Anti Fungals Flashcards
What states can fungi live in?
Yeast - unicellualr and budding
Filamentous - multicellular and two forms septate and aseptate
What is growth called where a fungi can change its state?
dimorphic
Why is treatment with antifungals more problematic than antibiotics?
Fungi are eukaryotes so are more similar to human cells therefore more side effects.
Have to treat for longer and have more side effects
What are the 5 classes of antifungals and how do they work?
Azoles
Echinocandins
Allyamines
Inhibit membrane synthesis
Polyenes
Inhibit membrane function
Other
Inhibit nucleic acid synthesis
How do azoles work?
Disrupt cytochrome P450 and stop formatinon of ergosterol which is a fungal cholesterol in cell membrane
What is the most common topical Azole and what is it used for?
clotrimazole
Candida
Tinea pedia and tine cruris
How can clotrimazole be given?
Cream, pessary
What is clotrimazole not good for?
Tinea capitis
Tinea uniguium
What are the three systemic Azoles?
Fluconazole
Voriconazole
Itraconazole
What is fluconazole used for and what type of antifungal is it
Fungicidal
Used for candida, cryptococcus (penetrates CSF) and dermatophytes (if serious)
What is voriconazole used for?
Fungicidal against aspergillus and candida
1st line for aspergillosis
What type of patient would you not use voriconazole in and what is another common side effect?
Renally Impaired
Visual disturbances
What is itraconazole used for and when would you use it?
Wide use against dermatophytes, candida, aspergillosis.
Used propylactically on those with HIV/Chemo
What is the only echinocandin and how does it work?
Caspofungin
Inhibits 1,3 beta-glucan synthase
What does caspofungin work on and when would you use it?
How is it given?
Only candida and aspergillus but it fungistatic so no good in the immunocompromised.
Only given IV and give via a loading dose
