Questions and Answers
Which antifungal drug is classified as an allylamine drug?
What type of fungal infection is characterized by infections of nails, skin, and mucous membranes caused by dermatophytes and yeasts?
What is the term for a dermatophyte infection of the nails?
Which of the following is NOT a causative agent of superficial yeast infections?
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What is the term for athlete's foot?
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Which antifungal drug is classified as a polyene antibiotic?
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What is the term for a dermatophyte infection of the body?
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Which of the following is an example of a systemic mycosis?
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Which of the following fungal infections can cause skin lesions and bony lytic lesions?
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What is the common name for Coccidioidomycosis?
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Which of the following fungal infections is endemic to North America?
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What is the name of the fungal disease caused by coccidioides immitis or coccidioides posadasii?
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Which of the following is a characteristic of Subcutaneous mycoses?
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What is the approximate percentage of asymptomatic cases of Coccidioidomycosis?
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Which of the following fungal infections can cause a flu-like illness?
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What is the classic triad of symptoms associated with Coccidioidomycosis?
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What is the primary organ affected by histoplasmosis?
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What is the primary mode of acquisition for cryptococcosis?
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What is the characteristic feature of mucormycosis?
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What is the typical treatment for severe mycoses?
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What is the limitation of amphotericin B in terms of its pharmacokinetics?
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What is the mechanism of action of polyene antibiotics?
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What is the typical combination therapy for systemic cryptococcal or candidal infections?
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What is the typical half-life of amphotericin B?
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Which antifungal drug causes some degree of renal toxicity in 80% of people who receive it?
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What is the route of elimination for fluconazole?
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Which of the following azole derivatives is particularly useful in the treatment of blastomycosis and histoplasmosis?
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What is the route of administration for natamycin?
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Which of the following echinocandin drugs has excellent activity against Candida spp. and good coverage of aspergillus spp.?
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What is the oral bioavailability of itraconazole?
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What is the half-life of elimination for ketoconazole?
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Which of the following azole derivatives is used to treat onychomycosis?
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What is the mechanism of action of flucytosine?
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What is the characteristic of griseofulvin?
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What is the main use of griseofulvin?
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What happens to the infected cells when using griseofulvin?
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How is griseofulvin metabolized?
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What type of fungal infections does griseofulvin treat?
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What is a characteristic of flucytosine?
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What is the route of administration for flucytosine?
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Study Notes
Antifungal Drugs
- Classification:
- Polyene antibiotics (e.g., amphotericin B)
- Azole derivatives (e.g., clotrimazole, fluconazole)
- Allylamine drugs (e.g., terbinafine)
- Echinocandin drugs (e.g., caspofungin)
- Other antifungal agents
Fungal Infections
- Divided into three main groups:
- Systemic mycoses (e.g., soft tissue infections, UTIs, PNA, meningitis, septicemia)
- Subcutaneous mycoses (e.g., sporotrichosis)
- Superficial mycoses (e.g., infections of nails, skin, and mucous membranes caused by dermatophytes)
Superficial Dermatophyte Infections
- Causative agents: Epidermophyton, Microsporum, and Trichophyton spp.
- Typically manifest as rash with pruritus and erythema
- Ringworm presents as annular, scaly rash with clear center
- Terms for dermatophyte infections:
- Onychomycosis, tinea unguium (dermatophyte infection of nails)
- Tinea pedis (athlete's foot)
- Tinea corporis (ringworm of the body)
- Tinea cruris (jock itch)
Superficial Yeast Infections
- Causative agents: Candida spp., usually C. albicans
- Present as oral candidiasis (thrush), vulvovaginal candidiasis, or candidiasis infections of axilla, groin, or gluteal folds (diaper rash)
- Less common causes: M. furfur and M. ovalis
- M. furfur causes tinea versicolor (also called pityriasis versicolor)
- Both yeasts cause seborrheic dermatitis
Subcutaneous Mycoses
- Often caused by puncture wounds contaminated with soil fungi
- Examples include chromomycosis, pseudallescheriasis, and sporotrichosis
Systemic Mycosis
- Chronic and indolent (e.g., blastomycosis, coccidioidomycosis, histoplasmosis)
- Invasive and life-threatening (e.g., aspergillosis, candidiasis, cryptococcosis, mucormycosis)
Blastomycosis
- Fungal infection of humans and other animals (dogs, cats) caused by Blastomyces dermatitidis
- Endemic to North America
- Clinical symptoms similar to histoplasmosis
- Flu-like illness, acute illness resembling bacterial pneumonia, chronic illness mimicking TB/lung cancer, fast progressive disease like ARDS, skin lesions, bony lytic lesions
Coccidioidomycosis
- Also known as "valley fever", "California fever", and "San Joaquin Valley fever"
- Fungal disease caused by Coccidioides immitis or Coccidioides posadasii
- Endemic in certain parts of Arizona, California, Nevada, New Mexico, Texas, Utah, and northern Mexico
- 60% are asymptomatic, 40% have varied symptoms, including classic triad ("desert rheumatism") of fever, joint pain, and erythema nodosum
Histoplasmosis
- Also known as "cave disease", "spelunker's lung", and "Ohio Valley disease"
- Fungal infection caused by Histoplasma capsulatum
- Found in soil, often associated with decaying bat guano or bird droppings
- Primarily affects lungs, called disseminated when other organs affected
- Can be fatal if left untreated
Aspergillosis
- Wide variety of disease caused by fungi from the genus Aspergillus
- Majority of cases in people with underlying TB or COPD, but with otherwise healthy immune systems
- Most common occurs in form of chronic pulmonary aspergillosis, aspergilloma, or allergic bronchopulmonary aspergillosis
Cryptococcosis
- Potentially fatal fungal disease caused by Cryptococcus neoformans and Cryptococcus gattii
- Acquired by inhalation of infectious material from the environment; found worldwide in soil
- Defining opportunistic infection for AIDS, but also seen with lymphomas, sarcoid, liver cirrhosis, and patients on long-term steroid therapy
Mucormycosis
- Any fungal infection caused by fungi in the order Mucorales
- Characterized by hyphae growing in and around blood vessels; potentially life-threatening in diabetic or severely immunocompromised individuals
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Description
This quiz covers the classification of antifungal drugs, including polyene antibiotics, azole derivatives, and echinocandin drugs, as well as fungal infections, including systemic mycoses, cutaneous mycoses, and opportunistic mycoses.
