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ms 2 - unit 6 > Pharmacology - Antifungal Therapy - Christopher Miller > Flashcards

Pharmacology - Antifungal Therapy - Christopher Miller Flashcards

1
Q

Class: Flocuonazole

A

Triazole

Antifungal

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2
Q

Class: Itraconazole

A

Triazole

Antifungal

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3
Q

Class: Voriconazole

A

Triazole

Antifungal

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4
Q

Class: Posaconazole

A

Traizole

Antifungal

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5
Q

Class: Amphotericin B

A

Polyene macrolide

Antifungal

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6
Q

Class: Nystatin

A

Polyene macrolide

Antifungal

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7
Q

Class: Caspofungin

A

Echinocandin

Antifungal

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8
Q

Class: Micafungin

A

Echinocandin

Antifungal

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9
Q

Class: Anidulafungin

A

Echinocandin

Antifungal

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10
Q

Use: Nystatin

A

Skin infections - Candida

Usually topical preparations

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11
Q

MOA: Triazoles

A

Impede ergosterol synthesis through direct inhibition of the cytochrome P450 dependent enzyme 14-alpha-sterol-demethylase.

Ergosterol is an essential molecule of the fungal cell membrane. Inhibition of this stops fungal growth.

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12
Q

Spectrum: Flunazole

A

Some candida;
Cryptococcus;
Endemic Mycoses (ie Histoplasmosis, Coccidiomycosis)

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13
Q

Spectrum: Voriconazole, Itraconazole

A

Fluconazole spectrum PLUS

Aspergillus, broader Candida coverage

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14
Q

Spectrum: Posaconazole

A

Voriconazole, Itraconazole spectrum PLUS Fusarium, Mucorales

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15
Q

Adverse effects: Triazoles

A

Liver enzyme abnormalities

GI side effects

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16
Q

What adverse effect is specific to Voriconazole?

A

Visual disturbances

17
Q

What triazole has the lowest drug interaction profile?

A

Fluconazole

Triazoles have crossover with mammalian CYP450 system

18
Q

Use: Fluconazole

A

Susceptible candidiasis;
Severe thrush/exophageal candidiasis;
Secondary treatment of (and prophylaxis of) cryptococcal meningitis

19
Q

Use: Itaconazole

A

Secondary treatment and prophylaxis of systemic histoplasmosis

20
Q

Use: Voriconazole

A

Invasive aspergillosis

21
Q

Use: Posaconazole

A

Prophylaxis of aspergillosis/candidiasis in immunocompromised patients

22
Q

MOA: Amphotericin B

A

Pores are formed in the fungal cell membrane, allowing leakage of K+ and Mg+

23
Q

Spectrum: Amphotericin B

A

Broad spectrum: Candida spp, Aspergillus spp. Zygomyces spp., Hystoplasma, Cryptococcus

24
Q

Use: Amphotericin B

A

Life-threatening invasive fungal infections; broad antifungal spectrum; (occasionally used with flucytosine in immunocompromised hosts)

25
Q

Adverse effects: Amphotericin B

A

Nephrotoxocity;
Poor overall tolerability;

Chronic: fall in renal function (may only be partially reversible); K+ Mg+ wasting; renal tubular acidosis

26
Q

Use: Echinocandins

A
  • Candida infections
  • Refractory aspergillus infection
  • Esophageal candidiasis
  • Empiric antifungal therapy for febrile neutropenic patients

IV formulation only

27
Q

MOA: Nystatin

A

Pores are formed in the fungal cell membrane, allowing leakage of K+ and Mg+

28
Q

Adverse effects: Echinocandins

A

Liver toxicity possible, requires monitoring;

29
Q

MOA: Echinocandins

A

Inhibit synthesis of Beta(1,3)-D-glucan, an essential component of the fungal cell wall

30
Q

MOA: Flucytosine

A

Prodrug converted by fungal enzyme to analog inhibitor of pyrimidine nucleotide synthesis

31
Q

Use: Flucytosine

A

Cryptococcal meningitis;
Often in combination therapy;
Oral only

32
Q

Spectrum: Flucytosine

A

Crytpococcus, some Candida spp

33
Q

Adverse effects: Flucytosine

A

Bone marrow issues - low WBCS;
Liver toxicity;
GI issues

Follow with blood levels

34
Q

Class: Efinazonazole solution

A

Azole / Cell membrane synthesis inhibitor

35
Q

MOA: Efinazonazole solution

A

Inhibit ergosterol synthesis by inhibiting lanosterol demethylase

36
Q

Use: Efinazonazole solution

A

Candida; Tinea

ie toe fungus

37
Q

Adverse effects: Efinazonazole

A

Application site dermatitis, pain

ms 2 - unit 6 (34 decks)

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