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Pharmacology > Antifungal > Flashcards

Antifungal Flashcards

1
Q

First line treatment for onychomycosis

A

Terbinafine

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2
Q

First line treatment for tinea capitis and ringworm

A

Terbinafine

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3
Q

First line treatment for blastomyces

A

Itraconazole

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4
Q

First line treatment for cryptococcal meningitis in AIDS

A

FLUconazole
FLU easily penetrates BBB

Also prophylactic

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5
Q

First line treatment for inVasive aspergillosis

A

Voriconazole

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6
Q

First line treatment for invasive mucormycosis

A

Isavuconazole

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7
Q

First line treatment for ringworm and Trichophyton (athlete’s foot)

A

Miconazole

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8
Q

First line treatment for oral/vaginal thrush

A

Miconazole

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9
Q

Amphotericin B

A

Amphoteric polyene macrolide
Binds ergosterol and SEQUESTERS it —> death

Systemic

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10
Q

Amphotericin B indications

A

Broadest spectrum
Candida
Cryptococcus
Blastomyces
Histoplasma

Leishmania

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11
Q

Amphotericin B side effect

A

Nephrotoxic
Fever and chills

Azotemia if C-AMB

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12
Q

C-AMB and ABCD

A

Colloidal amphotericin B
More nephrotoxic

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13
Q

L-AMB and ABLC

A

Liposomal amphotericin B
More expensive

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14
Q

Notably hepatotoxic triazole

A

Itraconazole

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15
Q

Notably teratogenic triazole

A

Voriconazole

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16
Q

First line treatment for candida in oropharynx

A

Posaconazole (suspension)

17
Q

First line treatment for Leishmaniasis

A

Amphotericin B

18
Q

Terbinafine

A

Inhibits squalene epoxidase —> less ergosterol synthesis
Alters cell membrane permeability

19
Q

Terbinafine indications

A

Onychomycosis
Tinea capitis
Ringworm

20
Q

Triazole MOA

A

Inhibit 14-a-sterol demethylase
—> impair biosynthesis of ergosterol = more permeable
AND
—> accumulate toxic 14a-methyl-3,6-diol (ERGII gene)

Resistance from ERGII genes

21
Q

Itraconazole

A

Triazole

Blastomyces
Invasive aspergillosis
More
HEPATOTOXIC and GI

22
Q

Why amphotericin B before triazoles?

A

Triazoles are very hepatotoxic

23
Q

Voriconazole

A

Triazole

Invasive ASPERGILLOSIS***1
Candida
May cause visual/auditory hallucinations

24
Q

Fluconazole

A

Triazole

CYRPTOCOCCAL MENINGITIS**1
Candida
Coccidioides

25
Q

Posaconazole

A

Triazole

Candida

26
Q

Isavuconazole

A

Triazole

Invasive MUCORMYCOSIS**1
Invasive aspergillosis

27
Q

Ketoconazole

A

Imidazole, topical

Largely replaced by itraconazole

28
Q

Miconazole

A

Imidazole, topical

Ringworm
Tricophyton (athlete’s foot)
Oral/vaginal thrush

29
Q

What medication is an echinocandin?

A

Caspofungin

30
Q

Caspofungin

A

Echinocandin
Inhibit 1,3-b-d-glucan synthesis —> cell wall rupture
IV
Invasive candida & aspergillus

31
Q

Caspofungin side effects

A

Bloating or swelling face, arms, hands, feet
Blue lips, fingernails, skin
Less urine
Difficulty breathing

32
Q

Nystatin

A

Binds ergosterol —> sequester —> death
TOPICAL
CANDIDA: skin, vagina, mouth, esophagus

33
Q

Why isn’t nystatin given IV?

A

Too toxic

34
Q

Nystatin is used as prophylaxis for:

A

AIDS patients with fungal infection risk

Pharmacology (13 decks)

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