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Pharmacology > Unit 6-Antifungals > Flashcards

Unit 6-Antifungals Flashcards

1
Q

Amphotericin B

Drug class

A

Polyene macrolide

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2
Q

Amphotericin B

Mechanism

A

Pores are formed in the fungal cell membrane, allowing leakage of K+ and Mg+

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3
Q

Amphotericin B

Uses

A

Life-threatening invasive fungal infections; broad antifungal spectrum; (occasionally used with flucytosine in immunocompromised hosts)

Lipid formulations result in better tolerability

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4
Q

Amphotericin B

Side effects

A

Chronic: fall in renal function (may only be partially reversible); K+ Mg+ wasting; renal tubular acidosis
Acute during IV infusion: fever/chillls; potential for hypotension;

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5
Q

Nystatin

Drug class

A

Polyene macrolide

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6
Q

Nystatin

Mechanism

A

Pores are formed in the fungal cell membrane, allowing leakage of K+ and Mg+

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7
Q

Nystatin

Uses

A

Topically (powder) against superficial fungal infections (candidiasis only)

No use against dermatophytes

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8
Q

Fluconazole

Drug class

A

Triazole / Cell membrane synthesis inhibitor

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9
Q

Fluconazole

Mechanism

A

Inhibit ergosterol synthesis by inhibiting lanosterol demethylase

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10
Q

Fluconazole

Uses

A

Candida infections; secondary treatment and prophylaxis of cryptococcal meningitis

Clotrimazole = topical; fluconazole = systemic

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11
Q

Fluconazole

Side effects

A

Hepatotoxicity (rarely), GI side effects, inhibits CYP450

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12
Q

Voriconazole; Itraconazole

Drug class

A

Triazole / Cell membrane synthesis inhibitor

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13
Q

Voriconazole; Itraconazole

Mechanism

A

Inhibit ergosterol synthesis by inhibiting lanosterol demethylase

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14
Q

Voriconazole; Itraconazole

Uses

A

Candida & Aspergillus infections

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15
Q

Voriconazole; Itraconazole

Side effects

A

Hepatotoxicity (rarely), GI side effects, inhibits CYP450

Visual disturbances w/ voriconazole

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16
Q

Posaconazole

Drug class

A

Triazole / Cell membrane synthesis inhibitor

17
Q

Posaconazole

Mechanism

A

Inhibit ergosterol synthesis by inhibiting lanosterol demethylase

18
Q

Posaconazole

Uses

A

Candida, Fusarium, Mucorales infections

19
Q

Posaconazole

Side effects

A

Hepatotoxicity (rarely), GI side effects, inhibits CYP450

20
Q

Efinazonazole (Jublia)

Drug class

A

Azole / Cell membrane synthesis inhibitor

21
Q

Efinazonazole (Jublia)

Mechanism

A

Inhibit ergosterol synthesis by inhibiting lanosterol demethylase

22
Q

Efinazonazole (Jublia)

Uses

A

Candida; Tinea

23
Q

Efinazonazole (Jublia)

Side effects

A

Application site dermatitis, pain

24
Q

Tolnaftate; Terbinafine

Drug class

A

Allylamine / Cell wall synthesis inhibitor

25
Q

Tolnaftate; Terbinafine

Mechanism

A

Inhibit ergosterol synthesis by inhibiting squalene epoxidase

26
Q

Tolnaftate; Terbinafine

Uses

A

Topical dermatophytes (limited utility against candida)

Terbinafine effective against onychomycoses; tolnaftate: oral only; weak agent

27
Q

Tolnaftate; Terbinafine

Side effects

A

Hepatotoxicity (rarely)

Low side effect profile

28
Q

Capsofungin; Micafungin; Anidulafungin

Drug class

A

Echinocandin / Cell wall synthesis inhibitor

29
Q

Capsofungin; Micafungin; Anidulafungin

Mechanism

A

Inhibit synthesis of Beta(1,3)-D-glucan, an essential component of the fungal cell wall

30
Q

Capsofungin; Micafungin; Anidulafungin

Uses

A

Life-threatening fungal infections unresponsive to older agents (especially candida, aspergillus)

31
Q

Capsofungin; Micafungin; Anidulafungin

Side effects

A

Low side effect profile

Expensive; only available as IV formulation

32
Q

Flucytosine

Drug class

A

Nucleic acid synthesis inhibitor

33
Q

Flucytosine

Mechanism

A

Prodrug converted by fungal enzyme to analog inhibitor of pyrimidine nucleotide synthesis

34
Q

Flucytosine

Uses

A

Used in combo with amphotericin B in life threatening fungal infections in immunocompromised patients.

35
Q

Flucytosine

Side effects

A

Bone marrow toxicity; Liver dysfunction possible

Pharmacology (26 decks)

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