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77 Cards in this Set
- Front
- Back
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A cat receiving griseofulvin develops a fever. A WBC reveals profound leukopenia. How should this be treated?
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discontinue the griseofulvin
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A common final cell wall target of antifungal drugs
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ergosterol
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A drug approved for use for treatment of dermatophytosis in dogs and cats
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griseofulvin
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A drug often combined with ketaconazole to increase concentrations and decrease dose
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cyclosporine
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A lag time characterizes imidazole therapy because of this
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Time to steady-state (long half-life); inhibition of cytochrome P 450 requires sufficient growth
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A renal active drug that should not be combined with amphotericin B
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furosemide, NSAIDs
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A small test dose is indicated prior to imidazole adminsitration: T or F?
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False (this is true for amphotericin B)
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Amphotericin B acts predominantly as a weak base: T or F?
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False: it acts as both ("amphoteric")
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Amphotericin B can cause anaphylaxis: T or F?
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False (anaphylactoid: true)
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Amphotericin B can directly cause mast cell degranulation: T or F?
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True
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Amphotericin B is an antibiotic: T or F?
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TRUE
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Amphotericin B is orally bioavailable: T or F?
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False
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Amphotericin B is water soluble: T or F?
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True (it is both lipid and water soluble)
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An antifungal drug whose sole systemic indication is sporotrichosis
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iodine
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An imidazole approved for use in dogs for topical administration (otic)
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clotrimazole (or thiabendazole: Tresaderm)
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An over the counter drug used to treat dermatophyte infections in humans
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terbinafine
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Antifungals are characterized by marked inherent resistance to many antimicrobial drugs: T or F?
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TRUE
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At high concentrations, amphotericin B may be fungicidal: t or F?
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TRUE
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Better descriptor: virulent pathogens or opportunistic pathogens
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Opportunistic
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Culture and susceptibility testing is routinely done for antifungal therapy: T or F
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FALSE
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Differentiates anaphylactoid versus anaphylaxix
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The lack of antibody (IgE)
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Fungal organisms are highly envasive: T or F
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FALSE
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Fungal organsisms generally produce large amounts of exo and endotoxins: T or F
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FALSE
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Griseofulvin is a potent in hibitor of drug metabolizing enzymes: T or F?
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false: it is an INDUCER
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Host cholesterol and fungal ergosterol are structurally similar: T or F?
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TRUE
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Imidazoles are more effectivey absorbed in a pH of 3 or 6?
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3
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In addition to drug metabolizing enzymes, another mechanism of drug interactions involving imidazoles
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competition for p-glycoprotein efflux pumps
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In the event that anaphylactoid response is anticipated or occurs, this class of drugs is used to antagonize the effects of histamine at target receptors
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benadryl (diphenhydramine)
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In the event that anaphylactoid response is anticipated or occurs, this class of drugs is used to prevent mast cell degranulation
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glucocorticoids
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Itraconazole inhibits drug metabolizing enzymes: T or F
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True (they all do, including fluconazole)
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LamB
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liposomal amphotericin B
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Most antifungals are fungistatic or fungicidal in action?
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fungistatic
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One mechanism based on preparation administered that amphotericin B toxicity might be reduced
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administer as a liposomal or lipid based product
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One mechanism based on route of delivery that might be used to reduce amphotericin B toxicity
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diluting the drug or slowing increasing the dose, or alternate day therapy
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One mechanism whereby the efficacy of amphoterin B can be improved
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local deliver or combination antifungal therapy
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Pre-treatment with a small dose of amphotericin B can be used to predict an anaphylactoid reaction: T or F?
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TRUE
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Resistance develops rapidly to antifungal drugs: T or F?
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FALSE
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Sodium chloride should be used to minimize this mechanism of amphotericin B toxicity
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intense renal arteriolar constriction
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Terbinafine may be effective in combination with other antifungals for treatment of non-dermatophyte fundal disorders: T or F
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TRUE
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The enzyme inhibited by imidazoles that is common to ergosterol synthesis and ergosterol synthesis
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cytochrome P450
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The half-life of imidazoles: hours, days or weeks
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Days
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The impact of amphotericin B in fungal cell membranes
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Channels disrupt permeability
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The impact of imidazoles on ergosterol
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inhibitiion of synthesis
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The location of drug in liposomes
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center (inside the lipid membrane)
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The mechanism of action of amphotericin B
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binding to membrane ergosterol
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The minimum duration of therapy with griseofulvin
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4 to 6 weekws (new hair growth)
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The model polyene macrolide
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amphotericin B
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The most effective of the antifungals for non-dermatophytes
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amphotericin B
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The oral bioavailability of the ultramicrosize compared to the microsize product (griseofulvin)
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50% higher
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The organism is protected by a thick capsule
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cryptococcosis
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The polyene component of amphotericin b renders it lipid or water soluble?
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Lipid
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The rationale for "mannitol" in a cocktail designed to minimize amphotericin B toxicity
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reduce intracellular (renal tubular) edema, maintain renal blood flow
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The rationale for sodium bicarbonate in a cocktail designed to minimize amphotericin B toxicity
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to reduce renal tubular acidosis
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The reason that amphotericin B causes renal tubular damage
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Binding to cholesterol results in channels and loss of cell impermeability
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The reason that amphotericin B kinetics are "complex"
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binding to host cholesterol
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The reason that liposomal drug delivery is safer
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Selective uptake by inflammatory cells at the site of infection
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The site of accumulation of griseofulvin
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keratin
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The spectrum of griseofulvin
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dermatophytes only
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The spectrum of imidazoles
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essentially everything (although amphotericin B is better at most save dermatophytes)
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The type of adversity associated with griseofulvin in cats: A or B (I or II)?
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B or II (idisosycratic; probably allergy)
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This approach to drug formulation markedly enhances the safety of amphotericin B
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preparation in lipids, but particularly liposomes
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This characteristic of amphotericin B results in the potential for anaphylactoid reactions
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cation (positive charge)
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This characteristic of fungal organisms renders antifungal drugs more toxic than antibacterial drugs
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eukaryotic target and host
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This characteristic of the patient renders it susceptible to fungal infections
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immunocompromise
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This class of fungal organsisms is NOT included in the spectrum of amphotericin B
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dermatophytes
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This compound renders fungal cell walls as a formidable barrier
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chitin
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This effect (other than antifungal) effect of antifungals contributes to efficacy
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immunomodulatory
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This growth characteristic decreases efficacy of antifungal drugs
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slow growth
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This host factor is not only a barrier to antifungal penetration, but also largely responsible for death
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antiinflammatory response
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This material that causes the yellow color of amphotericin products facilitates dissolution in vehicles
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deoxycholic acid (a bile acid)
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This mechanism of action results in clinically relevant drug interactions involving imidazoles
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inhibition of cytochrome P450 in the host
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This organism is more difficult to reach because of its intracellular location
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histoplasmosis
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This organism is protected by a thick covering (not really a capsule)
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coccidiodomycosis
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This should accompany oral adminsitration of griseofulvin microsize
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fatty meal
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This should accompany oral adminsitration of imidazoles
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feeding
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This should be monitored during amphotericin B therapy
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BUN, creatinine
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Which is better distributed: ketaconazole or intraconazole
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itraconazole
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