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10 Cards in this Set
- Front
- Back
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Amphotericin B |
Binds ERGOSTEROL and Forms PORES -> allows leakage of electrolytes. Use: Serious, SYSTEMIC mycoses. Cryptococcal meningitis (w,w/o Flucytosine). Blastomyces, Coccidioides, Histoplasma, Candida, Mucor. Supplement K/Mg -> altered renal tubule permeability. Toxicity: Fever/Chills, Hypotension, NEPHROTOXICITY (hydrate), IV Phlebitis, arrhythmias. |
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Nystatin |
Same mechanism as Amphotericin B -> binds ERGOSTEROL to form PORES and cause leakage of electrolytes. Use: Swish and swallow for oral candidiasis. Topical for diaper rash or vaginal candidiasis. |
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Fluconazole, Ketoconazole, Clotrimazole, Miconazole, Itraconazole, Voriconazole |
Inhibit fungal ERGOSTEROL SYNTHESIS (by inhibiting CYP450 enzyme that converts lanosterol to ergosterol). Use: Localized, less serious mycoses. Fluconazole -> chronic suppression of cryptococcal meningitis in AIDS pts and ALL candidal infections. Itraconazole for Blastomyces, Coccidioides, Histoplasma. Clomitrazole/Miconazole for topical fungal infections. Toxicity: INHIBITS TESTOSTERONE SYNTHESIS (Ketoconazole causes Gynecomastia), Hepatic dysfunction (CYP450 inhibition). |
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Flucytosine |
Inhibits DNA/RNA biosynthesis by conversion to 5-FU by CYTOSINE DEAMINASE. Use: SYSTEMIC Fungal infections (esp cryptococcal meningitis) in COMBINATION with Amphotericin B. Toxicity: BM Suppression |
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Capsofungin, Micafungin, Anidulafungin |
Echinocandins that inhibit B-glucan Synthesis -> inhibit cell wall synthesis. Use: INVASIVE Aspergillosis, Candida Toxicity: GI upset, FLUSHING (HISTAMINE release) |
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Terbinafine |
Inhibits squalene Epoxidase (required to convert Squalene into Ergosterol). Use: DERMATOPHYTES (esp ONYCHOMYCOSIS -> fungal infection of finger/toe nails). Toxicity: GI upset, headaches, hepatotoxicity, Taste disturbance |
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Griseofulvin |
Interferes with microtubule function -> disrupts mitosis. Deposits in keratin-containing tissues (NAILS). Use: oral treatment of superficial infections, inhibits growth of DERMATOPHYTES (tinea, ringworm). Toxicity: teratogen, carcinogenic, confusion, headaches. Induces CYP450 -> increased warfarin meatbolism. |
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Antiprotozoan Therapy |
Pyrimethamine (inhibit DHFR) + Sulfadiazine Suramin or Melarsoprol -> Trypanosoma Brucei. Nitrofurtimox -> T Cruzi (Chagas) Sodium Stibogluconate -> Leishmaniasis. |
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Chloroquine
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blocks detoxification of Heme into Hemozoin.
Heme accumulates -> toxic to plasmodia. Use: treatment of plasmodial species EXCEPT P Falciparum. Treat P Falciparum with artemether/lumefantrine or atovaquone/proguanil. For life-threatening Malaria, use QUINIDINE or Artesunate. Toxicity: Retinopathy, PRURITIS (esp in dark-skinned pts). Resistance: membrane pump that decreases intracellular concentration of drug. |
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Antihelminthic Therapy |
Mebendazole, Pyrantel Pamoate, Ivermectin, Diethylcarbamazine, Praziquantel -> all immobilize helminths. Use PRAZIQUANTEL against flukes (trematodes) -> SCHISTOSOMA. |
