Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
37 Cards in this Set
- Front
- Back
|
General Azole MOA |
Inhibit the production of ergosterol, a key component of the fungal cell membrane Inhibition via blocking a fungal CYP450 enzyme |
|
|
General Azole Spectrum of Activity |
Candida spp: -Excellent for albicans -Variable for glabrata Cryptococcus neoformans Endemic fungi Some dermatophytes Aspergillus Mucormycoses |
|
|
General Azole PK |
Highly bioavailable (IV=PO) |
|
|
General Azole Adverse Effects |
Hepatotoxicity |
|
|
General Azole DDI/ Other |
Notable DDIs: -HIV medications -Calcineurin inhibitors (cyclosporine, tacrolimus)-Anticonvulsants-Rifampin |
|
|
Fluconazole Class |
Azole |
|
|
Fluconazole Clinical Use |
Empiric antifungal treatment Candida infections UTI |
|
|
Fluconazole PK |
Only one that needs to be renally dosed |
|
|
Itraconazole Class |
Azole |
|
|
Itraconazole Clinical Use |
non-life threatening cases of endemic mycoses |
|
|
Worst DDI |
DDIs worst with itraconizole (and voriconazole) |
|
|
Voriconazole Class |
Azole |
|
|
Voriconazole Clinical Use |
-DOC for aspergillus |
|
|
Posaconazole Class |
Azole |
|
|
Posaconazole
Clinical Use |
Mucormycoses Some prophylaxis regimens |
|
|
Posaconazole PK |
Requires a high fatty meal for absorption |
|
|
Amphotericin B MOA |
Binds to ergosterol and forms pores that allow molecules to leak in/out of the cell Results in cell death |
|
|
Amphotericin B Spectrum of Activity |
Candida spp: broadest |
|
|
Amphotericin B Clinical Use |
-DOC for Cryptococcus neoformans- DOC for life threatening endemic mycoses- DOC for mucormycoses -Aspergillus (second line to Variconozol) -Broad Spectum Candida -oddball fungus |
|
|
Amphotericin B Adverse Effects |
Nephrotoxicity -Causes electrolyte abnormalities Infusion Reactions -fever, and chills Hepatotoxicity |
|
|
Amphotericin B DDI/ Other |
Now use lipid formulation that is believed to be less toxic: Premidicate before use |
|
|
Capsofungin, Micafungin, Anidulafungin Class |
Echinocandins |
|
|
Capsofungin,Micafungin,Anidulafungin MOA |
Inhibits the production of 1-3-B-D-glucan, a key component of fungal cell walls by inhibiting 1-3-B-D glucan synthase enzyme |
|
|
Capsofungin,Micafungin,Anidulafungin Spectrum of Activity |
Candida spp: -Includes glabrata -NO C.parapsilosis Aspergillus |
|
|
Capsofungin,Micafungin,Anidulafungin Clinical Use |
DOC for C.glabrata Aspergillus: -Combination or prophylaxis -Monotherapy only when patient can’t tolerate voriconazole or amphotericin |
|
|
Capsofungin,Micafungin,Anidulafungin PK |
IV only Not renally eliminated |
|
|
Capsofungin,Micafungin,Anidulafungin Adverse Effects |
VERY WELL TOLERATED |
|
|
Flucytosine MOA |
Converted by fungal cells to 5-FU, and then to other products to inhibit DNA/RNA synthesis |
|
|
Flucytosine Spectrum of Activity |
Candida Aspergillus Cryptococcus |
|
|
Flucytosine Clinical use |
Never as monotherapy! Synergy with amphotericin B in severe infections |
|
|
Flucytosine Adverse Effects |
Bone marrow suppression: Hepatotoxicity |
|
|
Terbinafine Class |
Antifungals for dermatophytes |
|
|
Terbinafine MOA |
Blocks ergosterol production by inhibiting squalene epoxidase production |
|
|
Terbinafine |
Hepatotoxicity |
|
|
Griseofulvin Class |
Antifungals for dermatophytes |
|
|
Griseofulvin MOA |
Prevents infections of new skin structuresEventually the infected ones die and get replaced |
|
|
Griseofulvin Adverse Effects |
Allergic reactions Hepatotoxicity |
