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Anti-fungal drugs
Mod5 lec1
Question | Answer |
---|---|
methods of susceptibility testing | macro-broth dillution |
AB biodisk interpretation | flucytosine- almost complete inhibition 95% |
Automated system for yeast susceptibility | TREK Sensititre YeastOne- microdillution method |
Technical variables in susceptibility testing | inoculum, media, incubation, end-points |
Issues with anifungal drugs | solubility, chemical stability, mode of action, partial inhibition, narrow MIC's |
Five groups of anti-fungal agents | polyenes, azoles, antimetabolites, echinocandins, anti-mitotic |
polyenes | amphotericin B |
amphotericin B mode of action | inserts itself into cell membrane by attaching to ergosterol forming pores through which cytoplasm leaks out |
Azoles | fluconazole, itraconizole, ketoconazole, voriconizole, posiconazole, ravuconizole |
Azole mode of action | attacks cytochrome enzyme P450 which converts lanosterol to ergostrerol. Cannot synthesize new cell membrane |
Anti-metabolite | flucytosine |
Flucytosine mode of action | converts to 5-fluorouracil which inhibits RNA and protein synthesis |
Echinocandin | caspofungin, micafungin, anidulafungin |
Eichocandin mode of action | inhibits synthesis of 1,3,B-glucan. Can not form cell wall |
Anti-mitotic | griseofulvin |
Griseofulvin mode of action | disrupts mitotic spindle formation |
Griseofulvin delivery system | taken orally- absorbs in skin layers- as it moves out it disrupts superficial mycotic infection. slow-working/ hepatotoxic |