Antifungals - pyrimidines and polyenes

Question 1

example of pyrimidine antifungal

Answer 1

5-fluorocytosine

Question 2

how does 5-fluorocytosine work, 2 ways

Answer 2

1. disruption of DNA synthesis

2. disruption of translation

Question 3

what is 5-fluorocytosine active against

Answer 3

crytococcus neoformans and candida species + some moulds

Question 4

is 5-fluorocytosine used on its own or as combo therapy? And why is it used this way?

Answer 4

combo with Amp or fluconazole. Less resistance experienced with combo therapy

Question 5

What is 5-fluorocytosine used generally for?

Answer 5

treatment of systemic fungal infections and mainly for crypt. meningitis

Question 6

What is the patient at risk of if 5-fluorocytosine is used for more than two weeks at >100mg/L?

Answer 6

Bone marrow supression

Question 7

What toxicity does 5-fluorocytosine present?

Answer 7

liver toxicity

Question 8

what does 5-fluorocytosine interact with?

Answer 8

Brivudine

Question 9

2 Examples of polyene?

Answer 9

Nystatin and Amphotericin

Question 10

Another name for Amphotericin

Answer 10

Ambiosome

Question 11

What can Amphotericin be used for

Answer 11

most yeasts and moulds

Question 12

Is Amphotericin broad or narrow spectrum?

Answer 12

Broad

Question 13

How is 5-fluorocytosine given?

Answer 13

IV

Question 14

How is Nystatin and Amphotericin given?

Answer 14

IV but occasionally given topically

Question 15

What type of therapy can Amphotericin be used for?

Answer 15

Empiric therapy (based on past experience)

Question 16

What toxicity do patients experience with Amphotericin

Answer 16

Nephrotoxicity

Question 17

Are most yeasts sensitive to Nystatin?

Answer 17

yes

Question 18

How is Nystatin given?

Answer 18

Topical

Question 19

why is Nystatin given topically?

Answer 19

too toxic

Question 20

What is Nystatin used to treat?

Answer 20

oral/vaginal candidosis