Systemic Antifungal Medications

Question 0

Cryptococcus neoformans

Answer 0

Encapsulated yeast found in soil of bird increase in it that causes invasive infections less frequently than candida

Most often causes meningitis and respiratory infections and immunocompromise patients

Question 1

Most common invasive fungal infection caused by:

Answer 1

Yeast or Candida species

Common inhabitants of mucocutaneous surfaces of the human body such as the genital trac gastrointestinal trac and skin

Risk factors for invasive candidiasis: neutropenia, diabetes, immunodeficiency, high-dose corticosteroids, immunosuppressants, antineoplastic agents, total parenteral nutrition, receipt of antibiotics, surgery and burns

Question 2

Molds

Answer 2

Fewer infections as they only infect severely suppressed immune system’s

The most common molds are aspergillus

Question 3

Antifungal’s

Answer 3

1. Azoles: inhibit synthesis of Ergosterol an essential component of fungal cell membranes
   - Fluconazole (diflucan), itraconazole (sporanox), voriconazole (vfend), posaconazole (noxafil), ketoconazole (nizoral)
2. Ecinocandins: inhibit synthesis of beta D glucan an essential component of fungal cell wall. Potential for adverse effects in humans is low due to the absence of mammalian cells of enzymes involved and can’t synthesis
   - Caspofungin (Cancidas), Micafungin (Mycamine), anidulafungin (eraxis)
3. Amphotericin B: binds to ergosterol in the fungal cell membrane, leading to the loss of membering integrity and leakage of cell contents
4. Flucytosine (ancoban)
5. Terbinafine (lamisil)

Question 4

Itraconazole

Answer 4

Capsule: Absorption enhanced by food

Solution: take on an empty stomach

Question 5

Voriconazole

Answer 5

Take one hour before a one hour after a meal and the tablets contain lactose so avoiding lactose intolerant patients

Question 6

Posaconazole

Answer 6

Administer with food as it increases absorption