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Emma Micro II > Pharm - Antifungals - General > Flashcards

Pharm - Antifungals - General Flashcards

1
Q

polyenes

A

amphotericin B

nystatin

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2
Q

azoles

A

fluconazole
voriconazole
posconazole
itraconazole

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3
Q

echinocandins

A

caspofungin

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4
Q

pyrimidine inhibitors

A

flucytosine

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5
Q

allylamines

A

terbinafine

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6
Q

Amphotericin B

MOA

A

binds ergosterol in cell membrane –> pore formation and efflux of K –> cell death

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7
Q

Amphotericin B

use

A

BROADEST spectrum

  • mucorales infections
  • candida
  • cryptococcal meningitis
  • severe endemic mycoses
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8
Q

Amphotericin B

AE

A

2 major toxicities

  1. infusion related (CK release)
  2. nephrotoxicity (distal RTA)
  • fever/chills
  • phlebitis
  • hypOtension
  • arrythmias
  • nephrotoxicity
  • hypOMg
  • hypOkalemia
  • nephrogenic DI
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9
Q

Nysatin

MOA/USE/AE

A

MOA: binds ergosterol

USE: thrush/diaper rash

AE: tox when IV, use topical only

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10
Q

terbinafine

MOA/USE/AE

A

MOA: blocks squalene epoxidase (essential for ergosterol synthesis)

USE: dermatophyte infec (skin, nails)

AE: 
HA
hepatotoxicity
blurry vision
taste change
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11
Q

which azole is least used due to tox

A

ketoconazole

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12
Q

-azoles

MOA

A

MOA: block ergosterol synthesis, inhibit p450 enzyme that converts lanosterol to ergosterol

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13
Q

-azoles

AE

A
  • metabolized by p450 (drug interactions)
  • hepatotoxicity
  • transaminitis
  • QT prolong
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14
Q

fluconazole

use

A
  • excellent against cryptococcus neoformans

- active against Candida, coccidiodes

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15
Q

voriconazole

AE:

A
  • if CYP2C19 polymorphism –> can vary metabolism
  • inhibits CYP43A4 –> drug interactions
  • visual changes
  • hallucinations
  • photosensitivity rash
  • QT prolongation
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16
Q

first line therapy for invasive pulmonary aspergillosis

A

voriconazole

17
Q

Posaconazole

use

A
  • active against candida, aspergillus, mucorales

- prophylaxis of invasive fungal infection in stem cell transplant

18
Q

echinocandins

MOA

A

MOA: inhibit b-(1,3)-D-glucan synthase (essential for Candida and Aspergillus)

19
Q

echinocandins

USE

A
  • fungicidal against candida (1st line)

- limited aspergillus activity (salvage therapy)

20
Q

flucytosine

MOA

A

-interrupts fungal DNA and protein synthesis

21
Q

flucytosine

AE

A
  • rapid resistance with monotherapy

- toxicity: BM suppression

22
Q

which antifungals are both metabolized by and affect the hepatic cytochrome p450 system

A

azoles

23
Q

echinocandins

AE

A

MINIMAL

mammalian cells fo not have cell walls

Emma Micro II (10 decks)

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