Anti-Mycotics

Question 1

Name some antimycotic drugs

Answer 1

Echinocandins - Caspofungin, Micafungin

Allylamines - Terbinafine, Naftifine

Flucytosine

Azoles - Fluconazole, Ketoconazole

Griseofulvin

Amphotericin

Nystatin

Question 2

What anti-mycotic drugs inhibit ergosterol synthesis in fungi?

Answer 2

Allylamines - Terbinafine, Naftifine

Azoles - Fluconazole, Ketoconazole

Inhibition of ergosterol (a component of fungal cell membranes) results in fungal cell death

Question 3

What drug inhibits fungal cell mitosis?

Answer 3

Griseofulvin - Interferes with microtubule assembly and mitosis of fungal cells, used topically in tinea pedis and orally in dermatophyte infections of the skin, scalp, hair and nails where topical therapy has failed

Question 4

What drug inhibits fungal DNA synthesis?

Answer 4

Flucytosine - Once converted into its active metabolite (5-fluorouracil), it is incorporated into fungal RNA, inhibiting protein synthesis and disrupting DNA synthesis. Is used in systemic infections through IV infusion, or as an adjunct to amphotericin B in the treatment of cryptococcal meningitis, also via IV infusion

Question 5

What drugs inhibit fungal cell wall synthesis?

Answer 5

Echinocandins - Caspofungin, Micafungin

They inhibit synthesis of glucan in the fungal cells wall - has a synergistic effect with amphotericin (combined, the two drugs produce a greater effect than they would individually)

Question 6

Name 4 serious systemic fungal infections

Answer 6

Candidiasis

Cryptococcal meningitis

Fungal Endocarditis

Pulmonary Aspergillosis (Main cause of death in patients receiving a bone marrow transplant)

Question 7

What three factors have caused the incidence of serious systemic fungal infections to increase in the last 40 years?

Answer 7

Increased use of antibiotics - Antibiotics can also destroy non-pathogenic bacteria that have the ability to inhibit certain fungi species

AIDs

The increased use of immunosuppressant drugs