Unit 4 Fungi and Antifungal Medication Flashcards Preview

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Flashcards in Unit 4 Fungi and Antifungal Medication Deck (15):
1

candida

-beefy red erythema
-can cause inflammation
-likes moist environments

2

histoplasma

-thermally dimorphic

3

Amphotericin (Ampho-terrible)

-MOA: inhibits ergosterol, but also cholesterol
-Pharmacokinetics: IV OR TOPICAL ONLY, renal and hepato-biliary
-Spectrum: BROAD SPECTRUM, drug choice for SYSTEMIC INFECTIONS
-Adverse Rxn: NEPHROTOXICITY (80%), anemia

4

Nystatin

-MOA: inhibits ergosterol, but also cholesterol
-Pharmacokinetics: TOPICAL ONLY (not orally absorbed)
-Spectrum: SUPERFICIAL CANDIDAL INFECTION
-Adverse Rxn: well tolerated when given topically, some GI upset when given for oral candidiasis

5

Caspofingin (enchinocandin)

-MOA: inhibits synthesis of cell wall
-Pharmacokinetics: IV INFUSION ONLY, levels dec. by P450 inducers
-Spectrum: ASPERGILLIS (if refractory to ampho B)
-Adverse Rxn: infusion related sx

6

MOA of Triazoles

-MOA: inhibit fungal P450, which inhibits ergosterol, selective

7

Fluconazole

-Pharmacokinetics: IV or oral, renal excretion, enters CNA
-Spectrum: MOUTH, THROAT, VAG candidiasis, can enter CNS
-Adverse Rxn: well tolerated, some GI upset, can't be used in pregnancy (cat D)

8

Itraconazole

-Pharmacokinetics: IV, oral, hepatic metabolism
-Spectrum: dermatophytosis, onychomycosis
-Adverse Rxn: n/v, diarrhea, headache, INHIBITS CYP450

9

Terconazole

-Pharmacokinetics: TOPICAL only (t and t clue)
-Spectrum: vaginal candidiasis
-Adverse Rxn: none

10

ketoconazole (imidazole)

-MOA: inhibit P450 ergosterol synthesis inhibiting membrane permeability
-Pharmacokinetics: IV, oral, topical, hepatic metabolism
-Spectrum: systemic infections, DERMATOLOGIC INDICATIONS
-Adverse Rxn: HEPATOTOXICITY, INHIBITS CYP450 and testosteron synthesis

11

Clotrimazole (Imidizole)

-MOA: inhibit P450 ergosterol synthesis inhibiting membrane permeability
-Pharmacokinetics: TOPICAL ONLY
-Spectrum: ORAL AND VAG CANDIDIASIS
-Adverse Rxn: none

12

Triazoles

-fluconazole,
-itraconazole
-terconazole

13

Terbinafine

-MOA: inhibits squalene oxidase reducing ergosterol synthesis
-Pharmacokinetics: oral and topical, metabolized by hepatic P450
Spectrum: ONYCHOMYCOSIS of FINGER/TOE NAILS, athlete's foot
-Adverse: INHIBITION of CYP450

14

Flucytosine

-MOA: converted 5FU in fungi- inhibits thymidylate synthesis and DNA synthesis
-Pharmacokinetics: well absorbed, renally eliminated
-Spectrum- serious infections of cryptococcosis and candidiasis
-Adverse: BONE MARROW DEPRESSION, skin rashes

15

Griseofulvin

-MOA: binds to fungal microtubules, inhibiting mitosis
-Pharmacokinetics: poor oral absorption, improved with fatty meal
-Spectrum: severe dermatophytosis of skin, hair, finger/toe nails
-Adverse: HYPERSENSITIVITY RXNS, GI distress, headache, confusion