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5 Cards in this Set
- Front
- Back
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Fluconazole |
Class: azole antifungal Mechanism: antagonist of CYP450 ergosterol synthesis required for cell wall function Spectrum: Candida albicans, cryptococcus, blastomycosis, coccidiomycosis Metabolism: 80% excreted unchanged Interactions: CYP2C19 strong inhibition, CYP2C9 3A4 moderate inhibition Side effects: long Qtc, hepatotoxicity, seizures, toxic epidermal necrolysis |
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Caspofungin |
Class: echinocandin antifungal Mechanism: antagonist of b(1-3) D glucan synthesis required for fungal cell wall synthesis Spectrum: invasive aspergillosis, invasive candidiasis Metabolism: hydrolysis and acetylation, mainly hepatic. <1% excreted unchanged Interactions: levels increased by calcineurin inhibitors/decrease levels of CNIs Side effects: cytopaenias, rash, hypertension, transaminitis, pleural effusion |
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Amphotericin B |
Class: polyene antifungal Mechanism: Binds to cell wall ergosterol causing leak of cell contents and cell death Spectrum: invasive aspergillosis, invasive candidiasis, cryptococcus, leishmaniasis Metabolism: long half life, non linear kinetics, no dose adjustment Interactions: antihypertensives, nephrotoxins Side effects: nephrotoxicity, proximal tubular defect, hypotension, bradycardia, heart failure, infusion reactions |
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Voriconazole |
Class: azole antifungal Mechanism: inhibits CYP450 ergosterol synthesis causing failure of cell wall synthesis Spectrum: invasive aspergillosis, Candida albicans, Candida glabrata, Candida krusei, prophylaxis in HSCT and haematological malignancy Metabolism: hepatic through CYP450, 2% FU Interactions: substrate for CYP2C19, 2C9, 3A4. Strong inhibitor of 3A4, moderate inhibitor of 2C19, 2C9. Saturable Metabolism Side effects: visual disturbance/hallucinations, photosensitivity, nephrotoxicity, transaminitis, pancreatitis, Qtc prolongation, rash |
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Itraconazole |
Class: azole antifungal
Mechanism: inhibits ergosterol synthesis causing failure of cell wall synthesis
Spectrum: invasive aspergillosis, oral/oesophageal candidiasis, histoplasmosis, coccidiomycosis, tinea
Metabolism: hepatic through CYP450, <0.02% FU
Interactions: substrate for 3A4, strong 3A4 inhibition, p-glycoprotein inhibition
Side effects: drowsiness, heart failure, hepatotoxicity, hearing loss, neuropathy |
