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15 Cards in this Set

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Which of amphotericin can you not use in renal?
Amphotericin B Complexed with deoxycholate: 90% bound to plasma.
Amphotericin accumulates significantly in:
- Liver
- Spleen
Amphotericin has little penetration:
1. CSF, Amniotic fluid
Adverse Effect of Amphotericin B:
1. Immediate reactions related to infusion.
use opiods, NSAIDS, aPAP, BENADRYL, TO DEcrease reactions
2. Kidney Toxicity: Irreversible
3. Hypokalemia, Mag
MOA of Flucytosine
- potent inhibitor of thymidylate synthetase.
Mechanism of Resistance for Flucytosine:
1. Loss of cytosine permease of cytosine transport.
2. Decreased activity of UMP pyrophosphorylase (adds phosphate) or cytosine deaminase.
Where is flucytosine excreted?
urine (80)
What are the adverse effects:

FLUCYTOSINE:
1. Bone marrow depression
2. Liver enzyme elevation
3. Extreme caution in pts w/ renal dysfunction.
Resistance mechanism for Azoles:
1. Increased efflux
2. Increased production of C14 - alpha - sterol demethylase
3. Accumulation of mutations in ERG11, the gene coding: C14 alpha-sterol demethylase.
MOA: of azoles:
- methylsterols may disrupt the close packing of acyl chains of phospholipids impairing the functions of certain membrane-bound enzymes such as ATPase and enzymes.
Terbinafine: ORALLY ACTIVE
- Inhibits Squalene epoxidase
- 99% protein bound --> 4 weeks after prolonged therapy.
A.E. of terbinafine:
1. GI
2. Dermatologic (rash, urticaria, pruritus)
3. HA
4. Liver failure rare.
Drug Interactions of terbinafine:
Rifampin decreases and cimetidine increases terbinafine.
Casofungin (CANCIDAS)I.V.
- inhibit the synthesis of beta (1-3) glucan (polysaccharide) -- fungal wall
A.E. of Casofungin:
- Histamine mediated effects.
- Liver toxicity

Cyclosporine + casofungin = increased liver enzyme