Antifungal

Question 1

What anti-fungal drug is used for systemic, life threatening disease?

What is the target?

Answer 1

Amphotericin B and Nystatin

Ergosterol

Question 2

What are superficial mycoses usually caused by? These are caused by what species of fungi?

Answer 2

Dermatophytes

Candida

Question 3

Epidermophyton
Trichophyton
Microsporum
These fungi are common what?

Answer 3

Dermatophytes

Question 4

Amphotericin B can be given via IV, liposomes, or _______________? Does not penetrate well into the CNS

Answer 4

Intrathecally (given in CNS)

Question 5

What types of effects can Amphotericin B have?

Answer 5

Thrombophlebitis, anaphylaxis, and Convulsions, and anemia

Question 6

What are ways that amphotericin B can be watered down to not make as bad?

Answer 6

slow infusion, hydrate, give with flucytosine, lower overall concentrated dose

Question 7

What are adverse reactions with Flucytosine?

Is normally given with what?

Answer 7

Bone marrow suppression, Hepatic dysfunction, Colitis

Amphotericin B

Question 8

What do -azole drugs block?

What part of the cell wall is blocked?

Answer 8

Ergosterol synthesis, inhibit 14-alpha demethylase, stops lanosterol to ergosterol in the ergosterol synthesis

Question 9

How is the absorption of ketoconazole and itraconazole affected with anatacids and food?

Answer 9

Ketoconazole is decreased by antacids

Itraconzaole is increased with food

Question 10

What is drug is the back up drug used for treatment of mucocutaneous cadidia?

Answer 10

Ketoconazole

Question 11

Ketoconazole has what effects on the endocrine system?

What kind of reation with alcohol?

Answer 11

Androgen and Adrenal Steroid Synthesis

Disulfiram like reaction

Question 12

What drug can cause gyncecomastia, low libido, and impotence?

This same drug inhibits the CYP450 system and can cause an increase or decrease in a lot of other drugs?

Answer 12

Ketoconazole

Increase in levels

Question 13

What is the drug of choice for Cryptococcal meningitis, Candidal infections, Coccidioidomycosis?

Does this drug reach into the CNS?

Answer 13

Fluconazole

Yes

Question 14

What is the azole of choice for Blastomycosis, sporotrichosis, paracoccidiomycosis, and histoplasmosis?

Answer 14

Itraconazole

Question 15

What Itraconazole adverse reactions are there?

Answer 15

Steven Johnson, avoid in pregnancy

Question 16

Voriconazole is the approved treatment for what fungus? What is the main contraindication?

Answer 16

Aspergillosis, twister from sketchy

Transient Visual Disturbance

Question 17

What drug is used for superficial fungi that binds to spindle formation, and inhibits fungi?

Answer 17

Griseofulvin

Question 18

What is the DOC for Tinea Capitis in children for efficacy, safety, and availability as an oral suspension?

What is ADR of this drug?

Answer 18

Griseofulvin

Acute Intermittent porphyria (blood in urine for a minute)

Disulfiram like reaction with alcohol

Question 19

What is the DOC for dermatophytoses, especially onychomycoses (fungal infections of nails/toenails/fingernails)?

Answer 19

Terbinafine

Question 20

What type of drug is Terbinafine?

What is the MOA?

Answer 20

Allymine

Prevents squalene synthesis via squalene epoxidase inhibition

Question 21

What is Terinafine very similar too?

Answer 21

Fungicidal agent

Question 22

What drug is tolerated better than griseofulvin, and is more effective than griseofulvin and itraconazole?

Answer 22

Terbinafine

Question 23

What type of ADR is there with Terbinafine?

What part of this drug works on onychomycosis with 100% response?

Answer 23

Rash, diarrhea, urticaria

Topical and Oral on nails

Question 24

What drug is used instead of Amphotericin B or Itraconazole?

What is the MOA?

Answer 24

Echinocandins/capsofungin

Stops 1,3 Beta glucan synthesis