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Pharmacology Lockdown > Anti-fungals > Flashcards

Anti-fungals Flashcards

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1
Q

What is the MOA for azole antifungal? 3

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

What is the primary indication for flucanazole use? 3

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

What are the routes of administration for flucanazole? 2

A
  1. IV
  2. Oral
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4
Q

What adverse effects are assoicated with fluconazole? 3

A
  1. Nausea
  2. Vommiting
  3. Rash
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5
Q

What PK are important to fluconazole?

A
  1. Good CSF penetration
  2. Least effect on hepatic enzymes
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6
Q

What is the primary indication for itraconazole? 4

A
  1. Oropharyngeal and oesophageal candidiasis
  2. Dematophytes
  3. Onychomycosis
  4. Dimorphic fungi infecs
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7
Q

What is the route of administration for itraconazole?

A

Oral/ oral solution

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8
Q

What are the adverse effects of itraconazole?

A

Hepatotoxic

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9
Q

What are the drug interaction for itraconazole? 3

A
  1. Inhibit P450 enzymes
  2. antacids
  3. PPI
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10
Q

PK notes on itraconazole?

A

Requires acid medium for absorption; avoid antacids

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11
Q

What is primary indication for voriconazole?

A
  1. Aspergiliosis
  2. Candidiasis
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12
Q

What is the route of administration for voriconazole?

A

oral

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13
Q

What are the adverse effects associated with voriconazole? 3

A
  1. Visual disturbance
  2. Hepatotoxic
  3. PS dermatitis
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14
Q

What is the primary indication for ketoconazole?

A

Dermatophytes:

  1. Seborrhoeic dermatitis
  2. Pityriasis vericolor
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15
Q

What is the route of administration for ketoconazole?

A

Topical

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16
Q

What is the indication for clotrimazole? 3

A
  1. Dermatophytes
  2. Oral candidiasis
  3. Vaginal candidiasis
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17
Q

PK about clotrimazole

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A

clotrimazole lozenges are pleasent tasting alt to nyastatin

18
Q

What are the routes of administration for clotrimazole? 3

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A
  1. Topical
  2. Lozenges
  3. Vaginal cream
19
Q

What are the adverse effects associated with azoles? 6

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A
  1. Hepatotoxic
  2. Nausea
  3. Vommiting
  4. Diahorrea
  5. Headache
  6. Skin rash
20
Q

What are the contrai-indications on azole use?

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A

Pregnancy: teratogenic

21
Q

List the azoles. 5

FICKV

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A
  1. Fluconazole
  2. Itraconazole
  3. Voriconazole
  4. Ketoconazole
  5. Clotriconazole
22
Q

What is the MOA for polyene macrolide antifungals?

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A

Bind to ergosterol and forms pores in the fungal cell membrane

23
Q

List the polyene macrolides 2

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A
  1. Amphotericin B
  2. Nystatin
24
Q

What is the primary indication for amphotericin b?

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A
  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
31
What is the MOA of echinocandins?
Inhibit fugal cell wall synthesis by inhbiting D-glucan
32
List the echinocandins. 3
1. Capsofungin 2. Micafungin 3. andiulafungin
33
What are capsofungin, anidulafungin and micafungin primary inidcations?
Capsofungin: candidiasis andulafungin and micafungin: invasive candiasis
34
What is the route of administration for capsofungin, andulafungin and micafungin?
IV
35
What PK notes on capsofungin?
Minor GIT effects, most well tolerated.
36
What is the MOA of allyl amine?
Inhibit ergosterol synthesis by inhibiting squalene epoxidase. This disrupts fungal cell wall integrity
37
List the allyl amine
Terbinafine
38
What are the primary indications for terbinafine use? 3
1. Onchomychosis (only treated with oral agents) 2. Dermatophytosis (tinea pedis, cruris, corporis) 3. Candida albicans
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Pharmacology Lockdown (2 decks)

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