Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
15 Cards in this Set
- Front
- Back
|
Fungi - general
|
Fungi include yeasts/molds
Eukaryotic; can be unicellular or form colonies (mycelium) Yeasts reproduction - budding Molds - tube-like extensions (hyphae) |
|
|
Types of fungal infections
|
1)Systemic mycoses - pneumonia, meningitis, septacemia, UTI
2)Superficial skin - rash, itching, erythema of nails/skin 3)Superficial GI/GU - oropharyngeal (thrush), vagina |
|
|
Antifungal resistance
|
In pts receiving chronic antifungal tx - immunocompromised (AIDS), neutropenic (cancer)
Prophylactic use in immunocompromised pts discouraged - not always effective, can get resistance |
|
|
Azoles - MOA, spectrum
|
flucon, itracon, voricon, ketocon
Decrease ergosterol synthesis - fungal cyp450 inhibition Broad spectrum, safe (few side effects) |
|
|
Fluconazole - spectrum, adverse effects
|
Penetrates CSF
Choice drug for cryptococcal meningitis, candidemia, mucocutaneous candidiasis choice drug for neutropenic/HIV/AIDs patients with recurrent oral/esophageal candidiasis adverse - stephens-johnson, cyp2c9 inhibition (phenytoin, warfarin) |
|
|
Itraconazole - spectrum, adverse effects
|
Choice drug for dimorphic fungi (hisplasma, blastomyces, sporothrix)
adverse - heart disease (not for pts w/ ventricular dysfunction), inhibits cyp3a4 (not for pts on statins) |
|
|
Voriconazole - spectrum, adverse effects
|
choice drug for aspergillosis (better outcome, less toxicity than amphoterin B)
adverse - visual disturbances |
|
|
Ketoconazole - spectrum, adverse effects
|
No IV use (high cyp450 inhibition)
topical use - mucocutaneous candidiasis, oral dermatophytes adverse - hepatitis |
|
|
Capsofungin - MOA, spectrum, adverse effects
|
Inhibits B(1-3) glucan synthesis (cell wall disruption)
used in invasive aspergillosis not responsive to ampho B or voriconazole; candidemia also Adverse - liver toxicity |
|
|
Amphotericin B - MOA, spectrum, adverse effects
|
Polyene; binds ergosterol and forms pore in membrane (ion/macromolecules leak out)
Very broad spectrum - life-threatening systemic mycotic infections; pregnancy adverse effects - binding of cholesterol in host cells IV admin only - slow excretion - can accumulate in tissues |
|
|
Conventional (deoxycholate) and lipid formulations
|
Conventional
-toxicity limits long-term use -immediate infusion reaction (fever, chills, headachve, vomiting) -renal damage (long term) -LIMIT cumulative dose (2g) Lipid -decreased renal toxicity -less severe infusion reaction -greater hepatotoxicity risk |
|
|
Nystatin - MOA, use
|
Polyene; too toxic for parenteral admin
Available in creams, ointments, suppositories Use - local candidal infections (oropharyngeal thrush, vaginal) |
|
|
Terbinafine - MOA, adverse, uses
|
Inhibits fungal enzyme - get toxic intracellular squalene levels
Use - dermatophytoses, esp. onychomycosis (fingernail/toenail infections) Keratophilic (like griseofulvin) but has other direct fungicidal properties Well-tolerated |
|
|
Griseofulvin - MOA, uses, adverse
|
oral admin (microcrystalline form)
mitotic inhibitor - intereferes w/ microtubule assembly deposits in new keratin of skin/nails and prevents infection --> tx must be 2-6 wks Adverse - allergic syndrome (similar to serum sickness), hepatitis, GI disturbances Interacts w/ warfarin, phenobarbital |
|
|
Flucytosine
|
Inhibits nucleic acid synthesis - converted to 5-fluorouracil - inhibits thymidylate synthase
Narrow spectrum - only used w/ others for synergy adverse - serious toxicity 9anemia, leukopenia, thrombocytopenia) |
