Infectious Disease: Antifungal Drugs

Question 1

What is the MOA of Amphotericin B

Answer 1

Binds ergosterol to create pores in the fungal cell wall

Question 2

What is Amphotericin B used for

Answer 2

Severe, invasive fungal infections

Question 3

How is amphotericin B given

Answer 3

IV lipid-based amphotericin B

Question 4

Why is lipid based amphotericin B used

Answer 4

lowers the risk of nephrotoxicity

Question 5

Common adverse effects of Amphotericin B

Answer 5

Fever and chills

Phlebitis

Nephrotoxicity

Hypomagnesemia

Hypokalemia

Anemia

Question 6

What common electrolyte abnormalities are caused by amphotericin B

Answer 6

Hypomagnesemia

Hypokalemia

Question 7

How does Amphotericin B cause Hypomagnesemia and Hypokalemia

Answer 7

Increases the distal tubule permeability to Mg/K

Question 8

What lab values are monitored in a patient using Amphotericin B

Answer 8

Bun/Cr

Electrolytes: Mg/K

CBC

Question 9

What is the MOA of Nystatin

Answer 9

Binds ergosterol to create pores in the fungal cell wall

Question 10

What is Nystatin used for

Answer 10

Swish and swallow: Thrust

Candida Diaper Rash

Question 11

What is the MOA of Flucytosine

Answer 11

Converted to 5-FU in fungi to block fungal DNA and RNA synthesis

Question 12

What is Flucytosine used in combination with

Answer 12

Amphotericin B

Question 13

What is the main use for Flucytosine

Answer 13

Cryptococcal Meningitis

Question 14

What is the main use of Flucytosine

Answer 14

Bone marrow suppression
-leukopenia
-thrombocytopenia

Question 15

What are some of the commonly used Azole drugs

Answer 15

Fluconazole
Itraconazole
Voriconazole
Clotrimazole
Miconazole
Ketoconazole

Question 16

What it the MOA of azoles

Answer 16

Blocks ergosterol synthesis by inhibiting the P450 enzyme in fungi that converts Lanosterol to Ergosterol

Question 17

What are the common adverse effects of Azoles

Answer 17

Inhibit P450 enzymes
-increase warfarin

Hepatotoxicity

Question 18

What are common adverse effects of Ketoconazole

Answer 18

Suppresses cortisol synthesis

Suppresses testosterone synthesis

Question 19

What are Voriconazole, Posaconazole, and Isavuconazole mainly used for

Answer 19

Severe, systemic fungal infections (aspergillus)

Question 20

What are the unique side effects of Voriconazole, Posaconazole, and Isavuconazole

Answer 20

Transient Vision Changes
Visual Hallucinations
Photosensitivity
Alopecia

Question 21

What are the common Echinocandin Drugs

Answer 21

Caspofungin

Micafungin

Question 22

What is the MOA of Echinocandin Drugs

Answer 22

Inhibit cell wall synthesis by blocking the synthesis of B-Glucan Polysaccharides

Question 23

What are Echinocandins used for

Answer 23

Severe, systemic infections
-Aspergillus
-Candidemia

Question 24

What are the common adverse effects of Echinocandins

Answer 24

GI Upset

Infusion-related histamine release (flush)

Question 25

What is the MOA of Terbinafine

Answer 25

Inhibits squalene epoxidase and inhibits ergosterol synthesis

Question 26

In what forms is Terbinafine given

Answer 26

PO or Topical

Question 27

What is Terbinafine commonly used for

Answer 27

Treat Dermatophyte Infections Especially Onychomycosis

Question 28

What are the common adverse effects of Terbinafine

Answer 28

Headache Hepatotoxicity Taste changes/loss of taste

Question 29

What is the MOA of Griseofulvin

Answer 29

Blocks mitosis by interfering with microtubules deposits in tissues with keratin binds keratin: resists fungal infection

Question 30

What form is Griseofulvin used in

Answer 30

PO

Question 31

What is Griseofulvin commonly used for

Answer 31

Fungal Skin and Nail infections

Question 32

What are the common adverse effects of Griseofulvin

Answer 32

Induces P450 -dec warfarin Teratogenic -not safe in pregnancy