Pharmcotherapy of Antifungal Agents 1 Flashcards
What are the three types of fungi and what are the characteristics of each
Yeast (unicellular), molds (multicellular), Dimporphims (can exist as a mold or a yeast)
T/F: Canida albicans are all molds
False: Candida albicans are all yeast
What type of fungi is cryptococcus neoformans, what is a distinctive feature
Yeast, large capsule
What allows aspergillus umigatus to reproduce, what is a distincitve feautre
Conidia (spores), acute branching
What are the prominent yeasts
Candida albicans, Cryptococcus neoformans,
What are the prominent molds
Aspergillus, mucor, fuscarium
What prominent dimorphic fungi
Blastomyces, dermatitidis, coccidiodes, histoplasma, capsulatum
What is a key difference in bacteria and fungi with regards to resistance
Bacteria has resistance that develops rapidly while fungi resistance is generally the same over time
T/F: Candida albicans and Candida tropicalis are susceptible to all of the antifungal agents
True
What are the only antifungals require a higher MIC to effect Candida parapsilosis
Caspofungin, Micafungin, Anidulafungin
What are the echinocandins
Caspofungin, micafungin, and anidulafungin
What species of Candida is resistant to fluconazole and amphotericin B but is succeptible to echinocandins
C. glarbrata and C. krusei
What is the only antifungal Candida lusitaniae is resistant to
Amphotericin B
What is the MOA of amphotericin B
Forms aggregates in the cell membrane with ergosterol leading to pores that cause leakage of cellular contents
Though Amphotericin is the broadsest spectrum agent what species foes it not cover
Candid lusitaniae and A. terreus
What is the dosing for the different amphotericin B products
Liposomal (3-4 mg/kg), lipid complex (5 mg/kg), deoxycholate (0.7-1 mg/kg) based on total body weight
What is a large adverse effect associated with amphoteric, What should be monitored when using amphotericin
Renal toxicity and electrolyte wasting/ serum creatinine, BUN, Mg, K
What is the more safe type of amphotericin, why
Lipsomal, has lower rate of side effects
What is the MOA of the Azoles
block biosynthessis of ergosterol, sterol needed for cell membrane stability
What fungi does Itraconazole cover
Endemic fungi (Histoplasma capsulatum), candida species with dose-dependent susceptibility or resistaqnce to C. glabrata and C. krusie, Aspergillus species
How is itraconazole dosed, what allows for better AUC
Loading dose 200 mg TID for 3 days then 200 mg BID, a more acidic environment
What are adverse effects of Itraconazole, what should be monitored
peripheral neuropathy, N/V, hypokameia/ K, LFTs, rash
What are drug interactions of itraconazole
Statins (except pravastatin), PPI and H2RAs
What is the therapeutic drug monitoring for itraconazole
Trough after minimum 5-7 days with a target 0.5-1
