Antifungals

Front 1

Drugs that alter cell membrane permeability

Back 1

Azoles, Polyenes, Terbinafin

Front 2

Drugs that Block nucleic acid synthesis

Back 2

Flucytosine

Front 3

Drugs that disrupt microtubule functions

Back 3

Griseofulvin

Front 4

Drugs for systemic fungal infections

Back 4

Amphotericin B
Flucytosine
Azoles
Echinocandins

Front 5

What type of drug is being used in systemic infections by physicians?

Back 5

Staring to use Triasoles for primary treatment but if it is severe still use Amphotericin B

Front 6

What is used for Candidiases?

Back 6

Amphotericin B with or without Flucytosine

Front 7

What is used to treat Aspergillosis?

Back 7

Treated with Riconazole
And Amphotericin B

Front 8

What is used to treat Coccidioidomucosis? Both meningeal and non-meningeal

Back 8

Fluconazole for meningeal
Amphotericin B for Non

Front 9

What is used to treat Histoplasmosis?

Back 9

Itraconazole

Front 10

How does Amphotericin B (Fungizone) work, what is it followed up by, how is it given and what is replacing it?

Back 10

Binds to ergosterol and causes formation of pores (by hroxyl groups)
Important in systemic mycoses often followed up my an Azole
IV use most common, but intrathecal use for meningitis
Starting to be replaced by Riconazole

Front 11

What is the most severe side effect of Amphtericin B?

Back 11

NEPHROTOXICITY: can be severe and irreversible
Intrathecal administration can lead to seizures and neurological damage

Front 12

What systemic fungus does Amphotericin B treat?

Back 12

Aspergillus, Blastomyces, Candida Albicans, Cryptococcus, Histoplasma and Mucor

Front 13

What do pateints often receive before treatment of Amphotericin B?

Back 13

Premedicated with an NSAID b/c at the site of administration there is a large scale hitamine release

Front 14

How does Nystatin (Mycostatin) work, how is it administered, what does it treat?

Back 14

Topical use only MAINLY EYE INFECTIONS
For treatment of C. Albicans and Dermatophytes
Disrupts the membrane by binding to ergosterol
Has been used oraly to treat GI fungi (HIGHLY TOXIC)

Front 15

How does Flucytosine (Ancobon) work, what is it used with and why, where does it go in the body?

Back 15

Converts Flucytosine to 5-FU by the enzyme CYTOSINE DEAMINASE
Used synergistic with AMP-B and resistance developes quickly if not used together
Penetrates all components of the body

Front 16

What is the main fungus that Flucytosin treats in conjugation with AMP-B?

Back 16

Crytococcal Meningitis

Front 17

What are the toxicity of Flucytosine?

Back 17

Reversible bone marrow damage, liver toxicity

Front 18

How do the azoles work,

Back 18

Inhibit the synthesis of ergosterol by binding and inhibiting P-450

Front 19

What does Ketonconazole (imidazole) inhibit and what is it used for because of this?

Back 19

Has an effect on the adreanl corticosteroids; inhibits cortisol
Used in treatment of Cushings
Hepatotoxicity

Front 20

What is Miconazole (imidazole)primarily used for?

Back 20

Topical application
Athletes foot
Vaginal infection (Monistat 7)

Front 21

Characteristics of the triazoles

Back 21

SYTEMIC USE
Safer does not inhibit adrenal steroids
Has a greater affinity for P-450 then the imidazole
Can cause hepatotoxicity and hypokalemia

Front 22

What is the use of Itraconazole?

Back 22

Broad spectrum triazole
Used extensively for treatment of Dermatophytoses, especially onychomycosis

Front 23

What is Fluconazle used for?

Back 23

Drug of choice for Coccidioidal Meningitis
Some cases before AMP-B
Alternative to AMP-B for cryptococcal meningitis

Front 24

What is Voriconazole used for and what makes it unique?

Back 24

Drug of choice for invasive Aspergillus
Important in bone marrow transplant, cancer and AIDS
Unique is the visual disturbance/photophobia it causes as a side effect

Front 25

How is Griseofulvin usd and how does it work?

Back 25

Used as a systemic drug for superficial fungal infections
Binds to Keratin and inhibits fungal microtubules in Dermatophytes

Front 26

What does Griseofulvin treat for and what are the Toxicities?

Back 26

Oral form indicated for Dermatophytoses of the skin and hiar
Largely been replace highly toxic,pregnant women, GI, CNS (vertigo) carcinogenic

Front 27

How does Terbinafine (Lamasil) work and what kind of agent is it?

Back 27

Inhibits fungal enzyme squalene epoxidase, which causes increased levels of squalene whic interferes with ergosterol synthesis
Fungosidal Agent

Front 28

What are the clinical uses and toxicity for Terbinafine (Lamasil)?

Back 28

Accumlates in Keratin, much more effective then Griseofulvin, for treatment of Dermatophytic/ringworm infections
Especially for Onychomycosis
GI and headache disturbance

Front 29

The three Ecinocandins and how do they work?

Back 29

Caspofungan, micofungin, anidulafungin
Inhibits the synthesis of Beta 1-2 glycan in cell wall synthesis

Front 30

What is Caspofungin used for?

Back 30

Used for disseminated Candida and for Invasive Asoergillosis for pts failing to respond to AMP-B

Front 31

What is Anidulafungin used for?

Back 31

Used for esophageal and invasive candidiasis

Front 32

What is Micafungin used for?

Back 32

Used for Prophylaxis of candida infections in BONE MARROW transplant pts.

Front 33

What are the toxicities of Ecinocandins?

Back 33

Histamine release occurs with IV
Combined with cyclosporine may elevate liver enzymes