Pharm- antifungal therapy Flashcards Preview

High yield step 1 > Pharm- antifungal therapy > Flashcards

Flashcards in Pharm- antifungal therapy Deck (23):
1

Amphotericin B

MECHANISM: Binds ergosterol (unique to fungi); forms membrane pores that allow leakage of electrolytes
CLINICAL USE: Serious systemic mycoses. Intrathecally for fungal menigngitis. Supplement K and Mg because fo altered renal tubule permeability
TOXICITY: Fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis. Hydration decreases nephrotoxicity

2

Nystatin

MECHANISM: Binds ergosterol- forms membrane proes that allow leakage of electrolytes
CLINICAL USE: "Swish and swallow" for oral canidiasis (thrush); topical for diaper rash or vaginal canidiases

3

Flucytosine

MECHANISM: Inhibits DNA and RNA biosynthesis by conversion to 5-fluoruracil by cytosine deaminase
CLINICAL USE: Systemic fungal infections (especially Cryptococcus meningitis) in combo with amp B
TOXICITY: Bone marrow suppression

4

Clotrimazole, fluconazole, intraconazole, ketoconazole, miconazole, voriconazole

CLASS: Azoles
MECHANISM: Inhibit fungal sterol( ergosterol) synthesis by inhibiting the cytochrome P-450 enzyme that converts lanosterol to ergosterol
CLINICAL USE: Local and less serious systemic mycoses.
TOXICITY: Testosterone synthesis inhibition ( gynecomastia, especially with ketoconazole) liver dysfunction ( inhibits cytochrome P-450)

5

Chronic suppression of cryptococcal meningitis in AIDS pateints and candial infections of all types

Fluconazole

6

Blastomyces, Coccidioides, Histoplasma

Intraconazole

7

Azoles for topical fungal infections

Clotrimazole and miconazole

8

Terbinafine

MECHANISM: Inhibits the fungal enzyme squalene epoxidase
CLINICAL USE: Dermatophytoses (especially onychomycosis- funal infection of giner or toe nails)
TOXICITY: GI upset, headaches, hepatotoxicity, taste disturbance

9

Anidulafungin, caspofungin, micafungin

CLASS: Echinocandins
MECHANISM: Inhibit cell wall synthesis by inhibiting synthesis of B-glucan
CLINICAL USE: Invasive aspergillosis, Canidia
TOXICITY: GI upset, flushing ( by histamine release)

10

Griseofulvin

MECHANISM: Interferes with microtubule function; disrupts mitosis. Deposits in keratin-containing tissues ( nails)
CLINICAL USE: Oral treatment of superficial infections; inhibits growth of dermatophytes ( tinea, rightworm)
TOXICITY: Teratogenic, carinogenic, confusion, headaches, ^ cytochrome P-450 and warfarin metabolism

11

Pyrimethamine

antiprotozoan therapy that treats TOXOPLASMOSIS

12

Suramin and melarsoprol

antiprotozoan therapy that treats Trypansoma brucei

13

Nifurtimox

antiprotozoan therapy that treats T. cruzi

14

Sodium stibogluconate

Antiprotozoan therapy that treats leishmaniasis

15

Permethrin, malathion, lindane

used to treat scabies (Sarcoptes scabiei) and lice (pediculus and Pthirus)
Permethrin (blocks Na channels leading to neurotoxicity)
lindane ( blocks GABA channals leading to neurotoxicity)
malathion (acetylcholinesterase inhibitor)

16

Chloroquine

MECHANISM: Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia
CLINICAL USE: Treatment of plasmodial species other than P. falciparum ( high resistance)
TOXICITY: Retinopathy; pruritus (especially in dark-skinned individuals)
RESISTANCE: due to membrane pump that decrease intracellular concentration of drug.

17

artemether/lumefantrine or atovaquone/proguanil

treatment of P falciparum

18

Life-threatening malaria treatmen

quinidine in US ; quinine elsewhere

19

Mebendazole

Antihelminthic: Nematodes- Enterobius vermiculars (pin worm) , Ascaris lumbricoides ( giant roundworm), Strongyloides stercoralis, Ancylostoma duodenale (hookworm), necator americanuse ( hookworms), Trichinella spiralis

20

pyrantel pamoate

Antihelminthic: Cestodes (tapeworms) - Taenia solium, Diphyllobothrium latum,
Treamatodes- flukes - Schistosoma, Clonorchis sinesis

21

ivermectin

Antihelminthic: Strongyloides stercoralis , Onchocerca colvulus

22

diethylcarbamzine

Antihelminthic: Tussue nematodes- Loa loa, wuchereria bancrofti

23

praizquantel

Antihelminthic: