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Phar 506 > Pharmcotherapy of Antifungal Agents 1 > Flashcards

Pharmcotherapy of Antifungal Agents 1 Flashcards

1
Q

What are the three types of fungi and what are the characteristics of each

A

Yeast (unicellular), molds (multicellular), Dimporphims (can exist as a mold or a yeast)

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2
Q

T/F: Canida albicans are all molds

A

False: Candida albicans are all yeast

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3
Q

What type of fungi is cryptococcus neoformans, what is a distinctive feature

A

Yeast, large capsule

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4
Q

What allows aspergillus umigatus to reproduce, what is a distincitve feautre

A

Conidia (spores), acute branching

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5
Q

What are the prominent yeasts

A

Candida albicans, Cryptococcus neoformans,

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6
Q

What are the prominent molds

A

Aspergillus, mucor, fuscarium

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7
Q

What prominent dimorphic fungi

A

Blastomyces, dermatitidis, coccidiodes, histoplasma, capsulatum

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8
Q

What is a key difference in bacteria and fungi with regards to resistance

A

Bacteria has resistance that develops rapidly while fungi resistance is generally the same over time

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9
Q

T/F: Candida albicans and Candida tropicalis are susceptible to all of the antifungal agents

A

True

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10
Q

What are the only antifungals require a higher MIC to effect Candida parapsilosis

A

Caspofungin, Micafungin, Anidulafungin

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11
Q

What are the echinocandins

A

Caspofungin, micafungin, and anidulafungin

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12
Q

What species of Candida is resistant to fluconazole and amphotericin B but is succeptible to echinocandins

A

C. glarbrata and C. krusei

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13
Q

What is the only antifungal Candida lusitaniae is resistant to

A

Amphotericin B

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14
Q

What is the MOA of amphotericin B

A

Forms aggregates in the cell membrane with ergosterol leading to pores that cause leakage of cellular contents

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15
Q

Though Amphotericin is the broadsest spectrum agent what species foes it not cover

A

Candid lusitaniae and A. terreus

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16
Q

What is the dosing for the different amphotericin B products

A

Liposomal (3-4 mg/kg), lipid complex (5 mg/kg), deoxycholate (0.7-1 mg/kg) based on total body weight

17
Q

What is a large adverse effect associated with amphoteric, What should be monitored when using amphotericin

A

Renal toxicity and electrolyte wasting/ serum creatinine, BUN, Mg, K

18
Q

What is the more safe type of amphotericin, why

A

Lipsomal, has lower rate of side effects

19
Q

What is the MOA of the Azoles

A

block biosynthessis of ergosterol, sterol needed for cell membrane stability

20
Q

What fungi does Itraconazole cover

A

Endemic fungi (Histoplasma capsulatum), candida species with dose-dependent susceptibility or resistaqnce to C. glabrata and C. krusie, Aspergillus species

21
Q

How is itraconazole dosed, what allows for better AUC

A

Loading dose 200 mg TID for 3 days then 200 mg BID, a more acidic environment

22
Q

What are adverse effects of Itraconazole, what should be monitored

A

peripheral neuropathy, N/V, hypokameia/ K, LFTs, rash

23
Q

What are drug interactions of itraconazole

A

Statins (except pravastatin), PPI and H2RAs

24
Q

What is the therapeutic drug monitoring for itraconazole

A

Trough after minimum 5-7 days with a target 0.5-1

25
Q

What does flucanozole cover

A

Candida species except DDP C. glabrata and all C. krusei, cryptococcus spp, endmic fungi

26
Q

What is the usual dosing for fluconazole, invasive candidiasis

A

200-400 mg daily with a loading dose doubling the daily requirement, 800 mg load (12 mg/kg) followed by 400 (6mg/kg) mg daily

27
Q

What is the only Azole that needs a renal adjustment

A

Flucanozole

28
Q

What is the only sufficient dose of flucanozole that can be given to a pregnant patient

A

150 mg single dose

29
Q

What is the drug of choice for Aspergillus, what other fungi does it cover

A

Voriconazole, fusarium species and scedosproium species

30
Q

T/F: Voriconazole mg/kg based dosing with a loading dose as well as liver adjustment

A

True

31
Q

What metabolizes voricanazole

A

CYP2c19

32
Q

What azole is usually used for prophylaxis but also has mucor coverage, what is key absorption tips

A

Posaconazole, requires acidic environment and high fat meal for the suspension while also having a loading dose

33
Q

What Azole is administered as a prodrug, how is it converted and what is its most important coverage

A

Isavuconazole, administered as isavuconazonium and is rapidly cleaved by plasma esterases, Mucor

34
Q

What is the MOA of echinocandins

A

Disrupt function of the 1-3 beta-d-glucan synthase complex

Phar 506 (37 decks)

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