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Flashcards in Anti-fungals Deck (40)
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1

What is the MOA for azole antifungal? 3

  1. Inhibit fungal P450 enzymes
  2. Inhibits ergosterol synthesis by inhibiting 14-demethylase
  3. Results in fungistasis

2

What is the primary indication for flucanazole use? 3

  1. Systemic candidiasis 
  2. Vaginal and oropharyngeal candidiasis 
  3. Cryptococcal meningitis

3

What are the routes of administration for flucanazole? 2

  1. IV
  2. Oral

4

What adverse effects are assoicated with fluconazole? 3

  1. Nausea
  2. Vommiting 
  3. Rash

5

What PK are important to fluconazole?

  1. Good CSF penetration
  2. Least effect on hepatic enzymes

6

What is the primary indication for itraconazole? 4

  1. Oropharyngeal and oesophageal candidiasis
  2. Dematophytes
  3. Onychomycosis
  4. Dimorphic fungi infecs

7

What is the route of administration for itraconazole?

Oral/ oral solution

8

What are the adverse effects of itraconazole?

Hepatotoxic

9

What are the drug interaction for itraconazole? 3

  1.  Inhibit P450 enzymes
  2. antacids
  3. PPI

10

PK notes on itraconazole?

Requires acid medium for absorption; avoid antacids

11

What is primary indication for voriconazole?

  1. Aspergiliosis 
  2. Candidiasis 

12

What is the route of administration for voriconazole?

oral

13

What are the adverse effects associated with voriconazole? 3 

  1. Visual disturbance
  2. Hepatotoxic
  3. PS dermatitis 

14

What is the primary indication for ketoconazole?

Dermatophytes:

  1. Seborrhoeic dermatitis
  2. Pityriasis vericolor

15

What is the route of administration for ketoconazole? 

Topical

16

What is the indication for clotrimazole? 3

  1. Dermatophytes
  2. Oral candidiasis
  3. Vaginal candidiasis 

17

PK about clotrimazole

clotrimazole lozenges are pleasent tasting alt to nyastatin

18

What are the routes of administration for clotrimazole? 3

  1. Topical
  2. Lozenges
  3. Vaginal cream

19

What are the adverse effects associated with azoles? 6

  1. Hepatotoxic
  2. Nausea
  3. Vommiting
  4. Diahorrea
  5. Headache
  6. Skin rash

20

What are the contrai-indications on azole use? 

Pregnancy: teratogenic

21

List the azoles. 5

FICKV

  1. Fluconazole
  2. Itraconazole
  3. Voriconazole
  4. Ketoconazole
  5. Clotriconazole

22

What is the MOA for polyene macrolide antifungals?

Bind to ergosterol and forms pores in the fungal cell membrane

23

List the polyene macrolides 2

  1. Amphotericin B
  2. Nystatin

24

What is the primary indication for amphotericin b?

  1. Drug of choice for most serious systemic infection (broad sprectrum):
  • Systemic candida
  • cryptococcus
  • aspergilus
  • histoplasma
  • blastomyces
  • coccidiosis
  1. Used as induction therapy and then replaced by a newer azole drug of choice once fungal burden is reduced

25

What is the route of administration for amphotericin b? 

IV

26

What are the adverse effects of amphotericin B?  10

  1. NEPHROTOXIC

Adverse effects can be groups as:

Infusion reactions:

  1. Fever
  2. Chills
  3. Headache
  4. Myalgia
  5. Nausea and vommiting and 
  6. Hypotension

Cumulative toxicity:

  1. Renal impairment
  2. Renal tubular acidosis: hypokalaemia and hypomagensaemia 
  3. Anaemia

27

What are the drug interactions? 5

  1. Aminglycosides 
  2. Tenofovir
  3. Ciclosporin
  4. Diuretics
  5. Digoxin

28

What is primary indication for nystatin use?

Superfiicial candidiasis (oral and vaginal)

29

What is the route of administration for nystatin? 4

  1. Topical
  2. Topical oral solution
  3. Vaginal tablet
  4. Vaginal cream

30

What are the adverse effect of nystatin?

unpleasant taste