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Antifungal Drugs

AUA Pharm 4

QuestionAnswer
Name a Polyene Antifungal Amphotericin B
Use of Amphotericin B IV for serious life-threatening infections: Aspergillus, Candida, Cryptococcus, Histoplasma
Mechanism of Action of Amphotericin B Binds to ergosterol
Side effects of Ampho B (Dose) Nephrotoxic, Hypokalemia, Normochromic normocytic anemia
Side effects of Ampho B (Influsion) Flu-like symptoms
Why do you premedicate patients on Ampho B and for what? To avoid flu-like symptoms that are infusion dependent. You premedicate with antipyretic, antihistaminic, and antiemetic agents
Does Ampho B penetrate the CNS? Yes, but with extremely low penetration. However, it does not cross blood brain barrier so you have to give it intrathecally
Does Ampho B have any drug interactions? Synergistic with flucytosine
Flucystosine is used for? Resistant Cryptococcus and candidiasis
What causes resistant cryptococcus and candidiasis? decreased ergosterol levels
Use of Nystatin Topically for Candidiasis. CANNOT USE SYSTEMICALLY --> Too toxic.
Name -Azole Antifungals Ketoconazole, fluconazole, itraconazole, clotrimazole, miconazole
How do -Azole antifungals work? block synthesis of ergosterol by inhibiting 14 alpha demethylase in the fungal 450 complex
How does resistance to -azole antifungals occur? decrease intracellular levels of drugs
What are -azole antifungals used for? Candidiasis, coccidiomycosis, paracoccidiomycosis, blastomycosis, and histoplasmosis.
Indications of clotrimazole and miconazole and method of administration given topically for candida and dermatophytic infections
side effects of ketoconazole gynecomastia and decreased libido as well as menstrual irregularities
the side effects of ketoconazole mimic the side effects to which other drugs? spironolactone
Does fluconazole penetrate the CSF? Yes
Does itraconazole penetrate the CSF? No
Antifungals with limited indications Griseofulvin, Terbinafine, and Flucytosine
MOA of Griseofulvin Disruption of mitotic spindle by interfering with microtubules
Griseofulvin used for? tinea cruris (jock itch)
a 27 y/o patient noticed increased effects of his griseofulvin. what may have caused this? alcohol
when is griseofulvin contraindicated? intermittent porphyria
MOA of Terbinafine Inhibits squalene epoxidase
Indication of terbinafine? onychomycosis (nail fungal infection)
side effects of terbinafine? elevated liver function tests
MOA of Flucytosine inhibits thymidylate synthetase to decrease thiamine
Flucytosine + Ampho B indicated in? severe candidiasis in immunocompromised patients
Side effects of flucytosine? decrease bone marrow, leukopenia, thrombocytopenia, severe enterocolitis, and hepatitis.
Created by: Samiaa76
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