Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm > Anti-fungals > Flashcards

Anti-fungals Flashcards

(47 cards)

Start Studying
1
Q

differentiate b/w fungi in the imperfect and perfect states

A

imperfect: only asexual spores
perfect: sexual spores (can be induced from imperfect)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

describe fungi characteristics

A
  • molds: tubular hyphae
  • dimorphic: yeast in host, mold at room temp
  • nonmotile, rigid cell wall (chitin, polysaccharides)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

are fungal infections transmissible person to person?

A

no- except scalp ringworm or neonatal thrush

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

four disease states with fungal infections

A
  1. dermatomycoses
  2. onychomycoses
  3. systemic
  4. mucous membranes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

briefly describe dermatomycoses

A

live on keratinized tissue (skin, hair, nails)

sx: itching, burning, skin cracking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

briefly describe onychomycoses

A

nail/nail bed
caused by a dermatophyte
sx: nail thickens, discolored (white/yellow/brown)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what drugs are used to treat dermatomycoses?

A
  1. tolnaftate (tinactin)
  2. clotrimazole (lotrimin)
  3. griseofulvin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

tolnaftate (tinactin) MOA

A

inhibits fungal squalene epoxidase - decreases ergosterol synthesis (for cell membrane)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some other squalene epoxidase inhibitors?

A

terbenafine
naftifine
butenafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

clotrimazole (lotrimin) MOA

A

azole drug: inhibits cyt p450, blocking 14a-demethylation of lanosterol to ergostanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

can clotrimazole react with human cells?

A

yes- although it is much more selective for fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

two other azole antifungals besides clotrimazole

A

miconazole

ketoconazole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is griseofulvin used for?

A

systemic treatment of dermatomycoses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

griseofulvin MOA

A

disrupts mitotic spindle by binding polymerized microtubules to inhibit mitosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what does griseofulvin treat?

A

onychomycoses: deposited in the newly formed keratin, where it prevents fungal growth

old nail can still have persistent infection, so therapy may last for up to or more than 1y

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

chemical properties of griseofulvin that are limiting? how do we get around these problems?

A

water insoluble

  • use microsize and ultramicrosize particles to increase dissolution rate
  • taken w/ high fat diet to increase absorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

AE of griseofulvin

A

photosensitivity
hypersensitivity
headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are 6 systemic antifungals?

A
  1. Amphotericin B (fungizone)
  2. 5-fluorocytosine (ancoban, flucytosine)
  3. Ketoconazole (Nizoral)
  4. Fluconazole (Diflucan)
  5. Itraconazole
  6. Echinocandins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

chemical properties of ampho B

Study These Flashcards
A
  • amphoteric
  • poor water solubility - not absorbed well from GI (so given IV slow infusion or as liposomal suspension injection)
  • bile salt complex form = deoxycholate complex
  • sterile lyophilized form = cholesterol complex
20
Q

SE of ampho B

Study These Flashcards
A
  • major acute rxn: fever/chills
  • headache, nausea, vomit, nephrotoxicity, hypotension
  • limiting toxicities: nephrotoxicity + hypokalemia
21
Q

what is the drug of choice for life-threatening fungal infections?

Study These Flashcards
A

ampho B (broad spec- can do deep mycoses)

22
Q

ampho B MOA

Study These Flashcards
A

binds ergosterol in membranes, opens pores - leakage of ions and small organic molecules

23
Q

why does ampho B cause some toxicity?

Study These Flashcards
A

it also binds some cholesterol

24
Q

5-fluorocytosine MOA

Study These Flashcards
A

bacteria convert 5-fluorocytosine to 5-fluorouracil to 5-fluorodeoxyuridine monophosphate - this inhibits thymidylate synthase, inhibiting DNA synthesis

25
alternate 5-fluorocytosine MOA
antimetabolite - 5-fluorouracil incorporated into RNA in place of uracil, inhibiting protein synthesis
26
why does 5-fluorocytosine not affect human cells?
humans have little or no cytosine deaminase activity
27
5-fluorocytosine uses
- combined w/ ampho B - systemic candida, cryptococcus, meningitis - also for Torulopsis glabrata, Cladosporium, Aspergillus
28
PK of 5-fluorocytosine
- well absorbed in GI + penetrates CSF | - low toxicity
29
toxicity of 5-fluorocytosine
- depress bone marrow fxn: leukopenia, thrombycytopenia - careful w/ patients w/ impaired renal fxn - nausea, vomit, diarrhea, rash, enterocolitis
30
uses of ketoconazole
- oral use for systemic infections | - tx: blastomycosis, histoplasmosis, coccidioidomycosis, paracoccidioidomycosis
31
PK of ketoconazole vs. ampho B
better tolerated than ampho B, but less effective
32
what kind of drug is fluconazole?
triazole (3 N's in a 5-membered ring)
33
PK of fluconazole
high bioavailability + penetrates CSF
34
AE and DDI with fluconazole?
decreased incidence b/c more selective for fungi | -rare: hepatotoxicity (monitor if abnormal liver fxn tests)
35
fluconazole uses
- IV: AIDS cryptococcal meningitis - 200 mg daily for prevention of crypto meningitis relapse controlled by ampho B - 150 mg p.o.- vaginal candidiasis
36
what is itraconazole a mixture of?
1:1:1:1 of 4 diastereomers | also a triazole
37
PK of itraconazole
more than 90% bound to serum proteins extensively bound in tissues does NOT go to CSF
38
itraconazole uses
- itraconazole > ketoconazole for nonmeningeal histo | - AIDS disseminated histo w/ stabilization during ampho B therapy
39
at what dose is itraconazole well tolerated?
200 mg/d
40
AE of itraconazole
- 400 mg/d: some GI distress - nausea, vomit, hypokalemia, rash - rare hepatotoxicity
41
what patients should not receive itraconazole?
CHF patients b/c it can cause heart failure
42
DDI with itraconazole
DDI if given with other drugs metabolized by cyt p450, including: - cisapride - pimozide - quinidine - dofetilide
43
echinocandins MOA
inhibits 1,3-B glucan synthesis in fungal cell wall by noncompetitive inhibitin of 1,3-B glucan synthase (selective for fungus)
44
uses of echinocandins
- broad spec w/ no cross resistance | - synergistic w/ voriconazole and ampho B
45
echinocandin admin
IV
46
AE of echinocandins
hepatotoxicity | sensitivity/allergies
47
examples of echinocandins (3)
Caspofungin (Cancidas) Anidulafungin (Erixis) Micafungin (Mycamine)

Pharm (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions