Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm exam 4 > Antifungals > Flashcards

Antifungals Flashcards

(51 cards)

Start Studying
1
Q

unique targets for antifungal therapy

A

fungal cell membrane - ergosterole and ergosterol synthesis

fungal cell wall - glucans

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

shared targets for antifungals

A

DNA/RNA synthesis

cell division

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

which drugs site of action is membrane function

A

amphotericin B

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

which drugs site of action is ergosterol syntheiss

A 
Fluconazole
Itraconazole
Voriconazole
Naftifine
Terbinafine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which drugs site of action is nucleic acid synthesis

A

5-fluurocytosine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

which drugs site of action is cell wall synthesis

A

caspofungin

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

systemically active drugs for systemic infections

  • oral or IV use
A

Polyenes - amphotericin B**drug of choice or alternative

Azoles - most of them

Flucytosine

Echinocandins

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

what drug has the broadest spectrum activity of all antifungals

A

amphotericin B

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

MOA of amphotericin B

A

binds to ergosterol in fungal CM

forms amp B containing pores - altering permiability

fungicidal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

how does resistance develop to amphotericin B

A

membrane ergosterol concentration is decreased

sterol target is modified

(Candida and Aspergillus)

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

Adverse effects of amphotericin B

A

**Nephrotoxicity (most common and most serious long term toxicity)

infusion related rxns - fever, chills, muscle spasms, vomiting, HA, hyper-/hypotension

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

how can amphotericin b be made less toxic

A

liposomal packaged formulations - decrease binding to human CM

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

MOA of azoles

A

bind to enzyme responsible for converteing lanosterol to ergosterol –>”leaky” cell membrane

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

SE of azoles

A

relatively non-toxic

minor GI

interaction with P450

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

Azole:

Frist oral azole

higher degree of inhibition of cytochrome p450

lower selective toxicity

largemely replaced by newer azoles

A

ketoconazole

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

highest therapeutic index of all azoles

lowest level of interaction with p450

A

fluconazole

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

Fluconazole is the agent of choice for treating what

A

candidiasis

cryptococcosis

coccidiomycosis

2nd line for other systemic infections: histoplasmosis, blastomycosis, sporotichosis

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

what drug has a broader spectrum of activity that fluconazole but poorer pharmacology and TI

A

Itraconazole

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

what does intraconazole require for absorption

A

low gastric pH

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

does itraconazole or fluconazole penetrate the CNS

A

fluconazole

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

what does itraconazole interact with

Study These Flashcards
A

hepatic microsomal enzymes - significant interaction with commonly used drugs

22
Q

what is itraconazole drug of choice for treating

Study These Flashcards
A
  1. blastomycosis
  2. coccidiomycosis
  3. histoplasmosis
  4. sporotrichosis
  5. dermatophyte (onychomycosis)
23
Q

due to its lower toxicity, what drug has replaced amphotericin B as tx of chioce for asperigillosis

24
Q

spectrum of activity for voriconazole

Study These Flashcards
A

Candida

Endemic dimorphic fungi

aspergillosis (tx of choice)

25
SE of voriconazole
- visual disturbances - hallucinations - liver enzyme abnormaliies - rash *similar to other azoles inhibits cytochrome p450
26
what has the broadest spectrum of activity of all azoles
Posaconazole
27
what does posaconazol treat
Candida Aspergillus Mucormycoses
28
Newer alternative therapy for invasive aspergillosis and mucromycosis increased sollubility compared to voriconazole and posaconazole less risk of nephrotoxicity good bioavailability and T1/2
Isavuconazole
29
what is flucytosine used for
combo therapy for systemic infections: cryptococcus
30
MOA of flucytosine
interferes with protein and nucleic acid synthesis
31
Flucytosine is distriubted throughout body fluids and tissues including the CNS. It can treat _____
cryptococcal meningitis
32
SE of flucytosine
bone marrow toxicity - anemia, leukopenia, thrombocytopenia
33
Lipopeptides that inhibit the synthesis of beta glucans of fungal cell walls high degreee of selectivity towards fungal cells administered IV poor penetration of CNS
echinocandins (caspofungin, micafungin, anidulafungin)
34
spectrum of activity/tx of echinocandins
- limited to fungi with high levels of beta glucan invasive infections caused by Candida and Aspergillus - primarily to tx infections that do not respond to other antifungal agents
35
oral systemic drugs for cutaneous and mucocutaneous infections
Griseofulvin Allylamines - terbinafine
36
what drug is used to treat dermatophyte infections (2nd line) concentrates in keratin precursor cells
Griseofulvin
37
drug interaction with griseofulvin
increase warfarin metabolism decrease effectiveness of oral contraceptivs
38
MOA of allylamines
inhibit ergosterol syntehsis - inhibit enzyme squalene epoxidase
39
first line drug in the treatment of onychomycosis keratophilic
oral terbinafine
40
what is the first TOPICAL triazole used to treat onychomycosis low affinity for keratin - better penetration of nail bed minimal systemic absorption
Efinaconazole
41
what are the topical antifungals
Polyenes - nystatin Azoles - clotrimazole, miconazole Allylamines - terbinafine, naftifine
42
polyene antifungal drug related to amphotericin B that is only used topically active against most species of Candida most commonly used in local infections - oropharyngeal and vaginal candidiasis
Nystatin
43
two most commonly used topical azoles (used for vulvovaginal candidiasis and dermatophytes infections) oral lozneges are available for oral thrush
clotrimazole and miconazole
44
Drug of choice for asperigillosis
Voriconazole alternative: posaconazole, amphotericin B, echinocandin
45
drug of choice to mild/moderate blastomycosis
intraconazole alternative: fluconazole
46
drug of choice for moderate to severe blastomycosis
amphotericin followed by itraconazole
47
drug of choice for vaginal candidiassi
- intravaginal azole: clotrimazole, miconazole or intravaginal nystatin or fluconazole (oral)
48
drug of choice for oropharyngeal candidiasis
clotrinmazole or miconazole lozenges nystatin fluconazole
49
drug of choice for esophageal candidiasis
fluconazole
50
drug of choice for invasive candidiasis or blood stream
fluconazole echinocandin
51
drug of choice for coccidiomycosis
fluconazole or itraconazole

Pharm exam 4 (15 decks)

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