Antifungals Flashcards Preview

MS2 Unit 6 Pharm > Antifungals > Flashcards

Flashcards in Antifungals Deck (21):
1

what are the three major categories of pathogenic fungus

yeast, molds, other (endemic mycoses, pneumocystis jiroveci)

2

what can you target on the fungal structure?

cell walls made of ergosterol. Beta 1,3 glucan synthase, an enzyme that makes cell walls

3

list the 4 triazole antifungals

fluconazole, itraconazole, posaconazole, voriconazole

4

triazole mechanism of action

impede ergosterol synthesis through direct inhibition of P450 dependent enzyme 14-alpha-sterol-demthylase. stops fungal growth

5

what is the most potent triazole

posaconazole

6

triazole adverse effects

pretty safe. liver enzyme abnormalities, monitor if long term treatment. GI side effects. Voriconazole causes visual disturbances

7

triazole drug interactions

all triazoles are substrates and potential inhibitors of CYP450. important to assess for drug interactions! fluconazole has lowest drug interaction potency

8

what does fluconazole treat

susceptible candidiasis. severe thrush/candidiasis.

9

what does itraconazole treat

secondary treatment and prophylaxis of systemic histoplasmosis

10

what does voriconazole treat

invasive aspergillosis

11

what does posaconazole treat

prophylaxis of aspergillosis/candidiasis in immunocompromised people

12

amphotericin B mechanism of action

travels across cell wall and inserts into the cell wall. pulls it apart to create pores

13

adverse effects with amphotericin B

nephrotoxicity! watch serum creatinine. Acute infusion related reactions such as chills, fever, rigors. Electrolyte abnormalities. many patients unable to tolerate full course of conventional amphotericin B

14

how do we make amphotericin B have less side effects?

lipid formulations. more renal protective. less infusion related side effects. putting it in lysosomes gets it taken up by the fungus, not the rest of the body!

15

echinocandin agents

caspofungin, micafungin, anidulafungin

16

what are the echinocandins used for?

candida infections, refractory aspergillus, esophageal candidiasis, empiric antifungal for febrile neutropenic patients

17

echinocandin mechanism of action

inhibits beta 1,3 glucan synthase. prevents making of the cell wall and destroys the cell. works well on yeast, less so on molds

18

what do echinocandins have great activity against?

excellent against candida!

19

flucytosine mechanism of action

pyrimidine analogue that inhibits DNA and RNA synthesis. only oral formulation

20

flucytosine spectrum of activity

active against cryptococcus and some candida species. clinically only used in combos!

21

flucytosine adverse effects

similar to a chemo drug. bone marrow toxicity. liver dysfunction possible. GI intolerances