Pharmacology Of Antifungals & Antiviral Agents

Front 1

Amphotericin B

Back 1

Antifungal, broadest spectrum.

MOA: Binds to Ergosterol (cell membrane).
PK/PD: Poorly Absorbed in intestines.

AR: immediate reactions (fever, vomit...). Slow renal impairment.

Front 2

TEST QUESTION: What is the major side effect of Amphotericin B?

Back 2

Amphotericin B causes renal impairment!

Front 3

Flucytosine

Back 3

Broad Antifungal. Not as broad as Amphotericin B.

AE: metabolizes to 5-FU, a toxic neoplastic agent. Results in bone marrow toxicitiy, toxic enterocolitis.

Front 4

Imidazoles

Back 4

Broad activity on Antifungals.

"...azoles"

MOA: reduce Ergosterol synthesis by inhibiting fungal Cytochrome P450.

Front 5

Fluconazole

Back 5

Imidazole type of drug. Antifungal.

Good oral availability. Most popular.

Decreased drug interactions since it has a low effect on hepatic enzymes.

Front 6

Voriconazole

Back 6

New Imidazole Antifungal drug.

AE: Rash, increased hepatic enzymes, transient visual disturbances in 30% of patients.

Front 7

Caspofugin

Back 7

Antifungal used as Salvage Therapy for people who can't take Amphotericin B due to toxicities.

IV

Front 8

Griseofluvin

Back 8

Fugistatic agent (requires immune system).

Tx for dermatophytosis.

Front 9

Terbinafine

Back 9

Tx for Onychomycosis.

AE: increased liver function tests.

Front 10

Nystatin

Back 10

Tx for Oral Candidiasis (thrush)

Front 11

Foscarnet

Back 11

Antiviral treatment for CMV.

MOA: Inhibits DNA polymerase.
SE: Renal insufficiency, electrolight disturbances.

Front 12

Ganciclovir

Back 12

Antiviral for CMV retinitis.
PK/PDs: IV,PO, or Intraocular Implant.

AE: Myelosuppression, Retinal Detachment, Vitreous Hemorrhage.

Front 13

Valganciclovir

Back 13

Same as ganciclovir but prodrug for better PO absorption.

Front 14

Cidofovir

Back 14

Very Broad Antiviral, IV only.

Given with Probenecid to prolong half life and decrease the nephrotoxicity of the agent.

AE: Dose Dependent Nephrotoxicity.

Front 15

TEST QUESTION: What antiviral has dose related nephrotoxicity?

Back 15

Cidofovir.

Front 16

Fomivirsen

Back 16

Antiviral that inhibits CMV.

Used for intravitreal injections in AIDS patients who cannot take alternative therapies.

Front 17

Acyclovir

Back 17

Tx for HSV & VZV.

Resistance exists.

Front 18

Valacyclovir

Back 18

ester of acyclovir, tx for HSV and VZV.

Better PO absorption (3-5x) than acyclovir.

Front 19

Famciclovir

Back 19

Converted to Penciclovir.

Tx for herpes, requires intake immune system.

Front 20

Penciclovir

Back 20

Topical application for herpes. Requires intact immune system.

Front 21

Interferon Alfa

Back 21

Tx for Hepatitis B & C.

AE: Flu like symptoms.

Front 22

Ribavirin

Back 22

Used with Interferon Alpha for the management of Hep. C patients.

Front 23

Amantadine & Rimantadine

Back 23

Inhibits RNA of Influenza A

Front 24

Zanamivir (Relenza) and Oseltamavir (Tamiflue)

Back 24

Inhibits viral replication.

AE: GI