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S52(2) Fungal Drug Review Flashcards

1
Q

Cell membranes

A

Azoles
Polyenes
Allylamines

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2
Q

Cell wall

A

Echinocandins

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3
Q

Intracellular

A

Pyrimidine analogs

mitotic inhibitors

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4
Q

Azoles

A 
ketoconazole
miconazole
fluconazole
itraconazole
voriconazole
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5
Q

Polyenes

A

amphotericin B

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6
Q

Allylamines

A

Terbenifine

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7
Q

Echinocandins

A

micafungin
caspofungin
anidulafungin

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8
Q

Pyrimidine analogs

A

flucytosine

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9
Q

mitotic inhibitors

A

griseofulvin

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10
Q

Peak:MIC
Amphotericin B
Echinocandins

A

True

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11
Q

Time:MIC

Flucytosine

A

True

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12
Q

AUC:MIC

Triazoles

A

True

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13
Q

Fluconazole is the drug of choice for candida albicans if susceptible

A

True

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14
Q

Itraconazole is the Drug Of Choice for Dimorphic molds

A

True

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15
Q

Voriconazole is the Drug Of Choice for Aspergillus

A

True

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16
Q

Posaconazole and Isavuconazole are drugs for mucor

17
Q

Amphotericin AE

A 
Riggors - add meperidine PRN
NEPHROTOXIC
Potassium wasting (try and keep close to ULN)
Magnesium wasting
Hepatotoxic
18
Q

Ampotericin monitoring

A 
BMP/ CMP daily
K/Mg daily
LFTs qWeekly (arbitrary)
CBC daily while inpatient
I/Os daily
QTc
19
Q

Itraconazole Clinical Pearls

A

Capsules taken w/ food, solution taken wo/food,

SUBA formulation is not food dependent, formulations NOT interchangeable, do not administer with antacids, prolongs QTc, Boxed warning for causing or exacerbating heart failure

20
Q

voriconazole Clinical Pearls

A

IV:PO 1:1, Requires a LD, Nonlinear PK,

unique ADRs: Visual disturbances, visual or auditory hallucinations, skin cancer, Prolongs QTC

21
Q

posaconazole Clinical Pearls

A

Suspension requires food (ginger ale) for acidic environment (DDI w/ acid suppressants),

tablets require food but not as much, NOT interchangeable, linear but saturable PK, takes a week to reach SS, prolongs QTc

22
Q

isavuconazole Clinical Pearls

A

IV:PO 1:1, Prodrug, requires a LD, unique ADR: shortens QTc

23
Q

flucytosine
BBW:
Extreme caution in patients with renal dysfunction
Closely monitor hematologic, renal, and hepatic status

24
Q

flucytosine
ADR:
Big points: bone marrow suppression, hepatotoxicity

25
Q

IV to PO (1:1)

A 
Flucytosine (5-FU)
Terbinafine
Triazoles:
- Fluconazole
- Voriconazole
- Isavuconazole
26
Q

Triazoles, Ketoconazole and Clotrimazole are CYP inhibitors

27
Q

amphotericin B can cause rigors with infusion

28
Q

amphotericin B liposomal formulation has the least nephrotoxicity associated with it

29
Q

You often have to aggressively replete K+ and Mg2+ when a patient is on amphotericin B

30
Q

amphotericin B is available as both an IV and inhaled formulation

Infectious Disease (56 decks)

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