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Infectious Disease > Pharmacology II > Flashcards

Pharmacology II Flashcards

1
Q

4 Classes of Systemic Fungal Infection

A

Polyene
Azoles
Echinocandins
Pyrimidine Analogs

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2
Q

What are the two types of anti-fungal drugs?

A

Superficial mycoses

Systemic Mycoses

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3
Q

What are the two types of Anti-fungal systemic mycoses drugs?

A

Opportunistic

Non-opportunisitc

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4
Q

Which fungal organisms cause opportunistic infections

A

Candida
Aspergillus
Cryptococcus neoformans
Mucor

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5
Q

What class of anti-fungal drug is Amphotericin B and Nystatin?

A

Polyene antibiotics

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6
Q

Which class of anti-fungal disrupts fungal cell wall by inhibiting beta-1,3-D-glucan?

A

Echinocandins

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7
Q

What are examples of Azole antibiotics?

A 
Fluconazole
Itraconazole
Ketoconazole
Posaconazole
Voriconazole
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8
Q

Which classes of anti-fungal antibiotics disrupt fungal cell membrane by binding/inhibiting ergosterol?

A

Polyenes

Azoles

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9
Q

What is ergosterol?

A

REQUIRED sterol in fungal cell membrane

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10
Q

Examples of Echinocandins

A

Caspofungin
Anidulafungin
Micafungin

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11
Q

Pyrimidine Analog mechanism of action

A

activated by cytosine deaminase intracellularly

incorporates into DNA chain –? termination and inhibition of DNA/RNA synthesis

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12
Q

Example of an Pyrimidine Analog

A

Flucytosine

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13
Q

What is the D.O.C. for systemic infections

A

Amphotericin B

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14
Q

What are the adverse effects of Amphotericin B?

A

Highly toxic!
Renal damage in >80% patients
Hypersensitivity

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15
Q

When is Amphotericin B used

A

Only treat life-threatening infections in immunocompromised patients

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16
Q

How is Amphotericin B given?

A

IV

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17
Q

What is the mechanism of Amphotericin B (Polyene)?

A
  1. Binds to ergosterol on cell membrane to increase membrane permeability
  2. fungal leakage of ions –> reduced viability
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18
Q

What class of anti-fungals does not affect mammalian cells?

A

Pyrimidine Analog (Flucytosine)

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19
Q

Why is Amphotericin B toxic to mammalian cells?

A

Mammalian membranes also have sterols (targeted by drug)

20
Q

Is Amphotericin B broad or narrow spectrum?

A

Broad (Opportunistic and non-)

21
Q

What is the likelihood of resistance from Amphotericin B?

A

extremely rare

22
Q

Examples non-opportunistic fungal organisms?

A

Sporothrix schenckii
Blastomyces dermatitidis
Histoplasma capsulatum
Coccidoides immitis

23
Q

What does Flucytosine treat?

A

serious infections by Candida and Cryptococcus neoformans

24
Q

What is the likelihood of resistance to Flucytosine?

A

common

25
Q

What is Flucytosine always used in combination with?

A

Amphotericin B

26
Q

Why does Flucytosine not affect mammalian cells?

A

no cytosine deaminase (how drug is activated)

27
Q

Flucytosine (Pyrimidine analog) mechanism of action

A

incorporation in DNA chain to terminate DNA/RNA synthesis

28
Q

Is Flucytosine broad or narrow spectrum?

A

narrow

29
Q

What are the adverse effects of Flucytosine

A

bone marrow depression

mild hepatotoxicity

30
Q

What is a safer alternative to Amphotericin B?

A

Azoles (given PO)

31
Q

What is the adverse effect of Azoles?

A

increase serum level of many drugs

inhibit hepatic p450

32
Q

What two anti-fungal drug classes have the same drug mechanism?

A

Polyenes

Azoles

33
Q

What infections do Azoles treat?

A 
Systemic infections
Superficial infections (Candidas and Dermatophytes)
34
Q

What is used to treat Candidas and Dermatophytes

A

Azoles

35
Q

What does Echinocandins treat

A

Aspergillus

Candida

36
Q

Echinocandin mechanism of action

A

inhibit 1,3-D-glucan to disrupt cell wall

37
Q

What organisms causes superficial mycoses

A

Candida

Dermatophytes

38
Q

What organism causes tinea infections

A

Dermatophytes

39
Q

What is the most common Candida infection

A

Candida albicans

40
Q

What do you use to treat Thrush (oral Candida)

A

nystatin
clotrimazole
miconazole

41
Q

What is Griseofulvin effective (only) against

A

dermatophytes (superficial)

42
Q

What is Griseofulvin mechanism of action

A

inhibit fungal mitosis

43
Q

What is the D.O.C for intestinal Candida

A

Nystatin

44
Q

What are examples of Allylamines

A

Naftifine
Terbinafine
Butenafine

45
Q

What infection is Allylamine used against

A

dermatophyte

46
Q

What is the differences between HIV-1 and HIV-2?

A

HIV-1: worldwide

HIV-2: mainly Africa

47
Q

What cell does HIV- attack

A

CD4 T-cells

Infectious Disease (2 decks)

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