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27 Cards in this Set
- Front
- Back
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How does grisefulvin work?
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targets microtubules
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How does flucytosine work?
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fungal DNA & RNA
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What component of the cell membrane does amphotericin target?
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ergoesterol
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How should systemic antifungals be administered?
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IV
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How is amphotericin excreted?
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slowly by kidney
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What are the toxicities related to amphotericin B?
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immediate: fever, chills, muscle spasm, ha, vomiting
cumulative related: *nephrotoxic* azotemia (abnormally high levels of nitrogen containing compounds) prolonged administration leads to irreversible kidney damage |
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How does flucytosine work?
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targets fungal DNA & RNA
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Which fungus is flucytosine used in combination with amphotericin B for?
(synergistic) |
cryptococcus neofrmans
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What toxicity is associated with flucytosine?
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depression of bone marrow, GI disturbances, liver impairment (elevates AST, ALT)
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What drug interaction is associated with all azoles?
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affects P450 enzymes
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What toxicity is associated with ketoconazole?
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gynecomastia, inhibition of adrenal & testicular function
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What is ketoconazole's clinical use?
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oral broad spectrum antifungal
widely distributed in body low CNS penetration |
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How is fluconazole eliminated?
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renally
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Which of the azoles has the least drug interactions?
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fluconazole
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Which of the azole is good at CNS penetration?
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fluconazole
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What is DOC for aspergillus?
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voriconazole
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What are the drug interactions associated with voriconazole?
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inhibits P450 enzymes (especially 2C9, 3A4, 2C19)
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What adverse effect is associated with voriconazole?
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visual impairment
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How is itraconazole administered and excreted?
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orally
liver |
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How are echinocandins adminstered?
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IV
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What are echinocandins used for clinically?
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amphotericin resistant and azole resistant fungi
also lacks nephrotoxicity |
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What is caspofungin used form?
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slow IV administration
DOC for candidiasis for treatment of invasive aspergillosis in voriconazole or amphotericin resistant pts |
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What is DOC for onychomycosis?
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griseofulvin
(binds to keratin) |
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What are the contraindications of griseofulvin?
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acute intermittent porphyria
hepatocellular failure |
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What is griseofulvin used for
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ringworm infections of skin, hair, nails
(binds to keratin) |
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Which antifungal has fungicidal activity against dermatophytes?
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terbinafine
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What is nystatin used for clinically?
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administered orally or topically for candida infections
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