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ANTIFUNGAL

ANTIFUNGAL, ANTIPROTOZOAN, ANTIHERLMINTHIC

QuestionAnswer
Lanesterol synthesis inhibitor Terbinafine
Ergosterol synthesis inhibitiors Azoles
Cell wall synthesis inhibitors Echinocandins (-fungin)
Inhibit formation of Membrane Pores Polyenes 1. Amphotericin B 2. Nystatin
Nucleid acid inhibitors 5-Flucytosine
Amphotericin B; MOA Binds ergosterol; forms membrane pores that allow leakage of electrolytes.
Amphotericin B; CLINICAL USE 1. Systemic mycoses. 2. Cryptococcal meningitis (with/without flucytosine) 3. Blastomyces, Coccidioides, Histoplasma, Candida, Mucor. 4. lntrathecally for fungal meningitis. Supplement K and Mg because of altered renal tubule permeability.
Amphotericin B; TOXICITY ("amphoterrible") Fever/chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis.
IV phlebitis Amphotericin B
What reduces Amphotericin´s nephrotoxicity Hydration
What reduces Amphotericin´s toxicity Liposomal amphotericin
Nystatin; CLINICAL USE 1. Oral: oral candidiasis (thrush) 2. Topical: diaper rash or vaginal candidiasis
Azoles; MOA Inhibit fungal sterol (ergosterol) synthesis, by inhibiting the P-450 enzyme that converts lanosterol to ergosterol.
Azoles; CLINICAL USE Local and less serious systemic mycoses. Clotrimazole and miconazole for topical fungal infections.
Cryptococcal meningitis in AIDS patients and candidal infections of all types Fluconazole
Itraconazole Blastomyces, Coccidioides, Histoplasma.
Topical fungal infections Clotrimazole and miconazole
Azoles; TOXICITY 1. Testosterone synthesis inhibition (gynecomastia, esp. with ketoconazole) 2. Liver dysfunction (inhibits cytochrome P-450).
Inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase. Flucytosine
Flucytosine; CLINICAL USE Meningitis caused by Cryptococcus in combination with Amphotericin B
Inhibits cell wall synthesis by inhibiting synthesis of beta-glucan. Echinocandins (-fungin)
Echinocandins (-fungin); CLINICAL USE Invasive Aspergillosis, Candida
Echinocandins (-fungin); TOXICITY FLUSHING
Inhibits Squalene Epoxide Terbinafine
Terbinafine; CLINICAL USE Dermatophytoses (especially onychomycosis-fungal infection of finger or toe nails).
Terbinafine; TOXICITY GI upset, headaches, hepatotoxicity, taste disturbance.
Taste disturbance Terbinafine
Monitor LFT´s Terbinafine
Griseofulvin; MOA Interferes with microtubule function; disrupts mitosis. Deposits in keratin-containing tissues (e.g., nails).
Deposits in keratin-containing tissues (e.g., nails). Griseofulvin
Interferes with microtubule function Griseofulvin
Griseofulvin; CLINICAL USE Oral treatment of superficial infections; inhibits growth of dermatophytes (tinea, ringworm).
Griseofulvin; TOXICITY Teratogenic, carcinogenic, confusion, headaches, Induces P-450 and warfarin metabolism.
Antiprotozoan therapy 1. Pyrimethamine (toxoplasmosis), 2. Suramin and Melarsoprol (Trypanosoma brucei), 3. Nifurtimox (T cruzi), 4. Sodium Stibogluconate (leishmaniasis)
Chloroquine; MOA Blocks detoxification of heme into hemozoin. Heme accumulates and is toxic to plasmodia
Chloroquine; CLINICAL USE Plasmodial species other than P. falciparum
P. falciparum artemether/lumifantrine or atovaquone/proguanil.
Life-threatening malaria Quinidine
Chloroquine; TOXICITY 1. Retinopathy 2. Pruritus (especially in dark-skinned individuals)
Pruritus (especially in dark-skinned individuals) Chloroquine
Antihelminthic therapy; immobilize helminths. Mebendazole, pyrantel pamoate, ivermectin, diethylcarbamazine, praziquantel
Against flukes (trematodes) such as Schistosoma. Praziquantel
Created by: heidy39