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NAPLEX > ID III: Antifungals, Antivirals, & Antiparasiticals > Flashcards

ID III: Antifungals, Antivirals, & Antiparasiticals Flashcards

1
Q

Name the most common Candida sp.

A

c. albicans, c. tropicalis, c. glabrata, c. krusei

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2
Q

Name the most common yeast species

A

candida sp. and Cryptococcus neoformans

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3
Q

What is a dimorphic fungi?

A

Fungi that exists as a mold at lower temperatures and a yeast at higher temperatures.

“Mold in the cold, yeast in the heat”

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4
Q

Name the most common types of mold

A

Aspergillus sp. and zygomycetes (includes mucor sp. & rhizopus sp.)

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5
Q

Name the dimorphic fungi

A

histoplasma capsulatum, blastomuyces dermatitidis, and coccidiodes immitis

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6
Q

MOA of amphotericin B

A

Binds to ergosterol, altering the cell membrane permeability and causing cell death

*fungicidal

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7
Q

BBW and SE of ampho B

A

BBW: dosing based on specific product name and lipid-based form of ampho - use caution

SE: infusion related (fever, chills, HA, malaise, rigors, decreased K & Mg), nephrotoxicity
*Lipid formulations have decreased SE

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8
Q

Coverage of ampho B

A

yeasts, molds, and dimorphic fungi

Initial tx for INVASIVE fungal infxns - cryptococcal meningitis, histoplasmosis, and mucormycosis

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9
Q

MOA of flucytosine

A

penetrates fungal cells, converted to flurouracil - competes w/uracil and interferes w/fungal RNA and protein synthesis

*fungicidal

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10
Q

Coverage of flucytosine

A

Used with ampho B for invasive cryptococcal meningitis or candida infections

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11
Q

MOA of azole antifungals

A

Decrease ergosterol synthesis and inhibit cell membrane formation; also inhibitors fungal CYP450 system

*fungistatic, but can be fungicidal for some fungal pathogens

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12
Q

Coverage of fluconazole

A

yeasts: c. albicans, c. tropicalis, Cryptococcus

dimorphic fungi: coccidiodes

  • limited efficacy against c. glabrata d/t resistance
  • c. krusei is considered fluconazole-resistant
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13
Q

Brand name of fluconazole

A

Diflucan

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14
Q

Coverage of itraconazole

A

yeasts: c. albicans, c. tropicalis

dimorphic fungi

molds: Aspergillus

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15
Q

Brand name of itraconazole

A

Sporanox (capsule/tab), Onmel (solution)

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16
Q

SE of azole antifungals

A

increased LFTs, QT prolongation

CYP450 - especially CYP3A4 DDIs

17
Q

Renal dosing of fluconazole

A

Requires dose adjustment

18
Q

Counseling for itraconazole oral caps/tab vs. solution

A

Caps/tab: take with food

Solution: take without food

19
Q

Coverage of voriconazole

A

Broad spectrum w/ better coverage of aspergillus sp., c. glabrata, and c. kruesi than itra/fluconazole.

  • DOC for aspergillosis
  • NO coverage against zygomycetes
20
Q

Storage of voriconazole solution

A

Do NOT refrigerate

21
Q

Brand name of voriconazole

22
Q

SE of voriconazole

A

Visual disturbances, increased LFTs and SCr, CNS toxicity (hallucinations, HA, dizziness), teratogen, QT prolongation (correct K, Ca, and Mg prior to initiating tx)

23
Q

Monitoring of voriconazole

A

trough levels (1-5mcg/mL), visual fxn, LFTs, electrolytes

24
Q

Renal dosing of voriconazole

A

Requires adjustment w/ IV d/t containing sulfobutyl either beta-cyclodextrin - which can accumulate in worsen renal fxn

25
Q

Coverage of posaconazole

A

covers more resistant yeasts, and molds w/ activity against zygomycetes

26
Q

Brand name of posaconazole

27
Q

SE of posaconazole

A

QT prolongation (correct K, Ca, and Mg prior to initiating tx), increased LFTs, decreased K and Mg

28
Q

Counseling with posaconazole

A

Suspension and tabs should be taken with food

29
Q

Coverage of isavuconazonium

A

covers more resistant yeasts, and molds w/activity against zygomycetes

30
Q

Brand name of isavuconazonium

31
Q

Special administrations considerations with isavuconazonium

A

Requires a filter (0.2-1.2 microns) during administration

32
Q

MOA of echinocandins

A

Inhibit the synthesis of beta(1,3)-D-glucan, an essential component of the cell wall

*fungicidal

33
Q

Name the echinocandins

A

Caspofungin (Cancidas), Micafungin (Mycamine), Anidulafungin (Eraxis)

34
Q

Renal dosing of echinocandins

A

Do not required dose adjustment

35
Q

SE of echinocandins

A

increased LFTs, hypotension, fever, N/V/D, and decreased K and Mg

36
Q

Coverage of echinocandins

A

Candida sp. including c. glabrata and c. krusei and non-albicans strains resistant to azole antifungals.

Activity against aspergillus, but should be used in combo

37
Q

Hepatic impairment dosing of echinocandins

A

Caspofungin requires adjustment in moderate hepatic impairment

38
Q

MOA of griseofulvin

A

Bind to the keratin precursor cells which prevents fungal invasion

Indications: dermatomycosis and tinea infections of skin, hair, and nails

39
Q

Brand name of griseofulvin

A

Grifulvin V, Gris-PEG

NAPLEX (8 decks)

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