Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PHARM3 > Antifungal-Table 1 > Flashcards

Antifungal-Table 1 Flashcards

(77 cards)

Start Studying
1
Q

What are fungi?

A

Eukaryotic organisms that live as saprophytes or parasites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the fungal infections?

A

Mycoses
Superficial- skin, hair, nails, mucous membranes
Systemic- deep tissues and organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the 4th common cause of septicemia?

A

Fungal infections in the immunosuppressed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 groups of fungi that cause disease?

A

Mold, true yeast, yeast-like fungi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What results in fungal pathology?

A
  • Mycotoxin production
  • Allergenicity/inflammatory reactions
  • Tissue invasion
  • Opportunistic fungal infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What should you base your selection of antifungal therapy off of?

A

Extent and type of infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which infections get topical? Systemic?

A

Topical: superficial and cutaneous
Systemic: follicular, nail, widespread (>20%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the “drying effect” and how are the formulas ranked?

A

If it’s wet dry it, if it’s dry wet it

Gel>lotion/solution>cream>ointment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When are gels/lotions used? Creams? Ointment?

A
  • moist hary or intertriginous areas
  • scaling and non-oozing lesion
  • hyperkeratotic areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are powders used?

A

Adjuncts

Can use as an antifungal powder If absorbent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the polyene abx?

A

Amphotericin B and Nystatin

Flucytosine, Griseofulvin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the MOA of nystatin and ampho B?

A

Bind to ergosterol in the fungal cell membrane and forms a pore- makes them cidal
This leads to fatal damage- only in fungal cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does resistance develop against nystatin?

A

active transport mechanism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is resistance infrequent with AmphoB?

A

Decreased ergosterols in membrane

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the ROA for ampho and nystatin?

A

Ampho B- IV

Nystatin- topical, vaginal troche, suspension for oral mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What should you prep with when doing an ampho b IV?

A

Liposomal prep- less renal and infusion toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When is ampho B indicated?

A

Broad spectrum indicated in potentially fatal systemic infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are potentially fatal systemic infections?

A

Candida albicans, Histoplasma capsulatum, Crytococcus neoformans, Coccidoices immites, Blastomyces dermatitides, aspergillis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When is nystatin indicated?

A

To suppress candidiasis on the skin and mucous membranes- oral and vaginally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are ADRs of ampho B?

A

Hypotension, anemia (suppresses RBC production), nephrotoxicity, thrombophlebitis (add heparin), fever/chills (premedicate; abort with demerol), allergic reactions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the ADRs of nystatin?

A

N/V/D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the MOA of flucytosine?

A

Inhibits synthesis of fungal pyrimidines

Static

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the ROA of flucytosine?

A

PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When is flucytosine indicated?

A

In combo with AMphoB to tx systemic candidiasis and Cryptococcus meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the ADRs of flucytosine ?
N/V/D, rare hepatotoxicity, thrombocytopenia, neutropenia, bone marrow suppression
26
What is the MOA of Griseofulvin?
Static Binds to fungal microtubules disrupting mitotic spindles Selectively concentrated in keratin
27
What is the duration of therapy for Griseofulvin?
Depends on the rate of replacement of healthy skin or nails- anywhere from 6-12 mo
28
When is Griseofulvin indicated?
DOC in kids for widespread dermatophyte or intractable dermatophyte infection of nails
29
What are the ADRs of Griseofulvin?
Fever, HA, mental confusion, rashes, GI disturbance
30
What are the drug interactions of Griseofulvin?
P450 inducer- barbiturates, OCP- need to use other bc method, warfain High fat meals increase absorption and there are potential intoxicating effects with alcohol
31
What are the Azoles Imidazoles?
``` Ketoconazole, Clotrimazole (Lotrimin, Mycelex) Miconazole (Monistat, Desenex) Terconazole (Terazol) Butoconazole (Femstat 3) ```
32
What is the MOA of ketoconazole?
Predominantly fungistatic but can be cidal dose dependent | Inhibits C14 P450 enzyme – blocks demethyl of lanosterol to ergosterol which disrupts the membrane
33
What is ketoconazole active against?
* Histoplasma, blastomyces, candida, coccidioides | * NOT aspergillus
34
How does ketoconazole affect the human host?
Inhibits human steroid synthesis leading to decreased testosterone and cortisol production
35
How is ketoconazole administered?
PO- needs gastric acid for dissolution | Only systemic IV option?
36
Does ketoconazole enter the CSF?
No
37
What are the ADRs of ketoconazole?
- N/V, anorexia - Endocrine effects: gynecomastia, impotence, irreg menses - Teratogenic
38
What are the drug interactions of Ketoconazole?
P450 inhibitor
39
What leads to resistnace with keto?
- Mutation in C-14 alpha-demethylase gene leading to decreased azole binding - Ability to pump azole out of cell
40
How are the other Azoles Imidazoles administered?
TOPICAL ONLY- severe toxicity if IV
41
What are the indications for the other Azoles Imidazoles?
Contact dermatitis, vulvar irritation, and edema
42
What is topical miconazole a potent inhibitor of?
Warfarin metabolism
43
What are the Azole triazoles?
Fluconazole, itraconazole, voriconazole, posaconazole,
44
What is the MOA of fluconazole?
Same of keto
45
How is fluc different from keto?
Lacks endocrine side effects and can penetrate the CSF
46
What is fluconazole the DOC for?
Cryptococcus neoformans, candidemia and coccidioidomycosis; effective against all forms of mucocutaneous candidiasis
47
When is fluconazole used prophylactically?
In immunocompromised pts
48
What is the ROA of flucon?
PO or IV
49
What are the ADRs of flucon?
N/V, rash
50
What is fluco an inhibitor of?
Moderate inhibitor of CYP3A4 (cyclosporin, lovastatin) | strong inhibitor of CYP2C9 (phenytoin, warfarin)
51
Should flucon be used in preggos?
NO it is teratogenic unless in cream form
52
Is itraconazole static or cidal?
Statis- lacks endocrine side effects
53
When is itraconazole the DOC?
for tx of blastomycosis, aspergillis, sporotrichosis, paracoccidioidomycosis, histoplasmosis
54
What is the ROA for itraconazole?
PO- needs acid for dissolution
55
What are the ADRs of itraconazole?
N/V, rash, hyPOKalemia, HTN edema, HA | AVOID IN PREGGO
56
What are the drug interactions pf itra
Strong inhibitor and substrate of CYP3A4
57
When is itraconazole CI?
with lovastatin, simvastatin, midazolam, triazolam. May decrease oral contraceptives effectiveness and increase digoxin levels.
58
What is the ROA of Voriconazole?
PO or IV
59
When is Voriconazole used?
Reserved for severe infection due to csf and tissue penetration Invasive aspergillosis and serious infections caused by Scedosporium apiospermum and fusarium species
60
What are the ADRs of Voriconazole ?
similar to other azoles; transient visual disturbance occurring shortly after dose
61
What are the drug interactions of Voriconazole?
Inhibitor of CYP2C18, 2C9, 3A4. Contraindicated in patients taking rifampin, phenobarbital, carbamazepine. Dose adjustments may be required with statins, benzodiazepines, warfarin.
62
what are the specific requirements for taking posconazole?
Oral suspension and needs to be taken with a high fat meal for adequate absorption
63
When is posconazole more effective?
treating a number of fungal infections in immunosuppressed patients (myelogenous leukemia, stem cell transplantation, refractory esophageal candidiasis).
64
What are the Allylamines?
Terbinafine
65
What is the MOA of Terbinafine?
CIDAL - Prevents ergosterol synthesis by inhibiting the enzyme squalene oxidase - Decreased synthesis of ergosterol - Squalene accumulation leading to membrane disruption and cell death
66
What is the PK of Terbinafine?
Lipophilic-so penetrates superficial tissues and fingernails | ½ life 200-400 hours
67
What is the ROA of Terbinafine?
PO
68
What is the duration of tx for Terbinafine?
About 3 months
69
When is Terbinafin indicated?
Active against dermatophytes and Candida albicans
70
What are the ADRs of Terbenafine?
- HA, N/D, rash, taste and visual disturbances - Rare but serious adverse effects: - Cholestatic jaundice, blood dyscrasias, Steven-Johnson syndrome
71
What labs need to be done if you put a pt on Terbenafine?
Baseline LFT’s and CBC | •Repeat every 4-6 weeks during therapy
72
What are tx options for onychomycosis?
1) terbinafine 1st line agent (not candida) | 2) itraconazole alternative 1st line therapy,(preferred for candida infections)
73
What are the echinocandins?
Caspofungin, Micafungin, Anidulafungin
74
When is Caspofungin used?
2nd line therapy for those who have failed amphoB or itraconazole – super expensive so limited to aspergillus and candida species
75
When is micafungin used?
Esophageal candidiasis
76
When is micafungin used as prophylaxis?
invasive Candida infections in patients undergoing hematopietic stem cell transplantation
77
What are the ADRs of the echinocandins?
Fever, rash, nausea, phlebitis, flushing rxn

PHARM3 (16 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions