Flashcards
Antifungals
Cards in this deck (26)
- 1Fungi TypesYeast, molds, and dimorphic
Mycoses - 2Fungi -Where they are acquired -Who Gets themSurgical, ICU, Prostheses, IV catheters, HIV
Immunosuppressant, Cancer, and transplant patients - 3Traditional Fungal Diagnostic TestsCulture
- 4New Fungal Diagnostic tests (3)1) PCR
2) Western Blot
3) Antigen Detection - 5First Antifungal Agent availableAmphotericin B
- 6Fungal Infections Subgroups (3)1) Superficial mycoses
2) Subcutaneous mycoses
3) Systemic mycoses - 7Superficial mycoses Tx (3)Nystatin
Terbinafine
Griseofulvin - 8Subcutaneous Mycoses TxAmphotericin
Azole Derivatives
Flucytosine - 9Systemic Mycoses Tx (3)Amphotericin
Azole derivatives
Flucytosine - 10Amphotericin B MOAPolyene antifungal binds to membrane sterols (ergosterol) in fungal cell membranes, resulting in increased cell membranes, resulting in increased cell permeability, cell leakage, and death
- 11Amphotericin B Adverse Effects1) Infusion Related Reactions: Chills, fever, HA, N/V. Premedicaiton advised w/ anti-inflammatory drugs, steroids, and antipyretics. Slow the infusion rate
- 12Amphotericin B Adverse Effects2) Cumulative Toxicity: Nephrotoxicity is severe (80% of patients), Acute Tubular Necrosis occurs which is irreversible. There may also be Anemia, Leucopenia, and severe Potassium and Magnesium loss
- 13Nystatin (General)-Related to Amphotericin B
-Topical therapy only [toxic when used systemically] - 14Nystatin -use -Available forms-Tx for topical vaginal and oral fungal infections (Candida infection)
-Available as ointments, creams, mouthwash, suppositories - 15Azole Antifungals ClassesImidazoles
Triazoles - 16Imidazoles Examples (3)Ketoconazole
Clotrimazole
Miconazole - 17Imidazole -Delivery -Contraindication-Delivery: Oral and topical
-Contraindication: GI absorption of Ketoconazole does not occur in achlorhydria or when pt is receiving H2 blockers or PPI - 18Triazoles Examples (3)Itraconazole
Fluconazole
Voriconazole - 19Triazoles -Delivery-Delivery: Oral and IV
- 20Triazoles Common Adverse Effects-Common adverse effects include GI disturbances, HA, dizziness
-Alopecia areata and Stevens Johnson - 21Triazole Drug levels effected-Increased levels of Amitriptyline, Cyclosporine, Phenytoin, Warfarin
-Decreased Fluconazole levels Carbamazepine, isoniazid, phenobarbital - 22Azole Derivatives and Use (4)Itraconazole-onychomycosis
Voriconazole-aspergillus, Candida
Ketoconazole-Seborrheic dermatitis
Clotrimazole-Topical Candida - 23Echinocandins-Inhibit Fungal cell wall synthesis [Chitin, Beta D-Glycan]
-Beta glucans are carbohydrate polymers cross-linked with other fungal cell wall components
-Inhibition of Beta 1-3 glycans of the fungal cell wall - 24Echinocandins (Examples)-Caspofungin (Cancidas) for tx of Candida and Aspergillus
-Micafungin: esophageal, oropharyngeal, and invasive candidasis
-Used in hemaopoietic stem cell transplantation patients
Adverse effects: HA, fever, phlebitis at injection site, abnormal LFTs - 25Grisefulvin-Deposited in keratin precursor cells of skin, hair, and nails where it disrupts microtubule function and inhibits dermatophyte growth
-Induces CYP450 to reduce warfarin and Oral contraceptive concentration
-Absorption enhanced w/ fatty foods - 26Terbinafine-Synthetic allylamine used for onychomycosis
-Fungicidal because it interferes w/ Ergosterol synthesis
-Used for Tinea corporis and tinea cruris
Information
- Description
- Antifungal info from Dr. Chand's Lecture
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- jmburk07
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