA
Binds ergosterol in fungal cell membrane and increases the membrane permeability (leakage of cell components).
Also bind to mammalian cholesterol - renal adverse effects
Polyene antibiotic indicated for systemic and subcutaneous mycoses
Amphotericin B
Which polyene drugs are only adm topically? (2 drugs)
Natamycin
Nystatin
Polyene antibiotic to treat fungal meningitis (1 drug)
Amphotericin B
Amphotericin B - adverse effects
Renal toxicity (80% of pt) Hypokalemia, hypomagnesemia. Azothemia Acute liver failure, cardiac arrhythmias. Anemia, leukopenia, thrombocytopenia
How can side effects of Amphotericin B be reduced?
Reduced nephrotoxicity with parenteral lipid formulations.
Reduced fever, vomiting ect by pretreatment with corticosteroids, antipyretic drugs, antihistamines.
Nystatin - indications
Candidiasis (mucocutaneous, intestinal and vaginal)
Natamycin - indications
Fungal blepharitis, conjunctivitis and keratitis (by aspergillus, candida, fusarium, penicillium species)
Antifungal drugs (4 groups, + 4 other drugs)
Polyene antibiotics Azole derivatives Allylamine drugs Echinocandin drugs Others (ciclopirox, flucytosine, griseofluvin, tolnafate)
Amphotericin B - indications
Severe systemic mycoses
Which drugs are alternatives to amphotericin B?
Azole derivatives
