Unit 3: K48.Antifungals

Question 1

Downside of antifungals

Answer 1

Lots of side effects

Question 2

Why do antifungals have so many side effects?

Answer 2

Fungi are eukaryotes, just like human cells

Question 3

Antifungals that alter cell membrane permeability

Answer 3

Azoles
Polyenes
Terbinafine

Question 4

What antifungals are used for more serious fungal infections?

Answer 4

Echinocandins

Question 5

What antifungals are used for severe fungal infections, especially of the scalp?

Answer 5

Griseofulvin

Question 6

First antifungal available?

Answer 6

Amphotericin B

Question 7

Amphotericin B has a ______ spectrum

Answer 7

WIDE

Question 8

Nickname for Amphotericin B…and why?

Answer 8

“Amphoterrible”

Chills, fever, muscle spasms, hypotension
Nephrotoxic

Question 9

Flucytosine is related to which cancer drug?

Answer 9

5-FU

Question 10

Flucytosine has a ______ spectrum

Answer 10

NARROW

Question 11

Side effects for flucytosine (5-FC)

Answer 11

Bone marrow depression
Alopecia
Liver dysfunction

Question 12

Name some Azoles

Answer 12

Ketoconazole
Itraconazole
Fluconazole
Voriconazole
Posaconazole*
Isavuconazole*

*rarely used

Question 13

Azoles: MOA

Answer 13

Interfere with fungal cell membrane permeability

Question 14

Ketoconazole has a _____ spectrum

Answer 14

NARROW

Question 15

Ketoconazole can cause _____ when used topically, so it must be used with caution

Answer 15

Hypersensitivity reactions

Angioedema

Question 16

Fluconazole’s brand name is _____

Answer 16

Diflucan

Question 17

Fluconazole is
EASY or HARD
to take?

Answer 17

EASY

Question 18

Fluconazole can be used for

Answer 18

candidiasis, yeast infections, thrush

Question 19

What antifungal is used for rose thorn scratches?

Answer 19

Itraconazole

Question 20

What is voriconazole used for?

Answer 20

Candidemia

Invasive aspergillosis

Question 21

Azole toxicity

Answer 21

Lots of drug interactions
Vomiting, diarrhea, rash
Hepatotoxicity —> monitor liver function

Question 22

Why are there so many drug interactions with Azoles?

Answer 22

Inhibitor if P450 isozymes; increases levels of many other drugs

Question 23

Voriconazole can cause…

Answer 23

Visual blurring (immediate but transient)

Question 24

Griseofulvin is given via what route for what indication?

Answer 24

PO
Skin infections (e.g. tinea of the scalp)

Question 25

Terbinafine is used to treat _____

Answer 25

Nail fungus

Question 26

Monitor what with Terbinafine?

Answer 26

Liver function

Question 27

How is Amphotericin B usually given and why?

Answer 27

poorly absorbed through GI tract –> given via IV

Question 28

Name antifungals that block beta-glucan synthesis

Answer 28

echinocandins

Question 29

name antifungals that block nucleic acid synthesis

Answer 29

flucytosine

Question 30

what are the primary drugs for systemic infections?

Answer 30

azoles
Amphotericin B
Echinocandins

Question 31

Name the steroid unique to fungal cell membranes

Answer 31

ergosterol

Question 32

How does amphotericin B work?

Answer 32

alters fungal membrane permeability

Question 33

Name the azole with the broadest spectrum

Answer 33

posoconazole

Question 34

What azole has a spectrum similar to Posoconazole?

Answer 34

Isavuconazole

Question 35

What is the mechanism of action for the azoles?

Answer 35

interfere with fungal cell membrane permeability by inhibiting ergosterol synthesis

Question 36

What anti fungal is related to the anti-cancer drug 5-FU?

Answer 36

flucytosine (5-Fluorocytosine, 5-FC)

Question 37

Name some topical azoles

Answer 37

clotrimazole
miconazole
ketoconazole

Question 38

name some topical allyamines

Answer 38

terbinafine

naftilfine