Term
| Mechanism of Polyene antimycotics? |
|
Definition
| Bind to ergosterol and poke holes in the membrane |
|
|
Term
| Which are the polyene antimycotics? |
|
Definition
| Nystatin, Amphotericin B, Natamycin |
|
|
Term
| Which polyene is used in the eye? |
|
Definition
|
|
Term
| Which antimycotics are used topically? |
|
Definition
| Polyene antimycotics (Nystatin, Amphotericin B, Natamycin), Tolnaftate, Ciclopirox, Terbinafine, Imidazoles (Miconazole, Clotrimazole) |
|
|
Term
| Which antimycotics are used topically for ringworm? |
|
Definition
| Tolnaftate, Ciclopirox, Terbinafine, Miconazole, other "-azoles" |
|
|
Term
| Which antimycotic agents are used for candida? |
|
Definition
| Miconazole and other "-azols" |
|
|
Term
| Which antimycotics are given systemically for skin infections (mainly nail)? |
|
Definition
| Griseofulvin and Terbinafine |
|
|
Term
| What is the mechanism of Griseofulvin? |
|
Definition
| Binds to microtubules and inhibits mitosis |
|
|
Term
| Is Griseofulvin fungistatic or fungicidal? |
|
Definition
|
|
Term
| What are the side effects of Griseofulvin? |
|
Definition
| Headache, photosensitive, induces P450, cross-reacts for PCN allergy |
|
|
Term
| What is the mechanism of Terbinafine? |
|
Definition
| Inhibits ergosterol synthesis and causes a buildup of toxic squalene by inhibiting squalene epoxidase, which is necessary to convert squalene to squalene 2,3 oxide |
|
|
Term
| What are the side effects of Terbinafine? |
|
Definition
| Liver damage, inhibits P450 |
|
|
Term
| Which antimycotics are used for systemic infections? |
|
Definition
| Amphotericin B, Triazoles (Fluconazole, Itraconazole, Voriconazole), Imidazoles (ketoconazole), Flucytosine, Echinocandins |
|
|
Term
| What is the mechanism of Amphotericin B? |
|
Definition
| Forms pores in ergosterol-containing membranes |
|
|
Term
| Is Amphotericin B fungistatic or fungicidal? |
|
Definition
|
|
Term
| How is Amphotericin B adminstered, and why? |
|
Definition
| IV for 2-4 months; it is insoluble in water |
|
|
Term
| What are the side effects of Amphotericin B? |
|
Definition
| Impaired (irreversible) renal function in 80% of patients, thrombophlebitis, fever, chills, convulsions, anemia |
|
|
Term
|
Definition
| Miconazole, Clotrimazole, Ketoconazole |
|
|
Term
| What is the mechanism of the Imidazoles? |
|
Definition
| Inhibits fungal cyp450 (lanasterol demethylase), preventing conversion of lanasterol to 14 demethyl lanosterol |
|
|
Term
| What are the side effects of Ketoconazole? |
|
Definition
| Can inhibit host cyp450, can inhibit cortisol and testosterone synthesis |
|
|
Term
|
Definition
| Fluconazole, Itraconazole, Voriconazole |
|
|
Term
| What is the mechanism of the Triazoles? |
|
Definition
| Inhibits fungal CYP450 (lanasterol demethylase), preventing conversion of lanasterol to 14 demethyl lanosterol |
|
|
Term
| Side effects of Itraconazole? |
|
Definition
| Decreases heart contractility |
|
|
Term
| What are the side effects of Voriconazole? |
|
Definition
| Causes visual disturbances |
|
|
Term
| What is the mechanism of Flucytosine? |
|
Definition
| It is a prodrug that is converted to 5 fluorouracil by fungi; inhibits thymidine synthesis |
|
|
Term
| What are the side effects of Flucytosine? |
|
Definition
| GI upset, bone marrow depression |
|
|
Term
| What is Flucytosine used in combination with, and why? |
|
Definition
| Few targets are sensitive to Flucytosine alone; used in combination with Amphotericine B |
|
|
Term
| What is the mechanism of the Echinocandins? |
|
Definition
| Inhibit the synthesis of beta (1,3) glucan, a cell wall component of fungi |
|
|
Term
| How are Echinocandins adminstered? |
|
Definition
|
|
Term
| What are the targets of Echinocandins? |
|
Definition
|
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