Antifungals Flashcards
Amphotericin
Polyene group of antifungals
Acts on fungal cell membrane, resulting in loss of intracellular K+, disruption of cellular permeability and transport systems. High affinity for ergosterol, a fungal membrane sterol not found in mammalian cells.
Hypotension
Renal toxicity (80% experience renal issues, most cases reversible)
Hypokalemia
Thrombocytopenia
Anaphylaxis without IgE antibodies
Griseofulvin
Narrow-spectrum
Binds microtubules and interferes with mitosis
Photosensitivity
Caspofungin
Echinocandin
Inhibits 1,3-beta-glucan synthase, which is necessary for structural integrity of the cell wall
IV administration
Anidulafungin
Echinocandin
Inhibits 1,3-beta-glucan synthase, which is necessary for structural integrity of the cell wall
IV administration
Micafungin
Echinocandin
Inhibits 1,3-beta-glucan synthase, which is necessary for structural integrity of the cell wall
IV administration
Hepatotoxicity
Ketoconazole
Azole
Inhibits fungal cytochrome P4503A enzyme, lanosine 14-alpha-demethylase, which prevents ergosterol formation from lanosterol. Impaired replication.
Gynecomastia (issues with testosterone)
Fluconazole
Azole
Inhibits fungal cytochrome P4503A enzyme, lanosine 14-alpha-demethylase, which prevents ergosterol formation from lanosterol. Impaired replication.
Stevens-Johnson syndrome
Itraconazole
Azole
Inhibits fungal cytochrome P4503A enzyme, lanosine 14-alpha-demethylase, which prevents ergosterol formation from lanosterol. Impaired replication.
Stevens-Johnson syndrome
Miconazole
Azole
Inhibits fungal cytochrome P4503A enzyme, lanosine 14-alpha-demethylase, which prevents ergosterol formation from lanosterol. Impaired replication.
Flucytosine
Converted into 5-fluorouracil, inhibiting thymidylate synthase and DNA synthesis
Resistance is likely when used alone, typically used with amphotericin
Neutropenia
Alopecia
Hepatitis
Terbinafine
Inhibits squalene epoxidase, required for synthesizing ergosterol from squalene
Arthralgia
Myalgia
Hepatitis
