Chapter 35: Fungal Infections Flashcards Preview

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Flashcards in Chapter 35: Fungal Infections Deck (24)
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1

Flucytosine MOA?

converted to 5 FdUMP, which goes on to inhibit thymidylate sythase --> inhibit DNA synthesis!

2

Flucytosine is used to treat 1) 2) 3) ?

fluCytosine --> the three Cs

Candiasis
Cyptococcosis
Chromomycosis

3

How does flucytosine resistance manifest?

mutations in cytosine permease/deaminase lead to resistance

4

Which antifungal drug works by binding to tubulin and and a microtubule assc protein, thus disrupting assembly of the mitotic spindle?

Griseofulvin

Grizzly-fulvin comes in and RIPS APART THE MITOTIC SPINDLE!!!

5

Griseofulvin is used to treat __? But cannot

skin hair or nail infections

caused by trichophyton, microsporum, epidermophyton

6

You cannot use griseofulvin in patients with what medical conditions?

pregnancy; porphyria; hepatic failure

7

Giving barbituates with griseofulvin causes what?

increases GI absorption of griseofulvin

8

Which inhibitor of squalene epoxidase has a really long half life (~300 hr) because it accumulates in the nails, skin, and fat?

terbinafine

9

What is the drug of choice for onychomycosis (nail fungus tinea unguum)?

terbinafine

10

What class of drugs are used to treat the "tineas?"

squalene epoxidase inhibitors --> "fines"
terbinaFINE, naftiFINE, butenaFINE

that chick Tinea is sooo FINE!

11

Which inhibitor of sqaulene epoxidase is available only as a cream or gel?

naftifine

12

A lot of stuff interferes with ketoconazole - what?

amphotericin B
oral triazolam
anything that decreases gastric acidity
inhibits p450 so anyting like warfarin, h1 antihistamines...

13

which imidazole antifungal is NOT used for superficial eye infections?

ketoconazole

14

triazole antifungals include --?

fluconazole
itraconazole
posaconazole
terconazole
noriconazole

15

which triazole can be used to treat aspergillosis, blastomycosis, cadidiasis, histoplasmosis, onychomycosis?

itraconazole

16

Which triazole does not penetrate the CSF but may have strong effects on the meninges anyways?

intraconazole

17

amphotericin B MOA?

binds to ergosterol and forms pores that alter fungal membrane stability

18

what are the major adverse effects of amphotericin B?

renal toxicity
cytokine storm (fever, chills, hypotension)

19

What measures are taken to reduce renal toxicity of ampho B?

lipid formulations reduce drug exposure to the proximal tubule

20

Ampho B should be combined with what other antifungal to tx acute cryptococcal meningitis?

flucytosine

21

Which ergosterol inhibitor is used to treat only mucocutaneous candidiasis?

nystatin

22

what is the MOA of the "fungins"

noncomp inhibition of B 1 3 D glucans synthesis --> disrupts cell wall integrity

23

Echinocandins, the "fungins" are fungicidal against ___ and fungistatic against ___?

candidiasis species
aspergillus species

24

CSF sample reveals crytococcus neoformans. Tx begins with ampho B for two weeks then you switch to oral tx with __? Why?

fluconazole

bc it has good CNS penetration (unlike itraconazole and ketoconazole...so are not used to tx meningitis)