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CP1 = Core Micobiology > Introduction to Antifungals > Flashcards

Introduction to Antifungals Flashcards

1
Q

What are fungi classified into?

A

> Filamentous
Yeast
Mould

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2
Q

What is the most common filamentous fungi?

A

Athlete’s foot.

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3
Q

What does Pneumocystic Jiroveci cause?

A

Pneumonia in the immunosuppressed.

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4
Q

What does the fungal cell wall contain?

A

B-1,3-glucan

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5
Q

What does the fungal cell membrane contain?

A

Ergosterol

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6
Q

Why is it hard to target fungi?

A

They have similar processes to humans.

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7
Q

What is the function of Ergosterol?

A

Main cell membrane constituent, regulates membrane PERMEABILITY.

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8
Q

What is the synthesis pathways of Ergosterol?

A

Squalene -1-> Lanosterol -2-> Ergosterol.

1) Squalene Epoxidase
2) Lanosterol 14a demethylase

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9
Q

What is B-1,3-Glucan made up of?

A

Polymers of UDP Glucose, made from B-1,3-glucan synthase.

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10
Q

What does B-1,3-glucan do?

A

Makes up 50% fungal wall dry weight, fibrous network on inner surface.

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11
Q

How do Polyenes (Anti-fungal drugs work)?

A

> Work w/ Ergosterol.
Make pore-like aggregates
Lose membrane integrity
K+ leakage –> Cell Death

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12
Q

Specifically what does Amphotericin B do (Polyene)?

A

Stabs Ergosterol.

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13
Q

Nystatin problems?

A

> Not orally absorbed
Too toxic for systemic use
Only superficial infections

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14
Q

Amphotericin B problems?

A

> Allergic reactions

> Nephrotoxicity

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15
Q

Why is some Amphotericin B lipid associated?

A

Minimize delivery to kidney cells –> more target to fungal cells or reticulo-endothelial system (liver,spleen)

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16
Q

What do Allylamines do?

A

Inhibit Squalene Epoxidase - Ergosterol Synthesis.

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17
Q

What are Allylamines used for?

A 
> Superficial fungal infections
> Tinea Corporis/Cruris
> Athletes foot
> Scalp ringworm
> Onchyomycosis
18
Q

What type of Antifungal drug is Terbafine?

A

Allylamine

19
Q

What is Terbafines spectrum?

A

Broad

20
Q

What are the negative side effects of Terbafine?

A

Liver toxicity - Hepatitis, Jaundice.

21
Q

What do Azoles do?

A

Block lanosterol 14a-demethylase - Ergosterol synthesis.

22
Q

What are Azoles?

A

Synthetic compound with a 5M azole ring.

23
Q

What builds up as a result of using Azoles?

A

Non-ergosterol 14a-sterols in cell membrane.

24
Q

What type of spectrum do Azoles have?

A

Broad

25
Q

What can Fluconazole not be used to treat?

A

Aspergillus spp.

26
Q

What adverse effect do Azoles have?

A

Cause hepatotoxicity

27
Q

What do Azoles inhibit apart from lanosterol 14a-demethylase?

A

Cytochrome P450 enzymes.

28
Q

How many N atoms in Imidazoles?

A

2

29
Q

How many N atoms in Triazoles?

A

3

30
Q

Why arent Imidazoles used?

A

Toxic

31
Q

What are Triazoles used for?

A

Aspergillosis and candidiasis.

32
Q

How do Echnocandins work? (End in FUNGIN)

A

Inhibit B-1,3-glucan synthase –> abnormal cell wall.

33
Q

What do Echnocandins treat?

A

Aspergillus and candida.

34
Q

What do Echnocandins not treat?

A

Some moulds and cryptococcus.

35
Q

What type of analogue is 5 -FlouroCysteine?

A

Pyrimidine

36
Q

What does 5-FC do?

A

Inhibit DNA/RNA synthesis

37
Q

What does 5-FC need to get into a fungal cell?

A

Cysteine Permease

38
Q

What is 5-FC converted to inside the cell?

A

> 5- Flourouracil

> 5- Flourodeoxyuridine monophosphate

39
Q

What can 5-FC only be used for?

A

Yeasts

40
Q

Adverse effect of 5-FC?

A

Bone marrow depression

41
Q

What is the clinical use of 5-FC?

A

Cryptococcal meningitis ( use w/ Amphotericin B)

42
Q

What does Grisofulvin do?

A

Inhibit fungal mitosis in dermatophyte infections

CP1 = Core Micobiology (7 decks)

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