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23 Cards in this Set
- Front
- Back
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How does amphotericin B work?
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binds ergosterol --> membrane pores
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What is amphotericin B used for?
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serious systemic mycoses
Cryptococcus Blastomyces Coccidiodes Aspergillus Histoplasma Candida Mucor intrathecally for meningitis |
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What is given with amphotericin B?
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K and Mg due to altered renal tubule permeability
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What are toxicities of amphotericin B?
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fever/chills
hypotension nephrotoxicity arrhythmias anemia IV phlebitis (amphoterrible) reduced by liposomal administration |
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How does nysatin work?
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binds ergosterol like amphotericin B, but topical only due to toxicity
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What is nystatin used for?
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"swish and swallow" for oral candidiasis
diaper rash vaginal candidiasis |
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How do azoles work?
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block ergosterol synthesis by inhibiting P-450 converion of lanosterol to ergosterol
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What is fluconazole used for?
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cryptococcal meningitis in AIDS
candidal infections |
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What is ketoconazole used for?
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Blastomyces
Coccidioides Histoplasma Candida albicans hypercortisolism |
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What azoles are used for topical fungal infections?
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clotrimazole
miconazole |
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What are toxicities of azoles?
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gynecomastia from hormone synthesis inhibition
liver dysfunction (P450 inhibition) fever chills |
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How does flucytosine work?
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conversion to 5-fluorouracil by cytosine deaminase inhibits DNA synthesis
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What is flucytosine used for?
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combined with amphotericin B for systemic infections (Cryptococcus)
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What are toxicities of flucytosine?
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nausea
vomiting diarrhea bone marrow supression |
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How does caspofungin work?
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inhibits cell wall synthesis by inhibiting beta-glucan
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What is caspofungin used for?
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invasive aspergillosis
Candida |
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What are toxicities of caspofungin?
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GI
flushing |
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How does terbinafine work?
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inhibits squalene epoxidase
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What is terbinafine used for?
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treats dermatophytoses
onchomycosis - nail fungus |
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What are toxicities of terbinafine?
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abnormal LFTs
visual disturbances |
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How does griseofulvin work?
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interferes with microtubule function disrupting mitosis
deposits in keratinous tissue (nails) |
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What is griseofulvin used for?
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oral treatment for dermatophytes
tinea ringworm |
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What are toxicities of griseofulvin?
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teratogenic
carcinogenic confusion headaches increased P450 activity increased warfarin metabolism |
