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25 Cards in this Set
- Front
- Back
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3 classes of Antifungal drugs
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Allyamine, Echinocandin, Miscellaneous
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Amphotericin B
(Fungizone, Amphotec, Ambisone, Ablecet) |
NOT ABSORBED PO. MOA = binds to ergosterol, increase cell membrane permeability. Broad spectrum. SYSTEMIC INFX. Poor CNS penetration.
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What are the ADRs of Amphotericin?
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renal/hepatic impairment, anemia, hypokalemia, hypomagnesaemia, hypotension, phlebitis
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Is Amphotericin a first line drug?
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NO. $$$$. Difficult administration.
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Nystatin
(Mycolog, Mycostatin) |
Class B/C. Topical. Candida infx. **Preferred agent for superficial candida infx.
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Natamycin
(Natasyn) |
Class C. Opthalmic suspension. Tx for fungal blepharitis, conjunctivitis or keratitis caused by aspergillus or candida.
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Azole Derivatives
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MOA = inhibit synthesis of fungal lipid ergosterol.
Spectrum = wide range (esp. dermatophytes, yeast) Indications = topical for superficial infx, IV for systemic Kinetics = well abs. PO, may req. acidic medium for abs. ADRs= hepatotox/GI fx. Unique w/ each indiv drug. DDIs = CYP450 inhibition. Decreased abs w/ antacids. |
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Clotrimazole
(Mycelex, Lotrimin) |
Class C. Topical. No systemic use. Cream or vaginal tabs. Candida/tinea.
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Econazole
(Spectazole) |
Class C. Topical. Tinea/candida. 1 x daily.
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Fluconazole
(Diflucan) |
Class B. PO/IV. Tx = candida and cryptococcal meningitidis (crosses BBB). Prophylaxis for BMT.
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Ketoconazole
(Nizoral) |
Class C. PO/top. Tx = systemic infx. Does not enter CNS in large conc. Blocks adrenal/gonadal steroids-- endocrine like fx.
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Itraconazole
(Sporonox) |
Class C. PO/IV.
Spectrum = wide, esp. resistant sp. **Preferred Tx for blastomycosis, sporotrichosis. histoplasmosis. |
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Miconazole
(Monistat) |
Class B. Topical. Tx = candida/tinea. MC agent for vaginal yeast infx.
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Posaconazole
(Noxafil) |
Class C. PO. Newest. Prophylaxis for aspergillus/candida in immunocompromised pts. **MUST HAVE FULL MEAL/SUPPLEMENT W/DOSE.
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Vorizonazole
(Vfend) |
Class C. PO/IV. 2nd gen. triazole w/ improved antifungal activity vs. aspergillus and fluconazole resistant candida. ****CYP450 DDIs.
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What antifungal can cause gynocomastia?
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Ketoconazole
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Allyamine Class
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MOA = inhibit ergosterol synthesis.
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Terbinafine
(Lamisil) |
Class B. PO/top.
Indication = nail fungus ADRs = GI, headache, rash. Liver toxicity (rarely) |
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Naftifine
(Naftin) |
Class B. Topical. Tx for jock itch, ringworm, athlete's foot
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Echinocandin Class
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IV only
MOA = inhibit fungal cell wall synthesis. Good activity vs. aspergillus/candida ADRs = histamine like rxn |
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Examples of Echinocandin Class Drugs
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Capsofungin, micafungin, anidulafungin
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Flucytosine
(Ancoban) |
Class X. PO. *similar to chemo drugs.
MOA = inhibit DNA synthesis via conversion to 5-fluorouracil. Indication = Ltd usefulness as single agent. High resistance. 5-FU effect. ADR = BMS, hepatic dys. |
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Griseofulvin
(Fulvicin) |
Class C. PO
Indication = dermatophytes **DOC for TINEA CAPITIS Must be taken w/ high fat meal Rarely used today. ADRs = fever, rash, leukopenia, NVD, hepatotox, photosensitivity. MUST TAKE LFTs |
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Tonaftate
(Tinactin) |
Topical. Class C. Dermatophytes- specifically tinea pedis.
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Ciclopirox
(Penlac) |
Topical for nails. Not very effective.
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