Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Host And Defense - Exam 3 > Exam 3 - Smith - Antifungals > Flashcards

Exam 3 - Smith - Antifungals Flashcards

1
Q

T/F - Most antifungals target the fungal cell membrane or fungal cell wall.

A

TRUE

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

Fungi have a rigid cell wall composed of ________.

A

Chitin

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

What are fungal cell membranes composed of?

A

Ergosterol

Acts like cholesterol acts in human cell membranes

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

Antibacterial drugs are _____________ against fungal infections.

A

INEFFECTIVE

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

Superficial fungal infections deal with what?

A

Skin

Other soft tissues
-Oral and vaginal candidiasis

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

Systemic fungal infections involve what?

A

Whole body

-Major cause of death for immunocompromised pts

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

What are the high risk groups for systemic fungal infections?

A

Cancer, or its chemotherapy

Organ transplantation

HIV-1 infection

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

What is pulmonary aspergillosis?

A

Leading cause of death in immunocompromised pts, pts with asthma, or pts with cystic fibrosis

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

What are 4 targets of antifungals?

A

Fungal cell membrane
-Fx, permeability or ergosterol synthesis

Cell wall glucan synthesis

Nucleic acid synthesis

Microtubule fx

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

What are the primary drugs used for treating systemic fungal infections? (3, AAE)

What do they target?

A

Amphotericin B

Azoles

  • Fluconazole
  • Itraconazole
  • Ketoconazole
  • Voriconazole

Echinocandins

THESE INTERACT WITH OR INHIBIT ERGOSTEROL SYNTHESIS

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

Polyenes include what two drugs?

A

Amphotericin B

Nystatin

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

What do polyenes do?

A

Bind ergosterol in cell membranes and disrupt membrane fx and permeability

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

What 2 drugs are imidazoles and triazoles?

A

Itraconazole

Fluconazole

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

What do the imidazoles and triazoles do?

A

PREVENT ERGOSTEROL SYNTHESIS

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

What 2 drugs are the allylamines?

A

Naftifine

Terbinafine

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

What do the allylamines do?

A

PREVENT ERGOSTEROL SYNTHESIS

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

Which drugs inhibit fungal cell wall synthesis?

-Inhibit glucan synthesis

A

Echinocandins

Like, caspofungin

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

What is the polyene mechanism?

A

Bind to plasma membrane ergosterol and damage the membrane by forming pores
-K leaks out

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

T/F - Amphotericin B is taken for most serious systemic fungal infections.

A

TRUE

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

What does parenteral mean?

A

Cannot be absorbed orally

21
Q

How is Amphotericin B most often administered?

A

Slow IV infusion in a hospital setting

22
Q

What is the 1st line therapy for invasive, life-threatening systemic and localized Candidemia?

A

Amphotericin B

*Also works for aspergillus infections

23
Q

What are common side effects of Amphotericin B?

A

Toxic chronic rxns

  • Nephrotoxic
  • Neurotoxic
24
Q

What are immediate rxns of Amphotericin B?

A
  • Infusion-related toxicity*
  • Fever, chills, muscle spasms, vomiting, headache
  • Avoided by:
  • Slowing the infusion
  • Decreasing the daily dose
25
Q

What are slower rxns to Amphotericin?

A

Renal toxicity

Neurotoxicity

Hypokalemia and hypomagnesaemia

26
Q

Nystatin should be used in what way ONLY?

A

TOPICAL only

27
Q

What is nystatin used for?

A

Oral and esophageal Candidiasis albicans (thrush) as mouthwash

Topical cream for vaginal candidiasis

28
Q

Adverse effects of Nystatin?

A

Never administered systemically, due to toxicity

Disulfiram-Like rxns - Hangovers

29
Q

Two types of Azoles?

A

Imidazoles

Triazoles

30
Q

What are the 5 drugs that are imidazoles?

A

Bifonazole

Clotrimazole

Econazole

Ketoconazole

Miconazole

31
Q

What are the 3 drugs that are triazoles?

A

Fluconazole

Itraconazole

Vorionazole

32
Q

What is the mechanism for azoles?

A

Inhibit ergosterol synthesis

-Blocks lanosine 14alpha-demethylase

33
Q

How are azoles administered?

A
  • Topically

- Systemically

34
Q

What are 3 big contraindications to remember with azoles?

A

PREGNANCY

LACTATION

PTS WITH HEPATIC DYSFX

  • Also inhibits gonadal and steroid synthesis
  • Also loss of libido, gynecomastia in males, menstrual irregularity
35
Q

What is the MOST COMMONLY prescribed systemic antifungal?

A

Fluconazole
-An azole

*DRUG OF CHOICE FOR CANDIDIASIS ALBICANS

HIGHLY TERATOGENIC, AVOID DURING PREGNANCY

36
Q

What is the first line tx for aspergillis infections?

A

Vorconizole

37
Q

What was the first azole?

A

Ketoconazole

-Systemic or topical

38
Q

What azole is more toxic than Fluconazole?

A

Itraconazole

39
Q

What 2 azoles are available OTC and treat vaginal yeast infections, oral candidiasis, athlete’s foot, and jock rash?

A

Clotrimazole

Miconazole

*Both of these are TOPICAL only

40
Q

Based on their mechanisms of action, co-administering Ketoconazole to a pt currently taking Amphotericin B would __________ its ability to treat a fungal infection.

A - Help
B- Hinder
C - Not effect

Why?

A

B - HINDER

Ketoconazole decreases ergosterol in the membrane and this reduces the fungicidal action of Amphotericin B. Never give together.

41
Q

What drug is synergistic with Amphotericin B and these two drugs are given in combination for cryptococcal meningitis?

A

FLUCYTOSINE

42
Q

What is flucytosine’s mechanism?

A

Inhibits both DNA and RNA synthesis in fungi
-Systemic

Adverse effects: bone marrow suppression

43
Q

The echinocandins are called the _________ of the antifungal drugs.

A

Penicillins

44
Q

What is the mechanism for echinocandins?

A

Block cell wall synthesis and maintenance by inhibiting 1,3-beta glucan synthase

Fungicidal against candida
-Used especially for azole-resistant candida
Fungistatic against some molds
2nd line agent for refractory aspergillosis
Avoided in pregnancy

*IV administration

45
Q

What is one common example of an echinocandins?

A

Caspofungin

-Used for invasive (Cryptic) Aspergillis or Candida

46
Q

What drug disrupts microtubule fx, inhibits fungal mitosis, and inhibit growth of dermatophytes?

A

Griseofulvin
-Rarely used anymore
—Teratogenic, carcinogenic, severe headaches

47
Q

What drug inhibits squalene epoxidase to inhibit ergosterol synthesis and disrupts cell membrane permeability?

A

Terbinafine
-This drug has largely replace Griseofulvin for tx of onychomycosis

*Hepatotoxicity is an adverse effect

48
Q

When are topical antifungals used?

A

For localized candidiasis in pts w/ NORMAL immune fx

49
Q

When are systemic antifungals used?

A

Disseminated disease

AND

IMMUNOCOMPROMISED PTS

Host And Defense - Exam 3 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions