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Pharm 34 AntiFungals
LECOM Pharm Ch 34 antifungals
| Question | Answer |
|---|---|
| MOA of flucytosine | inhibits fungal DNA synthesis. As 5-FU |
| Flucytosine should be used with caution in these Pts | renal Pts |
| Concaminant use of amphotericin and this drug results in killing of Aspergillus | Flucytosine |
| Treats candidiasis, Cryptococcosis, Chromomycosis | Flucytosine |
| Use this to treat fungal Infx of the skin, hair and nails, and must be given until infected tissues are completely replaced | Griseofulvin |
| Use to treat Trichophyton, Microsporum, or epidermophyton | Griseofulvin |
| Concurrent treatment with barbiturates decreases Gi absorbance | Griseofulvin |
| Anti-fungal medication that induces P450 enzymes | griseofulvin |
| This drug taken orally can exacerbate psoriasis or subacute cutaneous lupes erythematosus | Oral terbinafine |
| MOA of Terbinafine and drug class | inhibit squalene epoxidase; allylamines |
| MOA of Naftifine and drug class | inhibits squalene epoxidase; allylamines |
| MOA of Butenafine and drug class | inhibits squalene epoxidase; benzylamine |
| 3 topical drugs more effective against common dermatophytes than azole | Terbinafine, Naftifine, butenafine |
| This is used to treat onychomycosis | terbinafine |
| Squalene epoxidase inhibitor available only in topical cream or gel | Naftifine |
| Terbinafine is not recommended for use in these 3 Pt groups | liver and kidney damage, pregnant women |
| This drug can be used to treat onychomycosis, but has varied oral availability so IV doses are used | itraconazole |
| These anti-fungals inhibit P450 3A4 | itraconazole, voriconazole, and fluconazole |
| 5 triazoles | Flu-, Itra-, Posa-, Ter-, Vori- conazoles |
| Ketoconazole cannot be used in Pt’s with achlorhydria, or use of drugs lowering stomache pH | ketoconazole |
| Anti-Fungal agent used for inhibition of all gonadal and adrenal steroids | Ketoconazole |
| MOA of azoles | inhibits 14α-sterol demethylase |
| This imidazole drug also affects fungal fatty acid synthesis | miconazole |
| Pt is allergic to sulfites, what topical azole should not be used | ketoconazole |
| Major adverse effect in itraconazole use | hepatotoxicity |
| Triazole that has potent effects on aspergillus and Zygomycetes | posaconazole |
| Triazole thathas almost 100% Bio-availability orally, is not influenced by stomach pH, and penetrates CSF, sputum, urine and saliva | fluconazole |
| DOC for systemic candidiasis and cryptococcal meningitis | fluconazole |
| DOC for cooccidioidal meningitis | fluconazole |
| In blastomycosis, histoplasmosis, and sporotrichosis which do you use? Itraconazole or fluconazole? | itraconazole, more active |
| Pathway of fluconazole resistant candida | P450 enzyme mutations, multidrug efflux transporter proteins |
| DOC for invasive aspergillosis, fusarium, scedusporium | voriconazole |
| Pt c/o strange symptoms such as photophobia and seeing colored lights after being started on a new drug. What is it? | voriconazole |
| This drug should not be used in renal secondary to increased CNS toxicity of an accumulating metabolite | voriconazole |
| Vaginal suppository inserted at bedtime to treat vaginal candidiasis | Terconazole |
| MOA of Echinocandins | non-competatively inhibit β-(1,3)- D-glucan synthesis |
| Used as primary therapy for esophageal candidiasis and candidemia | Caspofungin |
| Used as salvage therapy for Aspergillus Infx and as empiric therapy for febrile neutropenia | caspofungin |
| These 3 drugs can cause puritis and rash secondary to histamine release | caspo-, mica-, anidula-, -fungins |
| This is used as antifungal prophylaxis for hematopoietic stem cell transplant recipients | micafungin |