August 26, 2015 - Anti-Fungals

Question 1

Differences Between Human and Fungal Cells

Answer 1

Humans have cholesterol while fungus has ergosterol.

Fungus has chitin and glucan in their cell walls.

Question 2

Types of Fungus

Answer 2

1. Yeast - unicellular and reproduce by budding
2. Mold - filamentous with specialized reproduction apparatus
3. Dimorphic - either a yeast or a mold depending on the temperature of the surroundings. Often will be a yeast in the body at warm temperatures and a mold in the surroundings at cooler temperatures.

Question 3

Common Types of Yeast

Answer 3

• 1. Candida albicans*
• 2. Candida “non”-albicans*
• 3. Cryptococcus neoformans*

Question 4

Common Types of Mold

Answer 4

• 1. Aspergillus*
• 2. Zygomycosis*
• 3. Dermatophytes (tinia)*

Question 5

Common Types of Dimorphic

Answer 5

Many of these are endemic to different regions.

Question 6

Targets for Anti-Fungal Drugs

Answer 6

1. Glucan synthetase inhibitors
2. Cell membrane disruption / pore formation
3. Ergosterol synthesis inhibitors
4. DNA synthesis inhibitors

Question 7

Echinocandins

Answer 7

All end in -FUNGIN

Active against ALL Candida

Mechanism is to target glucan synthesis

Question 8

Polyenes

Answer 8

Amphotericin B (AmphoTerrible), Liposomal AmphoB, and Nystatin.

All target the cell membrane.

All very toxic in IV form.

Liposomal AmphoB is the first line treatment for Zygomycosis however (face melting disease with horrible prognosis).

Question 9

Azoles

Answer 9

All end in -AZOLE

All target ergosterol synthesis

All have high oral bioavailability. PO = IV