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Microbiology 2 > Lecture 2: Antifungal Agents, targets, and resistance > Flashcards

Lecture 2: Antifungal Agents, targets, and resistance Flashcards

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Biology 101 flashcards
1
Q

Are most antifungals fungi static or fungicidal

A

Fungistatic

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2
Q

What are the 4 major classes of antifungals

A
  1. Allylamines
  2. Azoles
  3. Polymers
  4. Echinocandins
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3
Q

What does nikkomycin do

A

Chitin synthase inhibitor

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4
Q

Are allylamines broad or narrow spectrum

A

Broad

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5
Q

What are the two members allylamines

A
  1. Naftitine
  2. Terbinafine
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6
Q

Is naftittine topical or systemic

A

Topical

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7
Q

Is terbinafine topical or systemic

A

Both

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8
Q

What is the mechanism of action of allylamines (naftitine and terbinafine)

A

Inhibits squalene epoxidase—> increase squalene and decrease Ergosterol

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9
Q

What are some adverse effects of allylamines (naftitine, terbinafine)

A

GI +/- skin disease

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10
Q

Terbinafine has lipophilic properties that allow it to concentrate in __

A

Dermis/epidermis, adipose tissue, hair and nails

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11
Q

Is terbinafine broad or narrow

A

Broad

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12
Q

What are the two groups of the azoles

A

Imidazoles, triazoles

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13
Q

Are azoles narrow or broad spectrum

A

Broad

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14
Q

What is the mechanism of action of azoles

A

Inhibit sterol 14-alpha demethylase—> decrease Ergosterol—> slowed growth

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15
Q

What patients are azoles contraindicated in

A

Teratogenic-pregnant animals

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16
Q

What are 2 examples of imidazoles

A

Ketoconazole, miconazole

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17
Q

What are two examples of triazoles

A

Fluconazole, itraconazole

18
Q

Triazoles vs imidazoles: greater affinity for fungal membranes and fever side effects

A

Triazoles

19
Q

What is fluconazole effective against

A

dermatophytes, candida, cryptococcus

20
Q

Are polyenes broad or narrow spectrum

A

Broad

21
Q

What is the mechanism of action of amphotericin B (Polyenes)

A

Binds to sterols/ Ergosterol

22
Q

What is an adverse effective of polyenes/ amphotericin B

A

Nephrotoxicity

23
Q

Are nikkomycins narrow or broad spectrum

A

Narrow

24
Q

What is the MOA of nikkomycin Z

A

Pyrimidine nuceloside similar to chitin precursor, binding chitin synthase and inhibiting its activity

25
Q

What is nikkomycin effective against

A

Cryptococcus and other dimorphic fungi

26
Q

Are nikkomycins systemic or topical

A

Systemic

27
Q

What is the mechanism of action of griseofulvin

A

Interferes with microtubule formation, disrupt mitotic spindle, inhibiting mitosis

28
Q

Griseofulvin requires pairing with __ or __ to enhance GI uptake

A

High fat meals or propylene glycol

29
Q

What patients should griseofulvin be avoided in

A

Pregnant cats and horses- teratogenic

30
Q

Is griseofulvin systemic or topical

A

Systemic

31
Q

Is flucytosine narrow or broad spectrum

A

Narrow- yeasts primarily

32
Q

What are some side effects of flucytosine

A

Hepatic/hematologic side effects

33
Q

Are iodides broad or narrow spectrum

A

Narrow

34
Q

How do you give sodium iodide to patients

A

IV

35
Q

How do you give potassium iodide to patient

A

Oral (NEVER IV)

36
Q

Prolonged use of iodides may result in iodism which can result in

A

Salivation, lacrimation, increase respiratory secretions, in appearance, dry scaly skin, tachycardia, cardiomyopathy, inhibited immune defense, infertility and abortion

37
Q

What host factors influence antifungal therapy outcomes

A
  1. Immune status
  2. Age and nutritional status
  3. Other therapeutic treatments that affect immune response
38
Q

What fungal pathogen factors influence antifungals therapy outcome

A
  1. Site and severity of infection
  2. Virulence factors
39
Q

What factors of antifungal drugs influence antifungal therapy outcome

A
  1. Activity and site of infection
  2. Drug selection and dosing
40
Q

What are some ways in which poor access of the drug to fungal target can cause tx failure and/or relapse

A

Granuloma, immunoprivileged sites, isolation in cells, rigid wall of chitin, capsular slim layer

41
Q

What is a main reason tx fungal infections is so hard

A

Discontinuation of therapy after resolution of clinical signs, before fungal eradication

42
Q

T or F: antifungal resistance develops more slowly compared to antibacterial resistance

A

True

Microbiology 2 (7 decks)

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