Antifungal drugs

Question 1

What is targeted in fungal cells

Answer 1

Ergosterol, it is not in animal/human cells

Question 2

Polyene antifungal MOA

Answer 2

Bind to ergosterol to create polar pore allowing ions to leak out

Question 3

Polyene antifungal

Answer 3

Nystatin

Question 4

Imidazole and triazole MOA

Answer 4

Inhibit ergosterol synthesis, impairing cell membrane synthesi/cell growth/ replication

Question 5

Imidazole

Answer 5

clotrimazole

Question 6

triazole

Answer 6

fluconazole

Question 7

Nystatin adverse effects

Answer 7

local irritation

Question 8

Fluconzaole adverse effects

Answer 8

GI (nausea, vomiting, diarrhoea, abdominal pain), headache, hepatitis, hypersensitivity, prolonged QT= arrhythmias, hepatic toxicity, cutaneous reactions and anaphylaxis

Question 9

What antifungal should be avoided in pregnancy

Answer 9

fluconazole

Question 10

What antifungal should have its dose reduced in moderate renal impairment

Answer 10

fluconazole

Question 11

Fluconazole warnings

Answer 11

liver disease, pregnancy, renal impairment

Question 12

Fluconazole interactions

Answer 12

Co-dynamic with pro-drugs needing liver metabolism activation like clopidogrel so clopidogrel dose needs to be increase, QT prolongation, amiodarone, antipsychotics, quinine, quinolone, macrolide and SSRI and pharmacokinetic inhibitor

Question 13

Clotrimazole uses

Answer 13

Skin and genital tract, such as tinea (ringworm, including athlete’s foot) and candida (thrush)

Question 14

Dose of clotrimazole/admin

Answer 14

1%, BD/TDS until 1-2 weeks after infection resolved

Question 15

When should Nystatin be taken

Answer 15

After food

Question 16

Liver poisoning signs

Answer 16

nausea, loss of appetite, lethargy/ dark urine