Anti Fungal Drugs

Question 1

In which patients are deep mycotic infections expected?

Answer 1

Immune-compromised patients

Question 2

What are the four targets of antifungal drugs in fungal cells?

Answer 2

1. Cell wall
2. Cell membrane
3. Nucleic acids
4. Mitosis

Question 3

Echinocandins act on which fungal structure?

Answer 3

β-glucan synthase

Question 4

Which antifungal drug inhibits β-glucan synthase?

Answer 4

Echinocandins

Question 5

What is the mechanism of action of Azoles?

Answer 5

Inhibits Lanosterol → Ergosterol conversion

Question 6

Which class of antifungal drugs includes Amphotericin B?

Answer 6

Polyenes

Question 7

Amphotericin B is (hydrophilic/lipophilic)?

Answer 7

Both hydrophilic and lipophilic

Question 8

What is the function of Amphotericin B?

Answer 8

It inserts into fungal membranes, binding to ergosterol and forming pores that increase permeability.

Question 9

What is a major side effect of Amphotericin B?

Answer 9

Nephrotoxicity

Question 10

How can the nephrotoxicity of Amphotericin B be reduced?

Answer 10

By using liposomal formulations

Question 11

What syndrome is associated with Amphotericin B infusion?

Answer 11

Cytokine release syndrome (rigors, fever)

Question 12

How can cytokine release syndrome from Amphotericin B be managed?

Answer 12

Antihistamines + corticosteroids

Question 13

Which antifungal drug is the gold standard for deep mycoses?

Answer 13

Amphotericin B

Question 14

What is an empirical treatment for febrile neutropenia?

Answer 14

Amphotericin B

Question 15

Which antifungal drug is converted intracellularly to 5-FU?

Answer 15

Flucytosine

Question 16

What is the mechanism of action of Flucytosine?

Answer 16

Inhibits DNA synthesis by converting dUMP → dTMP

Question 17

Which antifungal drug binds microtubules and inhibits mitosis?

Answer 17

Griseofulvin

Question 18

What is the effect of Griseofulvin on oral contraceptive pills (OCPs) and warfarin?

Answer 18

• OCPs: Decreased efficacy (contraindicated)
• Warfarin: Decreased efficacy (risk of clotting)

Question 19

Which antifungal drug accumulates in keratinized tissues and is used for dermatophytosis?

Answer 19

Griseofulvin

Question 20

Name two antibiotics that are given orally for their non-systemic effects.

Answer 20

1. Vancomycin (for pseudomembranous enterocolitis)
2. Neomycin (for surgical preparation)

Question 21

What happens when Amphotericin B is combined with azoles?

Answer 21

Formation of micropores

Question 22

How is Amphotericin B eliminated?

Answer 22

Removed by dialysis