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15 Cards in this Set
- Front
- Back
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Which of amphotericin can you not use in renal?
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Amphotericin B Complexed with deoxycholate: 90% bound to plasma.
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Amphotericin accumulates significantly in:
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- Liver
- Spleen |
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Amphotericin has little penetration:
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1. CSF, Amniotic fluid
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Adverse Effect of Amphotericin B:
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1. Immediate reactions related to infusion.
use opiods, NSAIDS, aPAP, BENADRYL, TO DEcrease reactions 2. Kidney Toxicity: Irreversible 3. Hypokalemia, Mag |
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MOA of Flucytosine
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- potent inhibitor of thymidylate synthetase.
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Mechanism of Resistance for Flucytosine:
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1. Loss of cytosine permease of cytosine transport.
2. Decreased activity of UMP pyrophosphorylase (adds phosphate) or cytosine deaminase. |
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Where is flucytosine excreted?
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urine (80)
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What are the adverse effects:
FLUCYTOSINE: |
1. Bone marrow depression
2. Liver enzyme elevation 3. Extreme caution in pts w/ renal dysfunction. |
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Resistance mechanism for Azoles:
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1. Increased efflux
2. Increased production of C14 - alpha - sterol demethylase 3. Accumulation of mutations in ERG11, the gene coding: C14 alpha-sterol demethylase. |
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MOA: of azoles:
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- methylsterols may disrupt the close packing of acyl chains of phospholipids impairing the functions of certain membrane-bound enzymes such as ATPase and enzymes.
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Terbinafine: ORALLY ACTIVE
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- Inhibits Squalene epoxidase
- 99% protein bound --> 4 weeks after prolonged therapy. |
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A.E. of terbinafine:
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1. GI
2. Dermatologic (rash, urticaria, pruritus) 3. HA 4. Liver failure rare. |
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Drug Interactions of terbinafine:
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Rifampin decreases and cimetidine increases terbinafine.
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Casofungin (CANCIDAS)I.V.
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- inhibit the synthesis of beta (1-3) glucan (polysaccharide) -- fungal wall
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A.E. of Casofungin:
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- Histamine mediated effects.
- Liver toxicity Cyclosporine + casofungin = increased liver enzyme |
