Term
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Definition
| Yeast, mold, dimorphic and anamorphic |
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Term
| Cryptococcus fungi group, spread by; effects? |
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Definition
| yeast; spread through chicken/pigeon droppings, by inhalation; goes to CNS (meningitis), increased in AIDS px. |
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Term
| Aspergillus fungi group; spread by |
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Definition
| mold; inhalation, construction jobs, vents |
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Term
| Dimorphic fungi example (states found in) |
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Definition
| Histoplasma (OH and MS river valley); S; Blastomyces (central/SE states); Coccidioides (SW states -> San Joaquin Valley Fever)... HSBC Hong Kong Shanghai Bank of Commerce |
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Term
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Definition
| microsporum (ringworm and athlete's foot) |
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Term
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Definition
| cell wall, cell membrane, nucleus, microtubules |
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Term
| echinocandins target, ending, mode of action, administration, duration, distribution, metabolism, tx. |
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Definition
| Cell wall active antifungal drugs, -fungin (casponfungin: main example); inhibition of beta (1,3) D-glucan synthase -> loss of D-glucan in cell wall -> osmotic fragility; IV only; taken once/day (highly protein bound); not much in CSF; no P450 interactions (soft drugs); tx: aspergillus mold (NOT yeast) |
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Term
| Azole antifungals target, ending, mode of action, tx, SE, softest? caveat? |
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Definition
| cell membrane active antifungal drugs; -conazole (ketoconazole only imidazole/2 N in ring, others triazoles: 3 N); inhibits P450 enzyme lanosterol demethylase (lanosterol -> ergosterol, component of fungal cell membrane); tx: posaconazole has most coverage: all categories except anamorphic, ketoconazole for mucous infections only (decreasing pH with juice increases absorption); SE: Cross reactivity with mammal P450, decreasing steroidneogenesis -> gynecomastia, esp. ketoconazole(like cimetidine and spironolactone), voriconazole: reversible visual disturbance (like sildenafil and digoxin); funconazole better tolerated than others; don't combine with Ampho B which needs ergosterol for action |
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Term
| Polyene antibiotics/Ampho B target, mode of action, administration, distribution; tx, SE (4), topical preparation? |
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Definition
| cell membrane active antifungal drugs; binds to ergosterol in cell membrane and creates leaky ion channels; IV; high affinity for kidneys, liver, spleen (stays up to a year), low affinity for eye, CSF, bone and brain; tx: most fungi, especially invasive and nonresponsive (but not aspergillus mold); SE: serious, nephrotoxicity (well hydrate, no aminoglycosides), hepatotoxicity, hypokalemia, influsion related reaction (cytokine storm, bp down, vasodilation up); topical: nystatin |
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Term
| Alylamines/Terbinafin target; mode of action |
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Definition
| cell membrane active antifungal drugs; inhibits squalene epoxidase, stops ergosterol synthesis |
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Term
| Pyrimidine analogs/5 Fluorocystine (5FC) target; mode of action, tx |
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Definition
| nucleus active antifungal drugs; selectively taken in by fungi and converted to 5-Fluorouracil (5FU), blocks RNA synthesis; tx: severe fungal infections (combination therapy only with Ampho B or fluconazole or else resistance quickly) |
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Term
| Griseofulvan target; mode of action, disadvantage |
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Definition
| microtubule active antifungal drugs; alters fungal microtubules and inhibits mitosis (like colchicine); very slow acting |
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