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Flashcards in Antifungals And Antiparasitics Deck (65):
1

What is a common ending for antifungal drugs

Conazole

2

Fungi are called ______

Mycoses
release mycotoxins

3

Systemic mycoses

Life threatening and increasing due to the number if immunosupresed patients

4

What are systemic mycoses that infect immunosupressed patients called

Opportunistic

5

What are the main opportunistic mycoses

Cryptococcal meningitis and aspergillosis

6

Two major types of mycoses

Yeasts and molds

7

Common yeast infection

Candida

8

Dermatophytoses

Ringworm, athletes foot, jock itch
Moist skin

9

Mycotic infections of the skin

Dermatopohytes

10

Cryptococcosis

Invasive fungal infection
Meningitis

11

People receiving broad spectrum Abx are at the greatest risk of this infection

Candida

12

MOA of amphotericin B

Binds to ergosterol in the fungal cell membrane and forms pores that allow electrolytes and small molecules to leak from the fungal cell, resulting in cell death
-pokes holes in the membranes

13

When do you use amphotericin B

In serious systemic infections, especially cryptococcus

14

Adverse effects of amphotericin B

Flushing and muscle spasms during IV infusion due to histamine, pretreat with steroid or antihistamine
-dose limiting decrease in GFR and renal tubular acidosis
-bone marrow suppression

amphoTERRIBLE
Pretty much never use unless absolutely necessary

15

Which antifungal is very damaging to the kidneys

Amphotericin B

16

Synergy in antifungal

Amphotericin B + flucytosine

17

MOA of flucytosine

Converts cytosine delaminase to 5-fluorouracil (5-FU), a cancer drug; 5-FU is converted to 5-FdUMP which inhibits thymidylate synthase

18

What might you use if you have fungal meningitis and it’s really bad

Amphotericin B + flucytosine

19

Antifungal spectrum of flucytosine (5-FC)

Used only in combination with amphotericin B for cryptococcus neoformans

20

When you use flucytosine, why does the fungus die?

Inhibits thymidilate synthase which causes DNA to stop, cant make thymidine

21

Azole antofungals MOA

Inhibit the synthesis of ergosterol by blocking the enzyme C-14 a-demthylase

22

Adverse effects of azole antifungal

Ketoconazole is a major P450 inhibitor and is not used much
-affects the synthesis of cortisol and androgens

23

What are the azole antifungals to know

Fluconazole
Voriconazole

24

Drug of choice for candidiasis and cryptococcal meningitis

Fluconazole

25

What is the only azole to penetrate CNS

Fluconazole

26

What is a good way to treat a very serious infection of cryptococcal meningitis

Start with amphoterocin B + flucytosine to knock it down and then switch to fluconazole to get rid of it

27

Why can’t you use azoles with amperotericin B?

Amphotericin B binds ergosterol, Azoles inhibit ergosterol, limiting the targets that ampho B can bind to

28

Drug used for invasive aspergillosis

Voriconazole

29

When do you see invasive aspergillosis

Damages the kings in immunosupressed
-HIV or organ transplant, or increase dose of steroids

30

MOA of caspofungin

Inhibits the synthesis of B-1,2 glucagon, a critical components of fungal cell walls

31

Antifungal spectrum of caspofungin

Candida and aspergillus

32

Adverse effects of caspofungins

Fevers, chills, rash, and flushing due to histamine release

33

Which antifungals cause a histamine release

Fungins and amphoterocin B

34

Systemic drugs for superficial fungal infections

Griseofulvin
Terbinafine

35

MOA of griseofulvin

Inhibits mitosis
Superficial fungal infection
Rarely used

36

MOA of terbinafine

Inhibits squalene epoxidase which normally converts squalene to squalene epoxide; accumulation of squalene is toxic, this is an early step in ergosterol synthesis

37

Antifungal spectrum of terbinafine

-Dermatophytic infections like atheletes foot
-onchomycosis (nails)

38

What drug is better to use than grisofulvin

Terbinafine

39

Do caspofungins work on the cell wall or cell membrane of fungi

Cell wall

40

Which drugs work on the fungal cell membrane

Amphotericin , azoles

41

What are the two plasmodium (malaria) species we are most concerned with

P. Falciparum, P. Vivax

42

____ accounts for 80% of all malaria cases

P. Vivax

43

_____ only accounts for 15% of malaria causes, but it is a much more serious infection

P. Falciparum

44

Tissue schizonticides

Primaquine

45

Blood schizonticdes

Chloroquine

46

Which malaria treatments work best for vivax

Chloroquine
Primaquine

47

Which drugs work best for P. Falciparum

Quinine
Mefloquine

48

MOA of chloroquine

Blood schizonticide
-intracellular heme accumulation, which is toxic to the parasite

49

What is the drug of choice for acute attacks of nonfalciparum (vivax) malaria?

Chloroquine
-also used as prophylaxis in sensitive regions

50

Side effects of chloroquine

Hearing and vision impairment (cinchonism), just Like quinidine

51

MOA of quinidine

Blood schizonticide

52

Clinical use of quinine

P. Falciparum, most commonly given with doxy

53

Side effects of quinine

Cinchonism

54

Which drugs can cause cinchonism (hearing and vision impairment)

Chloroquine, quinine, quinidine

55

What is mefloquine used for

Prophylaxis for P. Falciparum

56

What is the only tissue schizonticide used to treat malaria

Primaquine

57

MOA of primaquine

Tissue schizonticide, forms quinolone-quinone metabolites which are oxidative stress, damaging the organism

58

Clinical use of primaquine

Eradicates liver stages of vivax

59

Quinidine

Can be used for anti malaria

60

Treatment for giardia

Metronidazole

61

MOA of metronidazole

Don’t know really, free radical

62

DOC of giardia

Metronidazole

63

Side effects of metronidazole

Metallic taste in the mouth; disulfiram like effect if taken with alcohol (severe hangover)

64

Treatment of amebiasis (E. Hystalitica)

Metronidazole

65

Treatment of toxoplasmosis

Antifoalte drigs: pyrimethamine + sulfadiazine

-pyrimethamine: works like trimethaprim and blocks dihydrofolate reductase

-Sulfadiazine: blocks synthetase