09 Fungus Drug Table Questions Flashcards Preview

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Flashcards in 09 Fungus Drug Table Questions Deck (34):
1

What are the only anti-fungals to cover Zygomycoses (Rhizopus, Mucor)?

AMB. Pozaconazole

2

What are the only anti-fungals to cover Fusarium?

AMB. Voriconazole. Pozaconazole

3

What are the only anti-fungals to cover Cryptococcus neoformans?

AMB. Fluconazole

4

What are the only anti-fungals to cover Histoplasma blastomyces?

AMB. Fluconazole

5

What are the only anti-fungals to cover Histoplasma capsulatum?

AMB. Ketoconazole

6

What are the only anti-fungals to cover Coccidioides immitus?

AMB. Oral Azoles (all of them except Pozaconazole)

7

What are the only anti-fungals to cover Blastomyces dermatidis?

AMB. Ketoconazole

8

What are the only anti-fungals to cover Scedosporium?

Voriconazole. Pozaconazole

9

What are the only anti-fungals to NOT cover Candida parapsilosis?

Echinocandins

10

What are the only anti-fungals to NOT cover Candida lusitaniae?

AMB. Fluconazole. Itraconazole

11

What are the only anti-fungals to NOT cover Candida krusei?

Fluconazole. Itraconazole

12

What are the only anti-fungals that have NO Aspergillus spp. coverage?

Ketoconazole. Fluconazole

13

What are the only anti-fungals to NOT cover Aspergillus terreus?

AMB. Ketoconazole. Fluconazole

14

What form is AMB administered?

IV only

15

Where does AMB have POOR distribution?

CSF, brain, bone, eye

16

What are the goal levels of Azoles?

Maintain AUC:MIC > 50, or 1-2x MIC for entire dosing interval

17

What is the CYP450 inhibition heirarchy for Azoles?

Vori, Itra > Posa > Flu

18

What form is Ketoconazole administered?

PO only

19

What is a rare side effect of Ketoconazole?

Gynecomastia, Oligospermia, Decreased libedo, Adrenal insufficiency

20

What form is Fluconazole administered?

IV and PO

21

What is the main route in which Fluconazole is cleared?

80% renally

22

What form is Itraconazole administered?

Capsules. Oral solution

23

What is important to remember about Voriconazoles PK?

Non-Linear. large change in AUC w/ small change in dose. Differs among all patients

24

What form is Voriconazole administered?

IV and PO

25

What is dose adjustment like for Voriconazole?

Hepatic: Normal LD, decrease MD by 50% for Child-Pugh A, B. Renal: avoid in CrCl < 40 (d/t cyclodextran carrier accumulation)

26

What is dose adjustment like for Fluconazole?

Requires renal dose adjustment

27

What drugs are CI with Voriconazole?

Rifampin. Carbemazepine. Long-Acting Barbiturates. Sirolimus

28

What form is Pozaconazole administered?

PO only

29

What form are Echinocandins administered?

IV only d/t very low BA

30

What is the elimination of Anidulafungin like?

100% biliary

31

What is often used clinically for an Aspergillus infection?

DOC: Voriconazole (best for pulmonary aspergillosis). Other agents: L-AMB, echinocandins

32

What is often used for Coccidiomycosis treatment (Pulmonary cavitation)?

Oral azoles (onlyl if symptomatic). Ruptured lesions need lobectomy + antifungals

33

What is often used for Coccidiomycosis treatment (Chronic Progressive Fibrocavitary Pneumonia)?

Immediate therapy with oral Azole for 1 year

34

What is often used for Coccidiomycosis treatment (Disseminated (extra pulmonary))?

AMB. If meningitis: High dose Fluconazole or Intrathecal AmphoB