Anti-infective Drugs 1

Question 1

Antifungal Drugs: Polyene Antibiotics (3)

Answer 1

1. Amphotericin B
2. Natamycin
3. Nystatin

Question 2

Antifungal Drugs: Azole Derivatives (6)

Answer 2

1. Clotrimazole
2. Fluconazole
3. Itraconazole
4. Ketoconazole
5. Voriconazole
6. Posaconazole

Question 3

Antifungal Drugs: Allylamine Drugs (2)

Answer 3

1. Terbinafine

2. Naftifine

Question 4

Antifungal Drugs: Echicocandin Drugs (1)

Answer 4

Capsofungin

Question 5

Antifungal Drugs: Other Antifungals (4)

Answer 5

1. Ciclopirox
2. Flucytosine
3. Griseofulvin (Disulfiram like action)
4. Tolnaftate

Question 6

Antifungal Drugs: Polyenes - Amphotericin B: Buzzword

Answer 6

IV for SERIOUS and LIFE-THREATENING INFECTIONS

Aspergillus
Candidda
Cryptococcus
Histoplasma

Question 7

Antifungal Drugs: Polyenes - Amphotericin B: MOA

Answer 7

Binds to ergosterol

Question 8

Antifungal Drugs: Polyenes - Amphotericin B: Side Effects 1 (5)

Answer 8

1. Amphoterrible Dose Dependent
2. Nephrotoxicity
3. Hypokalemia
4. Normochromic normocytic anemia
   * Lipid formulations of Amphotericin B cause less renal toxicity

Question 9

Antifungal Drugs: Polyenes - Amphotericin B: Side Effects 2 and Premedicate with?

Answer 9

Infusion dependant
Flu-like symptoms

Premeidicate patients with antipyretic, antihistaminic, and anti-emetic agents

Question 10

Antifungal Drugs: Polyenes - Amphotericin B: Distribution (2)

Answer 10

1. Low penetration into CSF

2. No BBB crossing (given intrathecally)

Question 11

Antifungal Drugs: Polyenes - Amphotericin B: Drug Interactions

Answer 11

Synergistic with fluocytosine

Question 12

Antifungal Drugs: Polyenes - Amphotericin B: Rx of resistant?

Answer 12

Cryptococcus and cnadidiasis

Question 13

Antifungal Drugs: Polyenes - Amphotericin B: Resistance leads to?

Answer 13

Decreased ergosteral levels

Question 14

Antifungal Drugs: Polyenes - Nystatin Use

Answer 14

Used topically for candidiasis

Too toxic for systemic use

Question 15

Antifungals: Azoles - Buzzword (5)

Answer 15

1. Ketoconazole
2. Fluconazole
3. Itraconazole
4. Clotrimazole
5. Miconazole

Question 16

Antifungal Drugs: Azoles - MOA

Answer 16

Block synthesis of ergosterol by inhibiting 14-alpha demethylase in the fungal P450 complex

Question 17

Antifungal Drugs: Azoles - Resisance

Answer 17

Decrease intracellular levels of drugs

Question 18

Antifungal Drugs: Azoles - Indications (4)

Answer 18

1. Given PO
2. Candidiasis and coccidiomycosis (respiratory)
3. Paracoccidiomycosis
4. Blastomycosis and histoplasmosis

Question 19

Antifungal Drugs: Azoles - Clotrimazole and Miconazole given and rx of?

Answer 19

Given topically

Rx of candida and dermatophytic infections

Question 20

Antifungal Drugs: Azoles - Ketaconazole Use (3)

Answer 20

Gynecomastia and decrease libido

Menstrual irregularities

Seborrheic dermatitis

Question 21

Antifungal Drugs: Azoles - Kinetics

Answer 21

1. Fluconazole penetrates CSF rx of cryptococcal meningitis
2. Itraconazole: No CSF
   Rx of blastomycosis, histoplasmomsis, and onychomycosis

Question 22

Antifungal Drugs: Azoles - Absorption increased by?

Answer 22

Food

Question 23

Antifungal Drugs: Azoles - Fluconazole and itraconazole available by?

Answer 23

IV

Question 24

Newly Approved Triazole: Voriconazole Type, Rx, and

Answer 24

IV and Oral

Rx of invasive aspergillosis and candidiasis

Question 25

Newly Approved Triazole: Voriconazole Side Effects

Answer 25

Visual disturbances

Question 26

Newly Approved Triazole: Posaconazole Type and USe

Answer 26

Oral Propphylaxis in neutropenic and immunosuppressed patients

Question 27

Newly Approved Triazole: Posaconazole Side Effects

Answer 27

Hepatic failure and QT prolongation

Question 28

Antifungals: Echicocandin Drugs (New) MOA

Answer 28

Inhibits fungal cell wall synthesis

Question 29

Antifungals: Echicocandin Drugs - Caspofungin

Answer 29

Rx of candida species and aspergillus species Only given IV with few adverse effects with amphotericin B

Question 30

Antifungals: Echicocandin Drugs - Caspofungin Adverse Effects (4)

Answer 30

1. Headache 2. Fever 3. Phlebitis 4. Abnormal liver function

Question 31

Antifungals with Limited Indications: Griseofulvin MOA

Answer 31

Disruption of mitotic spindle by interfering with microtubules

Question 32

Antifungals with Limited Indications: Griseofulvin Rx of?

Answer 32

Tinea cruris (jock itch)

Question 33

Antifungals with Limited Indications: Griseofulvin Side Effects

Answer 33

Increase effects of alcohol

Question 34

Antifungals with Limited Indications: Griseofulvin Contraindicated in?

Answer 34

Intermittent porphyria

Question 35

Antifungals with Limited Indications: Terbinafine MOA

Answer 35

Inhibits squalene epoxidase

Question 36

Antifungals with Limited Indications: Terbinafine rx of?

Answer 36

Onychomycosis (nail fungal infection)

Question 37

Antifungals with Limited Indications: Terbinafine Side effects

Answer 37

Elevated liver function tests

Question 38

Antifungals with Limited Indications: Flucytosine MOA

Answer 38

5 FC ----> 5FU (via fungal cytosine deaminase) 5 FU --> 5-fluorodeoxyuridine MP --> *inhibits thymidylate synthetase --> decrease thymind

Question 39

Antifungals with Limited Indications: Flucytosine Used with what in severe candidiasis?

Answer 39

Amphotericin B

Question 40

Antifungals with Limited Indications: Flucytosine Side Effects (3)

Answer 40

1. Decrease bone marrow 2. Leukopenia and thrombocytopenia 3. GI: Severe enterocolitis, hepatitis

Question 41

Antifungals with Limited Indications: Ciclopirox Rx of? (3) and Use

Answer 41

1. Dermatophytes 2. C. Albicans 3. M. furfur Used topically

Question 42

Antifungals with Limited Indications: Tolnaftate Rx of? And used

Answer 42

Rx of tinea versicolor and mild dermatophyte Used topically