PHARMA Anti Fungals

Question 0

2 antifungals that are amphoteric polyene macrolides

Answer 0

Ampho b

Nystatin

Question 1

Systemic antifungal drugs for systemic infections

Answer 1

Ampho b
Flucytosine
Azoles
Echinocandins

Question 2

Ampho b only available in this form

Answer 2

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

Question 3

DOC for systemic fungal infections except in CNS

Answer 3

Ampho b

Question 4

Ampho b moa

Answer 4

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

Question 5

Dosage of ampho b

Answer 5

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

Question 6

2 adverse effects of ampho b

Answer 6

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

Question 7

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

Answer 7

Flucytosine

Question 8

Enzyme that allows flucytosine to enter fungal cells

Answer 8

Cytosine permease

Question 9

Flucytosine MOA

Answer 9

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

Question 10

Tx for chromoblastomycosis

Answer 10

Flucytosine plus ampho b plus ITRACONAZOLE

Question 11

First DOC for cryptococcys neoformans

Answer 11

Ampho b and flucytosine

Question 12

Give 3 imidazoles (2 nitrogens)

Answer 12

Ketoconazole
Miconazole
Clotrimazole

Question 13

Give 4 triazoles (3 nitrogens)

Answer 13

Itraconazole
Fluconazole
Voriconazole
Posaconazole

Question 14

Azoles moa

Answer 14

Reduction of ergosterol synth by inhibiting cytP450 AND demethylation of lanosterol

Question 15

Only imidazole in oral form

Answer 15

Ketoconazole

Question 16

Topical imidazoles

Answer 16

Miconazole

Clotrimazole

Question 17

Azole with greatest propensity to inhibit liver enzymes

Answer 17

Ketoconazole

Question 18

2nd DOC for px and tx of cryptococcal meningitis

Answer 18

Fluconazole

Question 19

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

Answer 19

Itraconazole

Question 20

Azole of choice fir dimorphic fungi

Answer 20

Itraconazole

Question 21

Tx for invasive aspergillosis, and 2 salvage therapies

Answer 21

DOC - itraconazole

Salvage therapy - Posaconazole and echinocandins

Question 22

Azole with visual disturbances

Answer 22

Voriconazole

Question 23

Only azole with significant activity against MUCORMYCOSIS

Answer 23

Posaconazole

Question 24

Echinocandins moa

Answer 24

Inhibit beta glucan synthase

Question 25

Echinocandins examples

Answer 25

Caspofungin Micafungin Anidulafungin

Question 26

Systemic antifungal drugs for MUCOCUTANEOUS infections

Answer 26

Griseofulvin | Terbinafine

Question 27

Griseofulvin vs terbinafine

Answer 27

Griseofulvin - fungistatic | Terbinafine - fungicidal

Question 28

Terbinafine moa

Answer 28

Inhibits squalene epoxidase

Question 29

Topical anti fungal therapy

Answer 29

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

Question 30

Nystatin use

Answer 30

Active against most candida - thrush, vaginal candidiasis, interrtrigo