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33 Cards in this Set

  • Front
  • Back
what are the main targets for anti-fungals
ergosterol synth and in the membrane, cell wall synth, microtubules, nucleotide synthesis
what is the major drawback of most antifungals
toxicity (use topicals)
how do polyenes work
they bind to the strol and disrupt the membrane resulting in leakage
what is the drug of choice for many non-topical mycoses
Amp B
how do you get resistance to Amp B
no ergosterol in the membrane, reduced oxidative damage, cell wall permeability change
what are the three main polyenes
amp B, nystatin, pimaricin
Amp B is administered how?
what is the main side effect of Amp B
what are the advantages of lipid formulas of AmpB
decreased toxicity ONLY not more effective and expensive
Nystatin is used how?
topically and orally
what is the problem with oral nystatin
not absorbed well by GI
what was the 1st polyene discovered
nystatin (not well absorbed)
what are the Azoles
fluconazole, ketoconazole, itraconazole
how do azoles work
inhibit cytochrome P450 demethylation of lanosterol so ergosterol can't be made
what azole is currently the drug of choice for non-life threatening fungal infections
triazole (i.v. and orally)
what are examples of allylamines
naftifine, and terbinafine
how do allylamines work?
inhibit squalene epoxidase (used to synthesize ergosterol)
what is a problem with allylamines
generate a toxic intracellular squalene buildup
is allylamine hydrophilic or hydrophobic
what do we use allylamines for?
mostly dermatophytes
what allylamine is available as an oral formula
how do organisms become resistant to allylamines
enzyme target modification, poor penetration, overproduction of target enzyme
what are some examples of candins
echinocandin, papulocandin, caspofungin and micafungin
how do the candins work
noncompetitive inhibition of B 1,3 glucan synthase which makes the cell wall * may really affect the regulation proteins
when would you use a candin
candidiasis and secondary therapy maybe for aspergillous not much use against others
how can fungi develop resistance to candins
modify enzyme target and have low levels of B 1,3 glucan in the walls
how do nucleoside analogs work?
inhibits nucleotide synthesis and converts to 5 fluorouricil in the cytoplasm to stop DNA and RNA synth
what do nucleosides convert to?
5 fluorouricil
when do you use nucleosides
with amp B (resitance develops quickly)
what are the methods to identify antifungal susceptibility testing
Broth dilution
Elipsometer Test
Disk Method (fluconazole)
antifungal susceptibility testing is most useful for?
fluconazole and itraconazole
what mould is antifungal suspceptibility testing based on?
what is the important thing to remember about azoles when you are doing antifungal susceptibility testing
they require growth to work so you will see some growth in the well