Antifungal chemotherapy Flashcards Preview

Year 2 Pharmacology > Antifungal chemotherapy > Flashcards

Flashcards in Antifungal chemotherapy Deck (45):
1

what are the opportunistic fungal infections?

candida
aspergillus
cryptococcus

2

onychomycosis causes what type of fungal infection?

cutaneous / subcutaneous

3

dimorphic fungi usually cause what type of infection?

systemic

4

what are the unique targets for fungi?

fungal cell membrane (ergosterol, ergosterol synthesis)

fungal cell wall (glucans)

5

what is the MOA of amphotericin B?

weaken membrane function (bind ergosterol)

forms amp B containing pores to alter membrane permeability

6

caspofungin targets what fungal component / process?

cell wall synthesis

7

5-flurocytosine targets what fungal component / process?

nucleic acid synthesis

8

what are the systemically active drugs used for systemic infections?

polyenes
azoles
flucytosine
echinocandins

9

what is the most widely used drug in treating systemic mycoses?

amphotericin B

10

what drug has the broadest spectrum of action and is useful against systemic fungal infections?

amphotericin B

11

when does amphotericin B resistance occur?

decrease in membrane ergosterol concentration

modification of target - reduced affinity

12

what is the tissue penetration profile of amphotericin B?

widely distributed into most tissues but poor CNS penetration

13

what is the most common and most serious long term toxicity associated with amphotericin B?

nephrotoxicity

14

what is done to make amphotericin B less toxic? why?

liposomal packaged formulations

less interaction of drug with mammalian cell membrane

15

what is the MOA of the azoles?

inhibit ergosterol synthesis - bind to enzyme responsible for converting lanosterol to ergosterol

causes leaky membranes

16

what are the clinical uses for the azoles?

pathogenic yeast
systemic mycoses
dermatophytes

17

what are the adverse reactions of the azoles?

minor GI disturbances
interaction with hepatic cyp450s

18

what are the MORs of the azole drugs?

efflux pumps
mutations in target enzyme
decreased ergosterol content in cell membrane

19

which azole has the highest therapeutic index of all the azoles?

fluconazole

20

fluconazole is the agent of choice for what conditions?

candidiasis
cryptococcosis
coccidiomycosis

21

what is the drug of choice for candidiasis, cryptococcosis, and coccidiomycosis?

fluconazole

22

what is the drug of choice for blastomycosis, coccidiomycosis, histoplasmosis, sporotrichosis, and dermatophyte?

itraconazole

23

itraconozole is the drug of choice for what conditions?

blastomycosis
coccidiomycosis
histoplasmosis
sporotrichosis
dermatophyte

24

what drug has replaced amphotericin B as treatment of choice for aspergillosis?

voriconazole

25

what is the drug of choice for aspergillosis?

voriconazole

26

what azole has the highest spectrum of activity?

posaconazole

27

what are the main indications for posaconazole?

aspergillus
agents of mucormycoses

28

flucytosine is used as part of combination therapy for what organisms?

cryptococcus
candida

29

what is the MOA of flucytosine?

interferes with both protein and nucleic acid synthesis

30

flucytosine is effective against which organisms?

cryptococcal infections

31

what test is used to identify cryptococcus neoformans?

india ink stain

32

the india ink stain is used to identify which organism?

cryptococcus neoformans

33

which drug is effective against cryptococcus neoformans and meningitis?

flucytosine

34

what is the main toxicity of flucytosine?

bone marrow suppression

35

what is the general MOA of the echinocandins? what dictates their selectivity?

inhibit fungal cell wall synthesis

attack beta glucans (not present in mammalian cells)

36

what are the main indications for the echinocandins?

candida and aspergillus

37

what are the oral systemic drugs for cutaneous and mucocutaneous infections?

griseofulvin
allylamines (terbinafine)

38

griseofulvin and allylamines (terbinafine) are used for what purposes, generally?

cutaneous and mucocutaneous infections

39

what drug is used orally for dermatophyte infections?

griseofulvin

40

what specific infection is griseofulvin used for?

dermatophyte

41

what is the MOA of the allylamines?

ergosterol synthesis inhibitors

42

what is the first line treatment for onychomycosis?

terbinafine (allylamine)

43

terbinafine is the first line treatment for what condition?

onychomycosis

44

what are the topical antifungal classes?

polyenes
azoles
allylamines

45

nystatin is useful against what type of infection?

candida

Decks in Year 2 Pharmacology Class (70):