Term
| What drug has the MOA to bind to ergosterol and cause osmotic distruction of the fungus? |
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Definition
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Term
| What are the potential adverse effects (2) of amphotericin B? |
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Definition
| renal and infusion toxicity |
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Term
| What formulation of amphotericin B allows you to give a higher dose with less toxicity? |
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Definition
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Term
At which letter does Amphoteracin B work (two possible letters)?
[image]
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Definition
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Term
At what letter does flucytosine work at?
[image] |
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Definition
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Term
What drug works at letter C?
[image] |
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Definition
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Term
| What are the specific uses for amphotericin lipid formulations? |
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Definition
| fungal infections refractory to amphoteracin or individual s intolerant of amphoteracin |
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Term
| Why are lipid formulations not used as much as regular amphoteracin? |
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Definition
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Term
| What is the MOA of the azoles? |
|
Definition
| inhibits the enzyme 14 alpha dimethylase |
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Term
| What drug inhibits 14 alpha dimethylase? |
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Definition
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Term
| What does sterol 14 alpha demethylase do? |
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Definition
| converts lanosterol to ergosterol |
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Term
| What drug has numerous drug-drug interactions because it inhibits an enzyme in the P450 pathway? |
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Definition
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Term
| What azoles acutally use the P450 for their metabolism? |
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Definition
| itraconazole and voriconazol |
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Term
| What are the toxicities of fluconazole? 3 |
|
Definition
| cholesstasis, nausea, rash |
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Term
| Which azole is active against yeast only? |
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Definition
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Term
| What azole is active against yeasts and molds? |
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Definition
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Term
| You want an azole to treat candida or cryptococcal meningitis, what would it be? |
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Definition
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Term
| What candida specie is always fluconazole resistant? |
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Definition
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Term
| How is resistance to fluconazole acquired? (3) |
|
Definition
incresed efflux
incresaed produciton of sterol 14 alpha dimethalase
mutation of sterol 14... |
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Term
| Why is oral ketoconazole rarely used? |
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Definition
| b/c of its toxicities and other azoles are more safe |
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Term
| What are the adverse effects of ketoconazole? |
|
Definition
thyroid problems
liver enzyme abnormalities
decreases testosterone/cortisone |
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Term
| What drug has impoved symptoms in Cushing Syndrome? |
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Definition
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|
Term
| What fungi is itraconazole used for? |
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Definition
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Term
| How do you improve the oral absorption of itraconazole? |
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Definition
|
|
Term
| What was the first azole that was active agianst aspergillus? |
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Definition
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|
Term
| Do you use itraconazole in acute or chornic stages of a disesae? |
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Definition
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|
Term
| What drug reduces cardiac systolic function as an adverse effect? |
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Definition
|
|
Term
| What are the five adverse reactions of itraconazole? |
|
Definition
GI intolerance
Cholestasis
reduce cardiac function
edema
hypokalemia |
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|
Term
| What drug causes edema as an adverse reaction? |
|
Definition
|
|
Term
| What drug causes hypokalemia as an adverse reaction? |
|
Definition
|
|
Term
| What are the second generation azoles? |
|
Definition
voriconazole
posaconazole |
|
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Term
| What is the gold standard treatment of invasive aspergillus? |
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Definition
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|
Term
| What are the toxicities of voriconazole? (5) |
|
Definition
visual
liver enzyme abnormalities
nephrotoxicity
skin changes
drug-drug |
|
|
Term
| what drug causese blurred vision, and color differentiation problems? |
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Definition
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Term
| What azole is primarily used in high risk neutropenic or graft versus host disease patients? |
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Definition
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Term
| What is terbinafine mostly used for? |
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Definition
|
|
Term
| What is the mechanism of action of terbinafine? |
|
Definition
| inhibits squalene epoxidase which is involved in ergosterol synthesis |
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|
Term
| What drug inhibits squalene epoxidase? |
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Definition
|
|
Term
| What is the primary toxicity of terbinafine? |
|
Definition
|
|
Term
| What is the MOA of flucytosine? |
|
Definition
| replaces uracil with 5-FU |
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Term
| What drug is used in combination with amphoteracin B for use in cryptococcus meningitis? |
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Definition
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|
Term
| What are the two main toxicities of flucytosine? |
|
Definition
| GI toxicity and bone marrow supression |
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|
Term
| What do you have to worry about when treating cryptococcus meningitis with the typical combo therapy? |
|
Definition
| amphoteracin B can cause renal impairment which would reduce the excretion of flucytosine and increase the toxicity of flucytosine...GI toxicity and bone marrow suppresion |
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Term
| What is the MOA of the echinocandins? |
|
Definition
| they inhibit fungal B1,3 glucan synthase so the cell wall is not constructed properly |
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|
Term
At which letter do the echinocandins ultimatly have thier effect?
[image] |
|
Definition
|
|
Term
| What class of drugs do their names end in fungin? |
|
Definition
|
|
Term
| What do the echinocandins cause the cell wall to do? |
|
Definition
|
|
Term
| What two fungi are the echinocandins used to treat? |
|
Definition
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|
Term
| What drug when combined with an echinocandin may cause reversible liver enzyme abnormalities? |
|
Definition
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