Antifungals Flashcards Preview

Pharmacology > Antifungals > Flashcards

Flashcards in Antifungals Deck (37):
1

Antifungals that don't work on the cell wall?

Griseofulvin and flucytosine

2

Systemic fungal infection DOC

amphotericin B

3

Amphotericin B (Fungizone) MOA

Interacts with ergosterol within the membrane to create a pore that leads increased permeability and to depolarization. Fungicidal.

4

Amphotericin B Toxicity

NEPHROTOXIC (slow renal excretion).

5

Amphotericin B infusion toxicity

immediate during infusion. Chills, fever, muscle spasm, vomiting, HA.

6

Flucytosine (ancobon) MOA

Enters the cell. Is converted into 5-fluorouracil and interrupts DNA and RNA synthesis. Conversion happens in fungal and bacterial cells.

7

Flucytosine kinetics

Oral. Enters the CSF.

8

Amphotericin B kinetics

Broad spectrum. IV. Poor CNS penetration.

9

Cryptococcus infections DOC

Flucytosine with amphotericin B

10

Flucytosine toxicity

renal, bone marrow depression (anemia, leukopenia, thrombocytopenia),hepatotoxicity.

11

Azoles (4)

ketoconazole, fluconazole, voriconazole, itraconazole

12

Azoles MOA

inhibit the production of ergosterol. Causes an accumulation of toxic intermediates and increases membrane permeability which inhibits fungal growth. Fungistatic.

13

Ketoconazole toxicity

Inhibits P450s (drug interactions), gynecomastia.

14

Fluconazole kinetics

oral/IV. Renal elimination. Penetrates the CSF.

15

Antifungals that penetrate the CSF?

Fluconazole and flucytosine.

16

Fluconazole toxicity

Less drug interactions than the others

17

Aspergillus DOC

Voriconazole with amphotericin B

18

Voriconazole toxicity

Metabolized by and inhibits P450s mainly CYP2C19 (A LOT of drug interactions), Visual impariment.

19

Itraconazole toxicity

potent inhibitor or CYP3A4

20

Echinocandins (3)

Caspofungin, Micafungin, Anidulafungin

21

Echinocandins MOA

inhibits sythesis of cell wall component called beta (1,3)-D-glucan which is not present in mammalian cells. "penicillin of antifungals" Fungicidal.

22

Caspofungin uses

treatment of invasive aspergillosis in refractory patients. Also for esophageal candidiasis.

23

Caspofungin toxicity

Less drug interactions!

24

Griseofulvin (fulvicin U/F) MOA

enters the cell and binds to the microtubules to destroy the mitotic spindle. Fungistatic. Binds to keratin to prevent new skin infections.

25

Onychomycosis DOC

Griseofulvin

26

Griseofulvin kinetics

used for dermatophytes. Oral only.

27

Griseofulvin toxicity

headache

28

Griseofulvin contraindications

acute intermittent porphyria, hepatocellular failure.

29

Terbinafine (lamisil) MOA

interferes with sterol sythesis. oral or topical.

30

Terbinafine use

effective against onychomycosis but not the DOC

31

Nystatin (myostatin) MOA

polyene antibiotic. Creates pores in the membrane similar to amphotericin B.

32

Nystatin Uses

oral or topical for candida infections.

33

Naftifine (Naftin)

OTC for athletes foot/jock itch

34

Tolnaftate (tinactin)

OTC for athletes foot/jock itch

35

Tioconazole (vagistat)

OTC azole

36

Miconazole (monistat)

OTC azole

37

Clotrimazole (Lotrimin)

OTC azole. Lozenge for candidal infections.