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58 Cards in this Set
- Front
- Back
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What is Amphotericin B?
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polyene antifungal antibiotic
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How does Amphotericin B work?
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interaction with sterol of fungal membrane
causes loss of intercellular components |
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What bugs does Amphotericin B work best against?
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Histplasma
Cryptococcus Coccidioides Candida Glabrata Blastomyces B. Braziliensis Aspergillus |
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Other than fungus, what is Amphotericin B effective against?
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protozoa
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How is Amphotericin B administered?
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IV administration for systemic infections
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How is Amphotericin B excreted?
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kidneys- can also damage them
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How is renal damage of Amphotericin B measured?
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this is does dependent damage
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What other drugs should be given with caution when using Amphotericin B?
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aminoglycosides- because they are both nephrotoxic
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What is the DOC for aspergillus?
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Voriconazole
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What is the DOC for Cryptococus?
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Amphotericin B and flucytosine
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How does Flucytosine work?
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this gets converted to 5- fluorouracil
which then antagonises metabolism of fungal DNA |
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What bugs is Flucytosine most effective against?
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Cryptoccous**
candida aspergillus sporotrichum schenckii (rose thorn disease) |
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What is the administration of Flucytosine?
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absorbed orally
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What are the major side effects of Flucytosine?
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depression of bone marrow- anemia, leukopenia, thrombocytopenia
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How does ketoconazole work?
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this disturbs sterol of fatty acid metabolism of fungi.
may cause accumulation of toxic endoperoxides |
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how is ketoconazole given?
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orally
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What fluids does ketoconazole penetrate into?
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urine, saliva, milk
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Is ketoconazole metabolized by the body?
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yes it is extensively metabolized prior to elimination
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What is the major side effect of ketoconazole?
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inhibits P450 enzymes, CYP3A4
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What is the endocrine side effect of ketoconazole?
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inhibits adrenal and testicular function
causes gynecomastia |
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What kind of drug is Flucanazole?
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this is an antifungal azole
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How is Flucanazole given?
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oral and IV
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How does Flucanazole work?
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this blocks synthesis of ergosterol
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What bugs is Flucanazole active against?
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Blastomyces
Candidia Cryptococcus Coccidioides Histoplasma |
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What tissues does Flucanazole penetrate well?
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it gets in the CSF very well- key!
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How well does ketoconazole penetrate the CSF?
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not very well, only about 10% of plasma concentration
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How does Flucanazole compare to other antifungals?
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less toxic, and better tolerated in general.
also better CSF penetration |
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What are the endocrine effects with Flucanazole?
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None!
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What does Flucanazole interact wth?
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this can increase serum concentrations of a few drugs
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How is Itraconazole given?
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Orally
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How does Itraconazole work?
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this alteres the fungal cell membrane
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What bugs is Itraconazole used against?
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Blastomyces
Histoplasma onchomycosis (nail fungus) esophagenal candidiasis oropharyngeal candidiasis |
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How is Itraconazole metabolized?
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heptaically
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How is Itraconazole transported around the body?
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highly protein bound in plasma
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What are the side effects of Itraconazole?
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GI
Nausea rash |
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What is Voriconazole?
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this is similar to Itraconazole, so it alters fungal cell membrane
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what is important about Voriconazole?
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has lots of drug interactions
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How is Caspofungin given?
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IV
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What is Caspofungin meant to treat?
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invasive aspergillosis in refractory pts
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How does Caspofungin work?
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this inhibits the synthesis of beta (1,3)-D-glucan
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What is Griseofulvin used to treat?
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ringworm infections of the skin, hair, and nails
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How does Griseofulvin work?
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the binds to microtubule sof fungi and destroys the mitotic spindles
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How is Griseofulvin given?
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oral administation
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What does Griseofulvin bind to?
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keratin- so has high concentration in epidermis
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What are the side effects of Griseofulvin?
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GI
rash some blood problems |
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What is Griseofulvin given for?
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systemic treatment of dermatophytosis
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How does Nystatin work?
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this is a polyene antibiotic
binds to fungal membrane sterols and alters permeability |
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What bugs does Nystatin work against?
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Candida
Cryptococcus Histoplasma Blastomyces Trichopthyon |
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How is Nystatin Given?
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orally
or topically |
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is Nystatin absorbed orally?
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nope it just passes on through
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How is Terbinafine given?
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orally or topically
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What is Terbinafine used to treat?
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onychomycosis. better than griseofulven or intraconazole
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How does Terbinafine work?
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this exerts its antifungal effect through interfering with fungal sterol biosynthesis
inhibits squalene monooxygenase |
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Is Terbinafine absorbed orally?
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yes it is
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How you have to adjust Terbinafine dosing?
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nope
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What does Miconazole Nitrate treat?
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Trichophytons
Epidermophyton Microsporum candidia Cryptococus Aspergillus |
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What does Clotrimazole treat?
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this is lotrimin
treats dermatophytes, yeasts, and malassezia furfur |
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What does Tolnftate treat?
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this is tough actin tinactin
treats trichophyton microsporum epidermophyton |
