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Flashcards in PHARMA Anti Fungals Deck (31):
0

Systemic antifungal drugs for systemic infections

Ampho b
Flucytosine
Azoles
Echinocandins

1

2 antifungals that are amphoteric polyene macrolides

Ampho b
Nystatin

2

Ampho b only available in this form

Parenteral only, bc it is water insoluble and poorly absorbed in the git

3

DOC for systemic fungal infections except in CNS

Ampho b

4

Ampho b moa

Alters permeability by forming ampho b associated pores in the cell membrane, causing contents to leak out

5

Dosage of ampho b

0.5-1 mg per kg per day as slow IV infusion up to 1-2 g end point

6

2 adverse effects of ampho b

Infusion related toxicity (fever chills etc) and cumulative toxicity (renal damage)

7

Water soluble pyrimidine analog, good CSF penetration, related to fluoroura il

Flucytosine

8

Enzyme that allows flucytosine to enter fungal cells

Cytosine permease

9

Flucytosine MOA

Converted to 5dUMP (inhibit dna synthesis) and to FUTP (inhibit rna synthesis)

10

Tx for chromoblastomycosis

Flucytosine plus ampho b plus ITRACONAZOLE

11

First DOC for cryptococcys neoformans

Ampho b and flucytosine

12

Give 3 imidazoles (2 nitrogens)

Ketoconazole
Miconazole
Clotrimazole

13

Give 4 triazoles (3 nitrogens)

Itraconazole
Fluconazole
Voriconazole
Posaconazole

14

Azoles moa

Reduction of ergosterol synth by inhibiting cytP450 AND demethylation of lanosterol

15

Only imidazole in oral form

Ketoconazole

16

Topical imidazoles

Miconazole
Clotrimazole

17

Azole with greatest propensity to inhibit liver enzymes

Ketoconazole

18

2nd DOC for px and tx of cryptococcal meningitis

Fluconazole

19

Comes in newer formulations with better solubility and bioavailability due to CYCLODEXTRAN

Itraconazole

20

Azole of choice fir dimorphic fungi

Itraconazole

21

Tx for invasive aspergillosis, and 2 salvage therapies

DOC - itraconazole
Salvage therapy - Posaconazole and echinocandins

22

Azole with visual disturbances

Voriconazole

23

Only azole with significant activity against MUCORMYCOSIS

Posaconazole

24

Echinocandins moa

Inhibit beta glucan synthase

25

Echinocandins examples

Caspofungin
Micafungin
Anidulafungin

26

Systemic antifungal drugs for MUCOCUTANEOUS infections

Griseofulvin
Terbinafine

27

Griseofulvin vs terbinafine

Griseofulvin - fungistatic
Terbinafine - fungicidal

28

Terbinafine moa

Inhibits squalene epoxidase

29

Topical anti fungal therapy

Nystatin
Topical azoles - miconazole and clotrimazole
Topical allylamines - terbinafine and naftifine

30

Nystatin use

Active against most candida - thrush, vaginal candidiasis, interrtrigo