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Flashcards in Antifungals/Antiprotazoal Deck (39)
1

Mechanism of amphotericin B

binds ergosterol (unique to fungi)
forms membrane pores that allow leakage of electrolytes

2

Use of amphotericin B

serious, systemic mycoses
Crypto - w/wo flutocytosine for meningitis
Blasto, Histo, Candida, Mucor

Intrathecally for fungal meningitis

3

what electrolytes should you supplement with amphotericin B use?

K+ and Mg2+ because of altered renal tubule permeability

4

Toxicity of amphotericin B

fever/chills
hypotension
nephrotoxicity
arrhythmias
anemia
IV phlebitis
hydration decreases nephrototixicty
liposomal amphotericin decreases toxicity

5

Mechanism of nystatin

same as amphotericin B
topical use only as too toxic for systemic use

6

Use of nystatin

"swish and swallow" for oral candidiasis (thrush); topical for diaper rash or vaginal candidiasis

7

Mechanism of flucytosine

inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase

8

Use of flucytosine

systemic fungal infections (especially meningitis caused by cryptococcus) in combination with amphotericin B

9

Toxicity of flucytosine

bone marrow suppression

10

Name the azoles

clotrimazole, fluconazole, itraconazole, ketoconazole, miconazole, voriconazole

11

Mechanism of the azoles

inhibit fungal sterol (ergosterol) synthesis by inhibiting cytochrome p450 enzyme that converts lanosterol to ergosterol

12

Use of azoles

local and less serious systemic mycoses

13

Use of fluconzaole

chronic suppression of cryptococcal meningitis in AIDS patients and candidal infections of all types

14

Use of itraconazole

blastomycoses, coccidioides, histo

15

Use of clotrimazole and miconazole

topical fungal infections

16

Mechanism of terbinafine

inhibits the fungal enzyme squalene epoxidase

17

Use of terbinafine

dermatophytoses (especially onychomycosis - fungal infection of finger or toe nails)

18

Toxicity of terbinafine

GI upset, headache, hepatotoxicity, taste disturbance

19

Name the echinocandins

anidulafungin, caspofungin, micafungin

20

Mechanism of echinocandins

inhibit cell wall synthesis by inhibiting synthesis of beta-glucan

21

Use of echinocandins

invasive aspergillosis, Candida

22

Toxicity of echinocandins

GI upset, flushing (by histamine release)

23

Mechanism of griseofulvin

interferes with microtubule function, disrupts mitosis
deposits in keratin-containing tissues (e.g. nails)

24

Use of griseofulvin

oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)

25

Toxicity of griseofulvin

teratogenic, carcinogenic, confusion, headaches, increased cytochrome p-450 and warfarin metabolism

26

Use of pyrimethamine

toxoplasmosis

27

Use of suramin and melarsoprol

trypanosoma brucei

28

Use of nifurtimox

T. cruzi

29

Use of sodium stibogluconate

Leishmaniasis

30

Drugs to treat scabies and lice

permethrin
malathion
lindane

31

Mechanism of permethrin

blocks Na+ channels --> neurotoxicity

32

Mechanism of malathion

acetylcholinesterase inhibitor

33

Mechanism of lindane

blocks GABA channels --> neurotoxicity

34

Mechanism of chloroquine

blocks detoxification of heme into hemozoin
heme accumulates and is toxic to plasmodia

35

Use of chloroquine

tx of plasmodial species other than P. falciparum (frequency of resistance in P. falciparum is too high)

36

Mechanism of resistance to chloroquine

membrane pump that decreases intracellular concentration of drug

37

Tx of resistant malaria?

arthemether/lumefantrine or atovaquone/proguanil

38

Tx for life-threatening malaria?

quinidine (in US) or quinine (elsewhere) or artesunate

39

Name antihelminthic drugs

mebendazole, pyrantel pamoate, ivermectin
diethylcarbamazine, praziquantel