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Sketchy Medical > Antimicrobials: Antifungal Medications > Flashcards

Antimicrobials: Antifungal Medications Flashcards

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1
Q

Amphotericin is an

A

anti-fungal

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2
Q

Fungal cell membranes are composed of ________ not your usual cholesterol

A

ergosterol

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3
Q

amphotericin and nystatin bind

A

amphotericin and nystatin bind ergosterol to form holes in the fungal cell membrane

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4
Q

amphotericin treats

A

severe systemic fungal infections

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5
Q

IV administration of amphotericin is used for

A

treatment of severe systemic fungal infections

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6
Q

What decreases amphotericin toxicity

A

liposomal formulations of amphotericin prevent binding to human cholesterol membranes (decreased toxicity)

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7
Q

amphotericin toxicity results from

A

amphotericin toxicity results from non-selective binding to mammalian cholesterol membranes

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8
Q

What are immediate infusion-related toxicities of amphotericin

A
  1. hypotension
  2. headache
  3. fever
  4. chills
  5. thrombophlebitis
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9
Q

intrathecal administration of amphotericin to treat

A

fungal CNS infections

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10
Q

intrathecal administration of amphotericin can cause

A

seizure and other CNS side effects

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11
Q

______ is a cumulative toxicity of amphotericin

A

renal tubular acidosis (RTA) type 1

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12
Q

RTA type 1 is associated with

A

hypokalemia

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13
Q

amphotericin can cause

A

hypomagnesemia (due to renal magnesium wasting)

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14
Q

amphotericin can cause hypomagnesemia due to

A

renal magnesium wasting

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15
Q

volume expansion with IV normal saline before amphotericin administration prevents

A

kidney damage

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16
Q

___________ with IV normal saline before amphotericin administration prevents kidney damage

A

volume expansion

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17
Q

amphotericin induced damage to renal tubular cells can cause

A

anemia

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18
Q

amphotericin induced damage to renal tubular cells can cause anemia due to

A

decreased erythropoietin production

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19
Q

flucytosine is an

A

anti-fungal

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20
Q

cytosine deaminase in fungal cells converts

A

cytosine deaminase in fungal cells converts flucytosine (a fluorinated cytosine) into 5-fluorouracil (5-FU)

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21
Q

flucytosine halts

A

flucytosine halts fungal DNA and RNA synthesis

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22
Q

flucytosine and amphotericin combo treats

A

Cryptococcus infections (e.g. cryptococcal meningitis)

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23
Q

___________ combo treats cryptococcal meningitis

A

flucytosine and amphotericin combo treats cryptococcal meningitis

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24
Q

nystatin mechanism

A

nyastatin has the same mechanism of action as amphotericin

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25
nystatin treats
Candida infections (candidiasis)
26
topical nystatin treats
mucocutaneous candidiasis (e.g. vaginal candidiasis)
27
oral nystatin rinse treats
oropharyngeal candidiasis
28
Cone-azole antifungals include
1. voriconazole 2. fluconazole 3. itraconazole 4. clotrimazole 5. miconazole 6. ketoconazole
29
_______ comprises the fungal cell membrane
ergosterol
30
_______ antifungals inhibit the synthesis of ergosterol
azole
31
azole antifungals inhibit the synthesis of
ergosterol
32
azole antifungals inhibit the conversion of
lanosterol to ergosterol
33
azole antifungals inhibit
1. the synthesis of ergosterol 2. conversion of lanosterol to ergosterol 3. fungal cytochrome P-450
34
Voriconazole inhibits
mammalian cytochrome P-450
35
voriconazole side effects
1. blurry vision of flashes of light | 2. cause changes in color vision
36
voriconazole treats
1. invasive aspergillosis (caused by Aspergillus fumigatus) 2. Candida infections (e.g. esophageal candidiasis) 3. Cryptococcus infections (e.g. cryptococcal meningitis)
37
fluconazole treats
Candida infections (e.g. mucocutaneous candidiasis)
38
fluconazole treats what type of candida infection
mucocutaneous candidiasis
39
voriconazole treats what type of candida infection
esophageal candidiasis
40
one-time oral dose of fluconazole treats
vaginal candidiasis
41
_______ treats vaginal candidiasis
one-time oral dose of fluconazole treats vaginal candidiasis
42
systemic fluconazole treats
esophageal candidiasis
43
fluconazole has high levels of
fluconazole has high levels of CNS penetration (treats cryptococcal meningitis)
44
itraconazole is an
azole antifungal
45
itraconazole treats
1. systemic infections with dimorphic fungi (e.g. histoplasmosis, blastomycosis, coccidioidomycosis, sporothrix) 2. onychomycosis and dermatophytosis
46
itraconazole treats systemic infections with
dimorphic fungi (e.g. histoplasmosis, blastomycosis, coccidioidomycosis, sporothrix)
47
itraconazole treats what diseases
onychomycosis and dermatophytosis
48
Dermatophytes are
tinea
49
What drugs are used to treat tinea infections (dermatophytosis)
1. topical miconazole | 2. topical clotrimazole
50
clotrimazole and miconazole treat
vaginal candidiasis
51
topical ketoconazole treats
dermatophytosis(e.g. tinea corporis)
52
ketoconazole inhibits
1. 17,20-desmolase (the first step of steroid hormone synthesis from cholesterol) 2. production of androgens and estrogens 3.
53
Ketoconazole can cause
anti-androgenic side effects (e.g. gynecomastia)
54
dermatophytes include
tinea corporis, tinea pedis, and tinea cruris
55
griseofulvin is an
antifungal agent
56
oral griseofulvin treats
dermatophytosis
57
oral griseofulvin and terbinafine are first line therapy for
tinea capitis in children
58
griseofulvin binds
griseofulvin binds fungal cell microtubules, halting mitosis
59
griseofulvin activates
cytochrome P-450
60
terbinafine is an
anti-fungal agent
61
topical terbinafine is used to treat
tinea infections (e.g. dermatophytosis)
62
oral terbinafine treats
onychomycosis
63
terbinafine inhibits
terbinafine inhibits fungal squalene epoxidase causing accumulation of squalene
64
Terbinfine side effects
1. GI side effects | 2. hepatotoxicity
65
echinocandins are
caspofungin, micafungin, anidulafungin
66
echinocandins act at the
echinocandins act at the fungal cell wall
67
echinocandins inhibit
echinocandins inhibit the synthesis of beta-1-3-glucan in the fungal cell wall
68
echinocandins have excellent activity against
Candida infections (e.g. mucocutaneous candidiasis)
69
echinocandins are delivered IV for
systemic Candida infections (e.g. candidemia)
70
echinocandins are delivered
IV for systemic Candida infections (e.g. candidemia)
71
echinocandins treat
1. esophageal candidiasis | 2. invasive aspergillosis (caused by Aspergillus fumigatus)

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