Module 11 part 2 quiz

Question 1

Two species of superficial fungal infections

Answer 1

candida: mucous membranes and moist area

dermatophites: hair, skin, nails

Question 2

what superficial fungal infection is most common

Answer 2

Dermatophites

Question 3

Amphotericin B

Answer 3

class: Polyene abx
borad specturm, some protazoa
Drug of choice for most systematic infection despite toxicity
Reisistance is rare
Action: binds to fungal cell membrane, increased permeability

Highly toxic: use against potentially fatal infections

Infusion reactions, high incidence of phlebitis
RENAL DAMAGE OCCUR IN PRACTICALLY ALL PATIENTS, AVOID NEPHROTOXIC DRUGS
-can be minimized by giving 1L NS on infusion days

Treatment is really long, minimum 6-8 weeks, typically 3-4 months

Question 4

Itraconazole

Answer 4

Class: Azole
Broad spectrum: histoplasmosis, aspergillosis, and candidiasis

Action: inhibits synthesis of ergosterol a component of cytoplasmic reticulum

Considerations
-food increases absorption of capsules but not suspension
-increased effect with coca cola
-CYP inhibitor– increases warfarin
-ventricular arrhythmias can occur wit some cardiac meds
-PPIs can decrease absorption , d/t decreased stomach acid

well tolerated w/ potentially serious side effects
-cardiac suppression—negative inotrope-decreased LV Ejection, returns to normal 12 hours after intraconazole is stopped

-liver failure, rare, but fatal

Question 5

Caspofungin

Answer 5

class: echinocandin
narrow spectrum

action: disruption of fungal cell wall

-not absorbed in GI, given IV

well tolerated
-fever and phlebitis at injection site
-can decrease tacrolimus, check levels

Question 6

Flucytosine

Answer 6

class: pyrimidine analog
narrow spectrum, resistance is common

always used in combo with Ampho B

Action: disruption of fungal DNA and RNA

Considerations: renally excreted so use with caution in those w/ renal impairment
-bone marrow suppression
-hepatotoxicty