Pharm - Antifungals

Question 0

“azoles” inhibit the enzyme ………………

Answer 0

“azoles” inhibit the enzyme 14-alpha-demethylase, the enzyme responsible for the last step in ergosterol synthesis.

Question 1

Caspo “fungin” inhibits synthesis of …………

Answer 1

Caspo “fungin” inhibits synthesis of Beta-glucan(cell wall component)

Question 2

Terbinafine inhibits ………………..

Answer 2

Terbinafine inhibits Squalene epoxidase, an enzyme upstream from the in the ergosterol synthesis pathway.

Question 3

Amphotericin B(nystatin) mechanism of action?

Answer 3

Interact with ergosterol in fungal membranes to form artificial pores.

Question 4

drug with the widest fungicidial spectrum?

Answer 4

Amphotericin B - interacts with ergosterol in the membrane. Resistant has been described in fungi with low ergosterol content in the membrane.

Question 5

Amphotericin side effects?

Answer 5

renal toxicity, anaphylaxis

Question 6

ketoconazole, fluconazole, Itraconazole, Voriconazole mechanism of action?

Answer 6

the “-azoles” inihibit 14-alpha-demethylase, the last step in ergosterol synthesis.

Question 7

side effets of “-azoles”?

Answer 7

interfere with steroid synthesis

Question 8

Which “-azole” is the DOC in immuno suppressed patients?

Answer 8

Fluconazole

Question 9

side effects of “-azoles”?

Answer 9

lowered synthesis of steroids, including testosterone and cortisol = decreased libido, gynecomastia, menstrual irregularities.

Question 10

the enzymes 11-hydroxylase and 21-hydroxylase, responsible for steroid synthesis are part of what group of enzymes?

Answer 10

P450

Question 11

Flucytosine mechansim of action?

Answer 11

5FC mius NH2 group = 5FU(anticancer). 5FU is triphosphorylated and incorporated into fungal RNA

Question 12

Flucytosine side effect?

Answer 12

toxic o bone marrow

Question 13

Flucytosine syngergistic use?

Answer 13

coadministered with amphotericine B in severe cryptococcal and cadidal infctions

Question 14

Griseosulvin distributes where …………… is found.

Answer 14

Griseosulvin distributes where keratin is found. Skin, hair and nails.

Question 15

Caspofungin and Micafungin inhibits ……………

Answer 15

Caspofungin and Micafungin inhibits glucan synthesis

Question 16

Amphotericin B absorption and administration?

Answer 16

Poor GI absorption. Administered IV for systemic infections

Question 17

Amphotericin B side effects?

Answer 17

• chills
• fever
• impaired renal function

Question 18

Imidazoles moa?

Answer 18

inhibits fungal P450 demethylation of lanosterol to ergosterol

Question 19

Imidazoles adverse effects?

Answer 19

• interferes with steroid synthesis
• gastric upset
• toxicities

Question 20

DOC for disseminated blastomycosis?

Answer 20

intrconazole

Question 21

Miconazole areas of use?

Answer 21

applied topically

• ringworm
• Tinea pedis
• vulvovaginal candidasis

Question 22

Nystatin moa?

Answer 22

like Amphoterecin B - pores in fungal cell wall

Question 23

Nystatin route of administration?

Answer 23

too toxic for systemic use. Peroral or topical use only

Question 24

Nystatin areas of use?

Answer 24

Candidasis in

• Skin
• Mucous membranes
• GI tract(NOT absorbed in GI)

Question 25

Griseofulvin moa?

Answer 25

binds microtubules and prevents spindle formation and mitosis in fungi

Question 26

Griseofulvin areas of distribution?

Answer 26

where keratin is found - hair, nails, and skin

Question 27

Flucytocine moa?

Answer 27

converted to 5-fluorodeoxyuridylic acid which inhibits thymidilate sythase = in other words disrupted nucleic acid synthesis

Question 28

Flucytocine adverse effects?

Answer 28

bone marrow suppression

Question 29

Caspofungin area of use?

Answer 29

patients with severe aspergillosis

Question 30

Trimethorim-sulfa is used to murder….

Answer 30

PCP(pneumocystitis jirovecci)