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Antifungal Pharm

most important antifungal drug for severe infections ? * Amp-B
Are the mainstays of standard treatment ? * -Azoles (itra and flu)
Amphotericin B spectrum ? * treats just about everything.... DOC for most severe fungal infections
When to use ? * Systemic use reserved for severe, life-threatening infections
MOA of Amp-B ? * preferentially binds to ergosterol in fungal membranes to punch holes in it
Amp B Lipid Formulations ? * less toxicity and nephrotoxicity, but expensive
Amp-B SE's ? * Nephrotoxicity (constricts afferent arterioles)so monitor kidneys, Hypokalemia , cytokine storm - n/v/f,
Flucytosine Spectrum ? * Narrow spectrum antimycotic - Cryptococcals
Flucytosine use ? * Systemic candidiasis & cryptococcal infections ---Cryptococcal meningitis .... * never used alone, usu w/Amp-B
Flucytosine MOA ? * blocks dUMP/nucleic acid synthesis to make RNA/DNA
Flucytosine Side Effects ? * Bone Marrow Depression, n/v/d, GI mucositis - sores in mouth
Antifungal azoles advantages ? * treatment of systemic fungal infections bc low toxicity
Azole disadvantages ? * Inhibit P450 drug-metabolizing enzymes and can increase the levels of many other drugs
Azole MOA ? * Inhibits fungal cytochrome P450-dependent lanosterol 14-alpha-demethylase, which decreases ergosterol, which disrupts fungal cell membrane
Fluconazole usu uses ? * Coccidioidomycosis, meningitis, cryptococcosis, candidiasis.... * Not aspergillosis
Fluconazole bioavailability and drug/drug interactions ? * Absorption not affected by food or gastric pH.... * Fewer drug interactions than itraconazole.... * Eliminated by kidneys so can be used for UTIs
Itraconazole activity ? * Invasive aspergillosis , Blastomycosis, Cryptococcosis, Histoplasmosis , Suspected fungal infection w/ neutropenic fever , Coccidioidomycosis , Sporotrichosis
Itraconazole bioavailability ? * Requires food and acidic gastric pH for drug solubilization, acid lowering drugs can lower this drugs effectiveness
Itraconazole Oral Solution? * doesnt need an acidic environment.... but causes GI upset....excreted via hepatic system
Itraconazole Side Effects ? * drug/drug interactions, CYP3A4 inhibitor.... * has Negative Ionotropic Effects - Can cause hypertension, hypokalemia, and peripheral edema
Voriconazole use ? * invasive aspergillosis (DOC)
Voriconazole basics ? * not affected by pH or food.... * hepatically eliminated
Voriconazole Side Effects ? * Inhibits CYP3A4, Visual Changes, Neurotoxic, photosensitive rash, arrhytmias/QT prolongation
Caspofungin MOA ? * Impairs cell wall production inhibits beta-(1,3)-D-glucan synthesis (cell wall component) weaken cell wall
Active against ? * Active against Candida and aspergillus
When to use ? * salvage therapy when Amp B or voriconazole has failed (or drug intolerance)
Created by: thamrick800