Anti-fungal Agents

Question 1

Echinocandins target what?

Nucleic acid synthesis
Inhibits glucan synthesis (cell wall)
Inhibits ergosterol synthesis (cell membrane)
Direct membrane damage

Answer 1

Inhibits glucan synthesis (cell wall)

Question 2

“fungin” belongs to this class:

Flucytosine
Echinocandins
Azoles
Polyenes

Answer 2

Echinocandins

Question 3

What are some specific AE of posaconazole?

Answer 3

General N/V/D, pretty safe and well-tolerated

Question 4

Polyenes target what?

Nucleic acid synthesis
Inhibits glucan synthesis (cell wall)
Inhibits ergosterol synthesis (cell membrane)
Direct membrane damage

Answer 4

Direct membrane damage

Question 5

What are some specific AE of isavuconazole?

Answer 5

Hypokalemia

Question 6

MOA of Amphotericin B?

Answer 6

Binds to ergosterol + forms a channels
Causes loss of ions and small molecules
pH lowers

Question 7

Flucytosine AE?

Answer 7

1. Bone marrow suppression (concentration dependent)
2. N/V/D (dose related)
3. Hepatotoxicity

Question 8

Targets: Nucleic acid synthesis

Flucytosine
Echinocandins
Azoles
Polyenes

Answer 8

Flucytosine

Question 9

What are some specific AE of fluconazole?

Answer 9

Alopecia (reversible) and QT prolongation

Question 10

Which RX are echinocandins?

Answer 10

The ones that end w/ “fungin”

EX: Micafungin

Question 11

Amphotericin B + Nystatin belong to this class:

Flucytosine
Echinocandins
Azoles
Polyenes

Answer 11

Polyenes

Question 12

Which RX are polyenes?

Answer 12

Amphotericin B + Nystatin

Question 13

Azoles bind to ______ which inhibits the production of ergosterol

Answer 13

lanosterol 14-alpha-demethylase

Question 14

What are the AE reactions of azoles?

Answer 14

Rash, N/V, Diarrhea, and transient elevation in hepatic enzymes

Question 15

Flucytosine targets what?

Nucleic acid synthesis
Inhibits glucan synthesis (cell wall)
Inhibits ergosterol synthesis (cell membrane)
Direct membrane damage

Answer 15

Nucleic acid synthesis

Question 16

AE of Echinocandin?

Answer 16

1. Infusion related (most common)
2. Elevation of serum transaminases

Overall, this class is well-tolerated

Question 17

Which RX are azoles?

Answer 17

The ones that end w/ “conAZOLE”

EX: Fluconazole

Question 18

Targets: Cell wall; inhibits glucan synthesis

Flucytosine
Echinocandins
Azoles
Polyenes

Answer 18

Echinocandins

Question 19

How could you help treat infusion toxicity of Amphotericin B?

Answer 19

Common at the beginning of treatment, usually subsides w/ subsequent doses

Could use low dose corticosteroids or Meperidine (caution w/ renal dysfunction though)

Question 20

Echinocandin MOA?

Answer 20

Cyclic lipopeptide AB that interferes w/ fungal cell wall synthesis by inhibit glucan

Question 21

Which RX are flucytosine?

Answer 21

It is its own class lol

Question 22

Azoles MOA?

Answer 22

Inhibits fungal ergosterol synthesis and cell membrane formation

Question 23

How could you help treat nephrotoxicity of Amphotericin B?

Answer 23

Reversible unless their cumulative dose is over 4g

Question 24

Targets: Cell membrane; inhibits ergosterol syntheisis

Flucytosine
Echinocandins
Azoles
Polyenes

Answer 24

Azoles

Question 25

Targets: Direct membrane damage Flucytosine Echinocandins Azoles Polyenes

Answer 25

Polyenes

Question 26

Flucytosine MOA?

Answer 26

Enters cell via cytosine permease and changes to 5-FU | Impairs fungal DNA synthesis

Question 27

What are some specific AE of itraconazole?

Answer 27

Taste disturbance, osmotic diarrhea, increased LFTs

Question 28

AE of Amphotericin B?

Answer 28

1. Infusion Toxicity 2. Nephrotoxicity 3. Hypokalemia and hypomagnesemia

Question 29

Echinocandin inhibits cell wall synthesis by inhibiting __________ synthase

Answer 29

beta(1,3) D-glucan

Question 30

Azoles target what? Nucleic acid synthesis Inhibits glucan synthesis (cell wall) Inhibits ergosterol synthesis (cell membrane) Direct membrane damage

Answer 30

Inhibits ergosterol synthesis (cell membrane)