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Pharmacology Unit 6 > Antifungals > Flashcards

Flashcards in Antifungals Deck (17)
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1

What are the 4 target types common to antifungals?

Membrane function, ergosterol synthesis, cell wall synthesis, and nucleic acid synthesis

2

What are the molecular targets of cell wall synthesis inhibitors (and their matching drugs)?

Lanosterol demethylase: topical clotrimazole and tolnaftate, systemic fluconazole and terbinafine
Glucan synthesis: systemic caspofungin

3

What is the major topical cell membrane inhibitor? Systemic?

Topical: nystatin
Systemic: amphotericin

4

What is the major nucleoside analog used as an antifungal?

Flucytosine

5

Which topical drug class is broad spectrum? Narrow?

Imidazoles (clotrimazole): Candida and dermatophytes
Allylamines (tolnaftate): Dermatophytes only

6

Which allylamine is used systemically? Why?

Terbinafine for onchomycoses (nail infxn)

7

Memory tool: What are the two broad spectrum antifungal classes and how are they used, topically or systemically?

ImidAZOLES (topical) and triAZOLES (topical and systemic)

8

Which are more toxic imidazoles or triazoles?

Imidazoles - that's why they are topical

9

Triazole and allylamines side effects are centered in what organ?

Liver: hepatotoxicity and CYP inhibition

10

What two organisms are the primary clinical use for caspofungin?

Candida and aspergillus, especially when resistant

11

Which glucan synthesis inhibitor is less toxic than amphotericin B?

caspofungin

12

What is the best treatment for oral thrush?

Clotrimazole troches (lozenges) >> topical nystatin

13

Which two antifungals may be used in compination in the treatment of life threatening fungal infections in immunocompromised hosts?

Amphotericin B and flucytosine

14

When does amphotericin cause fever, chills, and hypotension?

During its infusion delivery

15

When does amphotericin cause decreased GFR, Mg/K wasting, RTA, and normocytic anemia?

After chronic use

16

Flucytosine is deaminated to 5-FU. Why is this not overly toxic to the human host?

the deamination is performed by cytosine deaminase, which is only present in fungi

17

What are common adverse effects of flucytosine?

sloughing of GI mucosa, centrilobular hepatitis, and bone marrow cytopenias