Antifungal Drugs

Question 1

Mechanism of actions of drugs:

Answer 1

Cell membrane permeability
Cell membrane synthesis
Direct tissue target
Nucleic acid analogue
Cell wall synthesis

Question 2

Primary antifungal drugs
For severe cases of mycoses
Derived: Streptomyces nodusos

Answer 2

Amphotericin B (AMB)

Question 3

Admin.of AMB

Answer 3

Intravenous (IV)

Question 4

Therapeutic use of AMB

Answer 4

Systemic mycoses
Systemic candidiasis
Cryprococcal meningitis
Invasive aspergillosis 
Sporothricosis
Mucormycosis

Question 5

Adverse effect of AMB

Answer 5

Phlebitis
*Nephrotoxic (dose dependent)
    Azotemia (increase bun and crea)
Fever
Anemia

Question 6

First antibiotic against fungi

Answer 6

Nystatin

Question 7

Admin.of nystatin

Answer 7

Oral
Topical
Suppository

Question 8

Therapeutic used of Nystatin (Candidiasis)

Answer 8

Vaginal (suppository)
Oral
Esopangeal
Skin

Question 9

Example of drugs under cell membrane permeability

Answer 9

AMB

Nystatin

Question 10

Example of Azole drugs

Answer 10

Imidazole

Triazole

Question 11

Inhibit the action of

CYTOCHROME P450 DEPENDENT-14-alpha-DEMETHYLASE

Answer 11

Azole dugs ( imidazole, triazole )

Question 12

Prevent oxidation of squalene epoxidase

Answer 12

Allylamines drugs:
Naftifine
Terbinafine
Amorilfine
Butenafine

Question 13

Under imidazole drug w/c is most toxic

Answer 13

Ketoconazole

Question 14

Therapeutic use of ketoconazole

Answer 14

Chronic mucocutaneous candidiasis

Question 15

Adverse effect of ketoconazole

Answer 15

Hepatotoxic
Male: dec. Testosterone component
Enlargement of breast (gynecomastia)

Question 16

Therapeutic use of miconazole and clotrimazole

Answer 16

Tinea versicolor
Dermatophytosis
Cutaneous candidiasis

Question 17

New version of drug that is less toxic and none more effective

Answer 17

Triazole

Question 18

Admin.of fluconazole

Answer 18

Oral

Question 19

Therapeutic use of fluconazole

Answer 19

Candidiasis (most commom opportunistic yeast infection)

Cryptococcal dx

Question 20

Alternative of AMB

Answer 20

Itraconazole

Question 21

Admin.of itraconazole

Answer 21

Oral

Question 22

Therapeutoc use of itraconazole

Answer 22

Systemic fungal infection

• blastomycosis
• histoplasmosis

Subcutaneous

• Sporothricosis
• Chromomycosis

Invasive aspergillosis
Candidiasis

Question 23

Admin.of Voriconazole (Vori) / Dosaconazole (Dosa)

Answer 23

Oral

Topical

Question 24

Therapeutic use of voriconazole/ dosaconazole

Answer 24

Candidiasis

Aspergillosis

Question 25

Admin.and therapeutic use of Naftifine

Answer 25

Oral Dermatophytosis

Question 26

Alternative drug for griseofulvin Dermatophytosis (nail infection)

Answer 26

Terbinafine

Question 27

Adverse effect of terbinafine

Answer 27

Gastrointestinal irritation

Question 28

Griseofulvin derived from:

Answer 28

Penicillum griseofulvin

Question 29

Therapuetic use and adverse effect of griseofulvin:

Answer 29

TU: Dermatophytosis AE: Leukopenia Neutripenia

Question 30

Drug under direct tissue target

Answer 30

Griseofulvin

Question 31

Drug under nucleic acid analogue

Answer 31

Flucytosine (5-FC)

Question 32

Admin. of flucytosine

Answer 32

Oral / IV together with AMB

Question 33

Therepeutic use of flucytosine

Answer 33

Cryptococcal meningitis | Candidiasis

Question 34

Adverse effect of flucytosine

Answer 34

``` Leukopenia Thrombocytopenia Aplastic anemia Pancytopenia Increase liver enzyme ```

Question 35

Drigs under cell wall synthesis

Answer 35

Caspofungin, Polyoxin D Anidulafungin, Micafungin Nikkomycin Z

Question 36

Inhibit glucan synthesis | For candidiasis, aspergillosis

Answer 36

Anidulafungin, micafungin

Question 37

Inhibit chitin synthesis

Answer 37

Nikkomycin Z

Question 38

Factors to consider in the selection of drugs:

Answer 38

1. Threat of morbidity/mortality pose by the infection 2. Immune status of the px 3. Toxicity of the drugs 4. Probable activity of the antifungal agent agents the fungus