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Session 3 Pharm- 11

Pharm -11- Antifungals

QuestionAnswer
What type of antifungal is Fluconazole (Diflucan) Azole antifungal that targets cell membrane synthesis of ergosterol
What type of drug is Itraconazole (Sporanox) Azole antifungal that targets cell membrane synthesis of ergosterol
What type of drug is Ketoconazole (Nizoral) Azole antifungal that targets cell membrane synthesis of ergosterol
What type of drug is Voriconazole (Vfend) Azole antifungal that targets cell membrane synthesis of ergosterol
What type of drug is Posaconazole (Noxafil) Azole antifungal that targets cell membrane synthesis of ergosterol
What type of drug is Terbinafine (Lamisil) Allylamine antifungal that targets cell membrane synthesis of ergosterol
What are the therapeutic uses for ketoconazole used in shampoos rarely PO used for mucosal infections only.
What are the s/e of ketoconazole N/V, hepatotoxicity, gynecomastia, oligospermatism, decreased libido (inhibits CYP 450 responsible for testosterone synthesis)
How can you increase absorption of ketoconazole give it with cola or fruit juice since its absorption is dependent on pH
What caution do you have to use when prescribing ketoconazole it has severe drug interactions with drugs such as cyclosporine, warfarin, corticosteroid and theophylline
What are the most common Candida spp. That infect humans C. Albicans, Tropicalis, Parapsilosis, Glabrata, Krusei
What drug has historically been first line tx for Candida infections (but due to increasing resistance has been loosing that status) Fluconazole also covers Cryptococcus neoformans and coccidiomycosis
What are the major s/e of using Fluconazole N/V and rash and a lot of drug interactions but not as severe as some of the other azoles
How are fungi becoming resistant to fluconazole genetic mutation, altered target site and up regulation of efflux pumps
Which azole has greater coverage itraconazole or fluconazole itraconazole
What is one of the biggest limitations in using itraconazole (where doesn't it get) doesn’t cross the BBB
What are the major s/e of using Itraconazole taste disturbances, N/V, osmotic diarrhea, rash, hepatic toxicity, avoid using in pts with ventricular dysfunction
What is itraconazoles place in therapy preferred azole to tx many varied infections 2nd line for Blastomyces, histoplasmosis, and 3rd line for Aspergillus
What place in therapy does Voriconazole have used to tx invasive aspergillosis (1st line) and resistant Candida infections esp. Glabrata and Krusei.
What is the best antifungal to tx Mucor and Rhizopus fungus Posaconazole
What are the major s/e of using Voriconazole Visual disturbances (30%)
What type of drug is amphotericin B Polyene antifungal that targets ergosterol
What type of drug is Nystatin Polyene antifungal that targets ergosterol and is only used topically
Why is Amphotericin B considered the big gun of antifungal tx is targets major fungi such as aspergillosis, blasto, Candida, coccidio, crypto, histo and Mucor just not Fusarium, lusitaniae and other rare fungi
What are the major s/e of using Amphotericin B in antifungal tx delayed toxicity, wasting of potassium and magnesium, (Na+ loading can combat this side effect), fevers, chills, hypotension (pretreat with Benadryl, APAP or hydrocortisone)
What drug interactions does amphotericin B have enhances nephrotoxicity (cyclosporins, aminoglycosides, foscarnet, pentamidine) Antineoplastic drugs (cisplatin and nitrogen mustard toxicities are enhanced)
What type of drug is Caspofungin Echinocandin (Glucan synthesis inhibitor)
What type of drug is micafungin Echinocandin (Glucan synthesis inhibitor)
What type of drug is Anidulafungin Echinocandin (Glucan synthesis inhibitor)
What are the advantages of Echinocandins in tx of fungal infections and what are the limitations tx most common fungal infections (Candida and Apergillus) limited adverse effects, no drug interactions, but IV only and limited activity against fungi outside Candida and Aspergillus
What are the major s/e of using Echinocandins for tx fungi infusion related affects (IV site irritation, fever, HA, flushing, erythema and rash), histamine release
What type of drug is flucytosine DNA/RNA synthesis inhibitor
What are the major s/e of using flucytosine Bone marrow toxicity, monitor blood levels when using with ampho B
If you need an extremely effective antifungal what is your gold standard choice Amphotericin B
Created by: smaxsmith