Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pulmonary > PHARM: Fungal Infections > Flashcards

PHARM: Fungal Infections Flashcards

1
Q

Presentation of candida albicans (yeast) in lung infection.

A

Fever, tachycardia, patchy infiltrates on chest film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Characteristics of candida albicans lung infection.

A

Uncommon cause of pneumonia; hematogenous spread seen in immunocompromised patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment of candida albicans lung infection.

A

Amphotericin B IV and Fluconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Presentation of cryptococcus neoformans (cryptococcus) lung infection.

A

Often asymptomatic

May have productive cough, fever, and weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Characteristics of cryptococcus neoformans (cryptococcus) lung infection.

A

Associated with pigeon droppings

Can cause cryptococcal meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Treatment of cryptococcus neoformans (cryptococcus) lung infection.

A

CNS: Amphotericin B IV + flucytosine PO

Non-CNS: fluconazole PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Presentation of aspergillus (mold) in lung infection.

A

Wheezing, dyspnea, and cough with allergic bronchopulmonary aspergillosis (ABPA)

Fever, cough, dyspnea, pleuritic chest pain, and hemophysis seen in invasive forms (in immunocompromised patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Characteristics of aspergillus (mold) in lung infection.

A

Aspergillomas (fungal balls) can form in pre-existing cavities

The invasive form spreads hematogeneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatment of aspergillus (mold) in lung infection.

A

1st line: Voriconazole IV then step down to PO

2nd line: Amphotericin B IV then step down to PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Presentation of blastomyces dermatitidis (dimorphic) in lung infection.

A

Fever, chills, productive cough

May also present with skin/bone lesions or GI involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Characteristics of blastomyces dermatitidis (dimorphic) in lung infection.

A

Causes pneumonia-like disease and may progress to disseminated disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment of blastomyces dermatitidis (dimorphic) in lung infection.

A

1st line: Fluconazole IV (or Amphotericin B IV if severe) step down to Voriconazole/Itraconazole/Fluconazole

2nd line: Amphotericin B IV step down to Voriconazole or Fluconazole PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Presentation of histoplasma capsulatum (dimorphic) in lung infection.

A

Often asymptomatic

Young or immunocompromised may have disseminated or chronic disease with fever, fatigue, and weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Characteristics of histoplasma capsulatum (dimorphic) in lung infection.

A

Caseating granuloma formation in tissue (like Tb)

Disseminated form is marked by multi-system involvement with macrophage infiltrates filled with intracellular fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment of histoplasma capsulatum (dimorphic) in lung infection.

A

SEVERE: Amphotericin B IV followed by Itraconazole PO
MILD: Voriconazole or posaconazole/fluconazole PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Presentation of coccidioides immitis (dimorphic) in lung infection.

A

Fever, cough, headache, Chest pain

Disseminate or chronic disease produces systemic symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Characteristics of coccidioides immitis (dimorphic) in lung infection.

A

May have acute, disseminated or chronic course. Fungal spheres containing endospores are found in granulomas.

18
Q

Treatment of coccidioides immitis (dimorphic) in lung infection.

A

SEVERE: Amphotericin B IV followed by Itraconazole PO or Fluconazole PO

MILD: Voriconazole or posaconazole PO

19
Q

What is the only fungal infection to use flucytosine?

A

cryptococcal infections

20
Q

Why do physicians want to use lipid formulations or stop using Amphotericin B in general?

A

it has nephrotoxicity associated iwth the deoxycholate form

21
Q

Aspergillus species is devleoping a resistant to what drug class? How?

A

Azoles. The resistance is associated iwth mutations in the promoter region of CYP51A (encodes lanosterol-14-alpha demethylase activity)

22
Q

Which azole has low and variable oral absorption and is beginning to fall out of favor?

A

itraconazole

23
Q

Which is the ONLY azole that can penetrate the BBB?

A

Fluconazole

24
Q

How are azoles metabolized?

A

hepatic CYP metabolism (2C9, 2C19, 3A4)

25
Q

Which types of antifungals do NOT undergo hepatic metabolism?

A

Amphotericin B

Flucytosine

26
Q

What agents interact with amphotericin B?

A

nephrotoxic agents

Drugs producing hypokalemia

27
Q

What agents should be avoided when using flucytosine? Why?

A

Hematoxic drugs, because flucytosine can produce anemia and blood dyscrasias (like agranulocytosis)

28
Q

MOA of Amphotericin B

A

Binds to ergosterol (in fungal membrane) and forms pores that allow leakage (leading to cell death

29
Q

AE of Amphotericin B

A

Infusion related reactions

Renal toxicity, anemia, abnormal liver function tests, seizures

30
Q

Which azole has the most CYP interactions?

A

Voriconazole

31
Q

Which azole has the least CYP interactions?

A

posaconazole

32
Q

The highest incidence of GI discomfort, weight loss, and side effects occurs with what azoles?

A

itraconazole

posaconazole

33
Q

Which azoles are contraindicated in pregnancy?

A

voriconazole

Fluconazole

34
Q

Which azole has severe liver side effects?

A

ketoconazole

35
Q

What are the adverse effects of voriconazole?

A

photosensitive dermatitis
elevated liver enzymes
temporary visual disturbances upon IV
neurologic symptoms (hallucinations)

36
Q

Which azole is orally administered and has activity against mucomycosis?

A

posaconazole

37
Q

What is the MOA of Flucytosine?

A

enters fungal cell via enzyme cytosine permease, converted to 5-FU, becomes incorporated into intermediary metabolism (eventual inhibition of DNA and RNA synthesis).

38
Q

Where is flucytosine converted to 5-FU?

A

intestines (needs flora)

39
Q

What are the side effects of flucytosine?

A

renal toxicity in impairment
Anemia, leukopenia, thrombocytopenia
NARROW THERAPEUTIC WINDOW

40
Q

What is the MOA of azoles?

A

inhibits ergosterol formation

Pulmonary (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions