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Flashcards in Review - Antifungal Agents Deck (22):
0

Name two medications in the polyene antifungal drug class.

1. Amphotericin B
2. Nystatin

1

How do fungi become resistant to polyene antifungals?

Reduction in the amount of membrane ergosterol.

2

Amphotericin B is synergistic with what other antifungal drug in the treatment of candidal and cryptococcal infections?

Flucytosine

3

Flucytosine is converted by fungal cytosine deaminase to what active compound?

5-fluorouracil which is subsequently converted selectively in fungal cells into two other compounds which inhibit DNA and RNA synthesis.

4

Does amphotericin B have good CNS penetration?

NO - intrathecal route if adequate CSF levels are warranted.

5

How can the "Shake and bake" adverse reaction caused by amphotericin B be prevented?

1. Test dose prior to IV therapy.
2. Pretreatment with antihistamines, NSAIDs, meperidine, glucocorticoids.

6

Pretreatment with meperidine prior to amphotericin B infusion is used to prevent what specific adverse reaction?

Rigors

7

How can the nephrotoxicity caused by amphotericin B be minimized?

1. Load with normal saline solution.
2. Use of amphotericin B in combination with another medication so that the dose of amphotericin B can be decreased.
3. Use of liposomal amphotericin B formulations.

8

Fluconazole is the drug of choice for what types of fungal infections?

1. Mucocutaneous candidiasis
2. Coccidioidomycosis
3. Prevention and treatment of cryptococcal meningitis

9

Itraconazole is the drug of choice for what types of fungal infections?

1. Sporotrichosis
2. Blastomycosis

10

Which antifungal is the drug of choice for paracoccidioides infections?

Ketoconazole

11

Which antifungal can be formulated into a topical shampoo gel to treat dermatiphytoses of the scalp?

Ketoconazole

12

What adverse effect of ketoconazole is also an adverse effect of spironolactone?

Gynecomastia (via inhibition of androgen synthesis).

13

Voriconazole can be used to treat what types of fungal infections?

1. Invasive aspergillosis
2. Invasive candidiasis
3. Candidemia

14

Is absorption of ketoconazole increased or decreased by alkalinization of gastric pH?

It is decreased. Do NOT use antacids with ketoconazole.

15

Some physicians may tell patients to drink what in order to enhance the oral absorption of ketoconazole?

Coca-cola, pepsi, etc. Carbonated beverages that contain phosphoric and/or citric acid are acidic and therefore enhance oral absorption.

16

β-(1-3)-d-glucan is an integral part of the fungal cell membrane or fungal cell wall?

Fungal cell wall.

17

Which antifungal, active only against dermatophytes, acts by depositing in newly formed keratin and disrupting microtubule structure?

Griseofulvin

18

Griseofulvin is active against dermatophytes when used orally or topically?

When used orally.

19

Griseofulvin is contraindicated in patients with which disease?

Acute intermittent porphyria.

20

Terbinafine is used to treat what types of fungal infections?

Dermatophytic infections.

21

Oral terbinafine is used to treat what specific types of dermatophytic infections?

1. Onychomycosis of the toenail.
2. Onychomycosis of the fingernail.

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