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33 Cards in this Set
- Front
- Back
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This mold has septated hyphae with 45 degree branching
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Aspergillus
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Amphotericin B
Mechanism |
Binds to ergosterol and increases cell membrane permeability, creating pores in fungal membrane.
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Amphotericin B
Spectrum of Coverage |
Fungicidal against most yeasts and molds
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Amphotericin B
Route |
Intravenous only
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Amphotericin B
Distribution |
Does not get into CSF, but it is treatment of choice for fungal meningitis
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Amphotericin B
Excretion |
Degraded in situ...very long half-life
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Amphotericin B
Toxicity |
1. Fever and Rigors
2. Creatinine rises to 2-3 mg/dl 3. Hypokalemia 4. Anemia |
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Advantage of lipid formulation over the conventional Ampho B
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Less renal toxicity
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Flucytosine
Route |
Oral
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Flucytosine
Spectrum |
Candida and cryptococcus, but resistance develops easily
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Flucytosine
Toxicity |
Bone marrow
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Flucytosine
Clinical use |
In combo with Ampho B for initial therapy of cryptococcal meningitis
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Azoles
Mech of Action |
Inhibit synthesis of ergosterol
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Fluconazole
Route |
1. Intravenous
2. Oral |
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Fluconazole
Distribution |
1. CSF
2. Eye 3. Urine |
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Fluconazole
Excretion |
Renal...may need to adjust dose
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Fluconazole
Toxicity |
Not common
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Fluconazole
Clinical uses |
1. Most candida
2. Cryptococcus |
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Itraconazole
First to treat... |
Aspergillus
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Itraconazole
Clinical uses |
1. Psudallesherica boydii
2. Sporotrichosis 3. Endemic mycoses (histo, blasto) |
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Drug of choice for Aspergillus
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Voriconazole
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Voriconazole
Route |
1. Intravenous
2. Oral |
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Voriconazole
Unique side effects |
Visual disturbances
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Echinocandins
Mech of Action |
Inhibit synthesis of 1,2-beta-D glucan of the cell wall (chitin)
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Echinocandins
Clinical uses |
1. Candida
2. Aspergillus |
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Echinocandins
Route |
Given once daily by IV, with no adjustment for renal function
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Capsofungin
Metabolism |
Liver...dose is adjusted in liver disease
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Caspofungin
Toxicity |
Almost none
***since this is an echinocandin, its route is IV and inhibits cell wall synthesis |
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What drug is used for most yeasts and molds?
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Amphotericin B
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What drug is used with Ampho B for cryptococcus?
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Flucytosine
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What drug is used for candida and cryptococcus?
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Fluconazole
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What drug is used for endemic mycoses?
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Itraconazole
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What drug is used for sporotrichosis?
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itraconazole
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