Term
|
Definition
yeasts
dimorphic fungi
mold
dermatophyte |
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Term
|
Definition
-single oval cells
Candida, cryptococcus, trichisporon |
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Term
|
Definition
HSBC
-histoplasma
-Sporothrix
-Blastomyces
-Coccidiomyces |
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Term
|
Definition
filamentous strands = hyphae
-Aspergillus
-Zygomyces
-Fusarium |
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Term
|
Definition
-microsporum
-trychophyton
-epidermophyton |
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Term
|
Definition
-yeast
-from soil contaminated by pigeon or chicken droppings or by inhalation (C. neoformans)
High CNS affinity --> meningitis
high incidence in immunocompromised patients |
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Term
|
Definition
-mold
-widespread in the environment; soil, water, dead leaves, compost
-Acquired through inhalation |
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Term
|
Definition
dimorphic
common to Ohio and Mississippi river valley
90% of residents exposed |
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Term
| Blastomyces and Coccidiomyces |
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Definition
dimorphic
Blastomyces - Central and SE states
Coccidioides - SW states (San Joaquin Valley Fever) |
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Term
|
Definition
anamorphic/dermatophyte
ringworm disease: tinea corporis
Athletes foot: tinea pedis |
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Term
| Echinocandins; MOA, Use, PK |
|
Definition
-fungins
MOA: inhibit cell wall synthesis by blocking B-(1,3) D-glucan synthase --> cell death
Use: Candida species, Aspergillus spp. (not good for cryptococcus neoformans)
PK: t1/2=15hrs, high protein binding, can cross BBB but low CSF concentration - not good for CNS infections
i.v. only |
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Term
| Azole antifungals; use, MOA |
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Definition
use: systemic infections
MOA: bind to lanosterol demethylase and inhibit production of ergasterol, a key component in fungal cell membranes |
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Term
| Ketoconazole; use, PK, ADR |
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Definition
Use: mucosal infections
PK: absorption dependent on pH - give w/ cola or juice, poor CSF penetration, t1/2=2-10hrs, 3A4 metabolized
ADRs: N&V, hepatotoxicity, CYP3A4 and 2C19 inhibition, decreased testosterone synth (gyenecomastia, oligospermia,decreased libido) decreased adrenal cortisol synth |
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Term
| Fluconazole, advantages/disadvantages |
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Definition
2nd Generation azole
-better tolerated, i.v. or p.o., longer halflife, better PK, better CNS penetration
-fungistatic, resistance is increaseing, narrowing of spectrum |
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Term
|
Definition
from i.v. or p.o.
Taste disturbances
N & V
Osmotic diarrhea
Long term compliance low
**but has a broader spectrum |
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Term
|
Definition
Visual disturbances (30%) - decreased vision, photphobia, altered color percception and discomfort *are reversible
more in i.v. than p.o.
Also PDE6 inhibition and increased digoxin |
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Term
| What antifungal can't be administered with Azoles? why? |
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Definition
Amphotericin B
decrease in ergosterol from Azoles will reduce the fungicidal effect of AmphoB |
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Term
|
Definition
"Lamisil"
Allylamine
MOA: inhibits ergosterol synthesis by inhibiting squalene epoxidase |
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Term
|
Definition
Polyene antibiotic, very efficacious
Use: invaseive fungal infection, not responding to other therapy
MOA: binds to ergosterols in fungal membrane, creates |
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Term
| Amphoteracin B; PK and metabolism |
|
Definition
PK: absorption from GI is negligible, only given i.v.
selective soft tissue distribution
kidney>liver>spleen>lung>heart>skeletal muscle>brain>bone>CSF>eyes
Metabolism: unknown, accumuates in tissue and is slowly released; inverse relationship between age and elimination |
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Term
|
Definition
| infusion related cytocine storm - inflammatory response, temp increase, vasodilation, drop in BP nephrotoxicity - decrease RBF and GFR, tubular ischemia, wasting of K, Na and MG Hepatatotoxicity Hypkalaemia |
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Term
|
Definition
Cytosol antifungal
only fungus selective Microtubule inhibitor
Must accumulate in skin, takes long to kick in |
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Term
|
Definition
Fungistatic
pyrimidine anologue, 5-fluorocytosine
5FC taken up selectively by fungus and converted to 5FU which stops DNA synthesis
Resistance develops quickly, use w/ AmphoB or fluconazole |
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