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PHARMA Anti Fungals Flashcards

0
Q

2 antifungals that are amphoteric polyene macrolides

A

Ampho b

Nystatin

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1
Q

Systemic antifungal drugs for systemic infections

A

Ampho b
Flucytosine
Azoles
Echinocandins

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2
Q

Ampho b only available in this form

A

Parenteral only, bc it is water insoluble and poorly absorbed in the git

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3
Q

DOC for systemic fungal infections except in CNS

A

Ampho b

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4
Q

Ampho b moa

A

Alters permeability by forming ampho b associated pores in the cell membrane, causing contents to leak out

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5
Q

Dosage of ampho b

A

0.5-1 mg per kg per day as slow IV infusion up to 1-2 g end point

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6
Q

2 adverse effects of ampho b

A

Infusion related toxicity (fever chills etc) and cumulative toxicity (renal damage)

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7
Q

Water soluble pyrimidine analog, good CSF penetration, related to fluoroura il

A

Flucytosine

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8
Q

Enzyme that allows flucytosine to enter fungal cells

A

Cytosine permease

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9
Q

Flucytosine MOA

A

Converted to 5dUMP (inhibit dna synthesis) and to FUTP (inhibit rna synthesis)

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10
Q

Tx for chromoblastomycosis

A

Flucytosine plus ampho b plus ITRACONAZOLE

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11
Q

First DOC for cryptococcys neoformans

A

Ampho b and flucytosine

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12
Q

Give 3 imidazoles (2 nitrogens)

A

Ketoconazole
Miconazole
Clotrimazole

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13
Q

Give 4 triazoles (3 nitrogens)

A

Itraconazole
Fluconazole
Voriconazole
Posaconazole

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14
Q

Azoles moa

A

Reduction of ergosterol synth by inhibiting cytP450 AND demethylation of lanosterol

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15
Q

Only imidazole in oral form

A

Ketoconazole

16
Q

Topical imidazoles

A

Miconazole

Clotrimazole

17
Q

Azole with greatest propensity to inhibit liver enzymes

A

Ketoconazole

18
Q

2nd DOC for px and tx of cryptococcal meningitis

A

Fluconazole

19
Q

Comes in newer formulations with better solubility and bioavailability due to CYCLODEXTRAN

A

Itraconazole

20
Q

Azole of choice fir dimorphic fungi

A

Itraconazole

21
Q

Tx for invasive aspergillosis, and 2 salvage therapies

A

DOC - itraconazole

Salvage therapy - Posaconazole and echinocandins

22
Q

Azole with visual disturbances

A

Voriconazole

23
Q

Only azole with significant activity against MUCORMYCOSIS

A

Posaconazole

24
Q

Echinocandins moa

A

Inhibit beta glucan synthase

25
Q

Echinocandins examples

A

Caspofungin
Micafungin
Anidulafungin

26
Q

Systemic antifungal drugs for MUCOCUTANEOUS infections

A

Griseofulvin

Terbinafine

27
Q

Griseofulvin vs terbinafine

A

Griseofulvin - fungistatic

Terbinafine - fungicidal

28
Q

Terbinafine moa

A

Inhibits squalene epoxidase

29
Q

Topical anti fungal therapy

A

Nystatin
Topical azoles - miconazole and clotrimazole
Topical allylamines - terbinafine and naftifine

30
Q

Nystatin use

A

Active against most candida - thrush, vaginal candidiasis, interrtrigo

Pharma (20 decks)

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