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Musculoskeletal/Skin - WLB > Week 2 - Antifungals > Flashcards

Week 2 - Antifungals Flashcards

1
Q

Are fungi autotrophic (produce their own food)?

A

NO, fungi feed on dead things

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2
Q

Amphotericin B

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
  6. Distribution
A
  1. Polyene
  2. Fungicidal - Binds ergosterol, creates holes in membrane
  3. Broad, Yeast and molds
  4. TOXIC (binds cholesterol), Nephrotoxicity
  5. Rare, decreased ergosterol in membrane
  6. Small fraction excreted, long tissue half life, can cross BBB
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3
Q

Nystatin

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
  6. Distribution
A
  1. Polyene (topical)
  2. Fungicidal - binds ergosterol - creates holes
  3. Broad: yeast & mold
  4. TOXIC (binds cholesterol) - nephrotoxicity
  5. Rare, decreased ergosterol in membrane
  6. Small fraction excreted, long tissue half life, can cross BBB
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4
Q

Fluconazole

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
  6. Distribution
A
  1. Azoles
  2. Fungistatic: binds Erg11 - blocks production of ergosterol
  3. Most widely used antifungal
  4. Drug-drug interactions, hepatotoxicity, neurotoxicity, Avoid if PREGNANT
  5. Altered cyt p450, efflux
  6. orally available
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5
Q

Itraconazole

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
  6. Distribution
A
  1. Azoles
  2. Fungistatic: binds Erg11 - blocks production of ergosterol
  3. Most widely used antifungal
  4. Drug-drug interactions, hepatotoxicity, neurotoxicity, Avoid if PREGNANT
  5. Altered cyt p450, efflux
  6. orally available, acid/cola helps facilitate absorption
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6
Q

Ketoconazole

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
  6. Distribution
A
  1. Azoles
  2. Fungistatic: binds Erg11 - blocks production of ergosterol
  3. Most widely used antifungal
  4. Drug-drug interactions, hepatotoxicity, neurotoxicity, Avoid if PREGNANT
  5. Altered cyt p450, efflux
  6. orally available, acid/cola helps facilitate absorption
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7
Q

Terbinafine (Lamisil)

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
A
  1. Allylamines
  2. Fungicidal - inhibits squalene epoxidase
  3. Dermatophytes
  4. Topical, drug interactions with CYP2D6 substrates
  5. Rare
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8
Q

Flucytosine (5-FC)

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
  6. Distribution
A
  1. Nucleic Acid Synthesis Inhibitor
  2. Fungistatic - converted to 5-fluorouracil, interfere with DNA/RNA synthesis (pyrimidine metabolism)
  3. Narrow: Yeast - Candida albicans & Cryptococcus
  4. Bone marrow suppression
  5. Loss of converting enzyme or transporters
  6. Oral, Penetrates CNS

*Often cotreat with Amphotericin B

(increase uptake, minimize potential resistance)

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9
Q

Griseofulvin

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
  6. Distribution
A
  1. Microtubule inhibitor
  2. Fungistatic - binds microtubules leading to multinucleate cells
  3. Dermatophytes
  4. Teratogenic
  5. change to beta-tubulin
  6. Lipids increase oral absorption, take with fat!

***Take for months because bacteria concentrates in dead keratinized skin.

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10
Q

Caspofungin

  1. Class
  2. MOA
  3. Spectrum
  4. Toxicity
  5. Resistance
  6. Distribution
A
  1. Echinocandins
  2. Impairs beta-1,3 glucan synthesis, Fungicidal: against Candida albicans, Fungistatic: against Aspergillus
  3. Candida albicans, systemic
  4. hypersensitivity rxn: fever, rash
  5. change in 1,3-beta-D-glucan synthase gene
  6. IV, large MW prohibits CNS penetration
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11
Q

Can fungi produce spores?

A

Yes

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12
Q

Are fungi multicellular?

A

Yes & No

Depends on type

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13
Q

Do fungi have a cell wall?

A

Yes, chitin

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14
Q

Do fungi have mitochonria?

A

Yes

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15
Q

What are single cell fungi called?

A

Yeast

(reproduce asexually via budding)

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16
Q

What are multicellular fungi called?

A

Molds

(hyphae, mycelium)

(reproduce sexually via spores)

17
Q

What are haustoria?

A

Hyphage on parasitic fungi

18
Q

What are the Cutaneous fungal infections discussed in class?

A

Malasssezia (tinea versicolor)

Dermatophytes: Microsporum, Epidermophyton, Trichophyton

19
Q

What are the Subcutaneous fungal infections discussed in class?

A

Infection through skin followed by subcutaneous and/or lymphatic spread.

Sporothrix

20
Q

What are the Opportunistic skin mycoses discussed in class?

A

Candida albicans = part of normal flora

-infections in patient with immune deficiences or patient on another/recent antibiotics

21
Q

How are fungal skin infections diagnosed?

A
  • Collect skin, nail, or hair with scraping
  • 10% KOH (dissolves human tissue) + stain
  • Wood’s lamp (UV-A light) under which some fungi fluoresce
  • PCR
  • Culture
22
Q

What fungi causes Tinea versicolor?

A

Malassezia furfur

  • Yeast is part of normal flora
  • Converts to mold in disease (requires lipids) in areas rich in sebaceous glands
  • Tropical climates, 15-24 yrs old
23
Q

What fungi is associated with seborrheic dermatitis (scaly, cradle cap)?

A

Malassezia

  • Diagnosed by: KOH, Wood’s lamp (yellow-green), cultures
  • Treatment: Topical therapy Ketoconazole shampoo, Selenium sulfide
24
Q

What fungi cause Dermatophytoses (ringworm, tinea, jock itch, athletes foot)?

A
  • Trichophyton
  • Microsporum
  • Epidermophyton
25
Q

Why are Dermatophyte fungal infections restricted to hair, nails, and superficial skin?

A

They require keratin for growth

27
Q

What fungi strain is the most common cause of tinea pedis?

A

Trichophyton rubrum

(anthrophilic)

28
Q

What fungal strain is the most common cause of tinea capitis in children of the US?

A

Trichophyston tonsurans

29
Q

What does endothrix mean?

A

dermatophyte infections of the hair that invade the hair shaft and internalize into the hair cell

Musculoskeletal/Skin - WLB (13 decks)

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