Questions and Answers
What type of antifungal drug is amphotericin B classified as?
What is the term for a dermatophyte infection of the nails?
What is the primary causative agent of superficial yeast infections?
What type of fungal infection is characterized by soft tissue infections, UTIs, PNA, meningitis, and septicemia?
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What is the term for a fungal infection of the axilla, groin, or gluteal folds?
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Which of the following antifungal drugs is NOT classified as an azole derivative?
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What is the term for a dermatophyte infection of the body?
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What is the primary characteristic of ringworm infections?
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What type of mycosis is often caused by puncture wounds contaminated with soil fungi?
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Which of the following is an example of invasive and life-threatening systemic mycosis?
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What is the classic triad of symptoms associated with coccidioidomycosis?
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What is the name of the fungal disease caused by blastomyces dermatitidis?
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Which of the following is NOT an example of a superficial mycosis?
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What is the name of the fungus that causes tinea versicolor?
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Which of the following regions is endemic for coccidioidomycosis?
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What percentage of people infected with coccidioidomycosis are asymptomatic?
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What is the primary organ system affected by histoplasmosis?
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Which of the following is NOT a characteristic of aspergillosis?
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What is the primary mode of transmission for cryptococcosis?
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Which of the following is a characteristic of mucormycosis?
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What is the typical treatment for severe mycoses?
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What is a characteristic of amphotericin B in terms of its pharmacokinetics?
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What is the purpose of combining flucytosine with amphotericin B?
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What is the biphasic half-life of amphotericin B?
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What percentage of people who receive Amphotericin B experience renal toxicity?
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What is the main advantage of lipid formulations of Amphotericin B?
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Which of the following azole derivatives does not achieve significant concentrations in CSF?
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What is the primary route of elimination of Fluconazole?
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Which echinocandin drug has excellent activity against Candida spp. and good coverage of Aspergillus spp.?
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What is a common side effect of systemic administration of azole derivatives?
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What is the primary indication for Itraconazole?
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Which of the following azole derivatives has a lower activity against fungi?
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What is the mechanism of action of flucytosine in fungal cells?
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Why is griseofulvin absorbed more effectively when taken with a high-fat meal?
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What happens to the infected cells when griseofulvin is used to treat fungal infections?
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What is the route of administration for flucytosine?
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Which of the following fungal infections is griseofulvin commonly used to treat?
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Why are human cells not affected by flucytosine?
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What is the fate of griseofulvin in the body after administration?
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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 (infections of nails, skin, and mucous membranes caused by dermatophytes or yeasts)
Superficial Dermatophyte Infections
- Causative agents: Epidermophyton, Microsporum, and Trichophyton spp.
- Typical manifestations:
- Rash with pruritus and erythema
- Ringworm presents as annular, scaly rash with clear center
- Term 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)
- Presentations:
- Oral candidiasis (thrush)
- Vulvovaginal candidiasis
- Candidiasis infections of axilla, groin, or gluteal folds (diaper rash)
- Less common causes: M. furfur (tinea versicolor, seborrheic dermatitis) and M. ovalis (seborrheic dermatitis)
Subcutaneous Mycoses
- Often caused by puncture wounds contaminated with soil fungi
- Examples: 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 caused by Blastomyces dermatitidis
- Endemic to North America
- Clinical symptoms: flu-like illness, acute illness resembling bacterial PNA, 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 C. posadasii
- Endemic in certain parts of AZ, CA, NV, NM, TX, UT, and northern Mexico
- 60% are asymptomatic, 40% have varied symptoms, including fever, joint pain, and erythema nodosum (classic triad, "desert rheumatism")
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, can be fatal if left untreated
Aspergillosis
- Wide variety of disease caused by fungi from the genus Aspergillus
- Majority of cases occur in people with underlying TB or COPD but with otherwise healthy immune systems
- Most common forms: chronic pulmonary aspergillosis, aspergilloma, or allergic bronchopulmonary aspergillosis
Cryptococcosis
- Potentially fatal fungal disease caused by Cryptococcus neoformans and C. gattii
- Acquired by inhalation of infectious material from the environment
- 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 of Mucorales
- Characterized by hyphae growing in and around blood vessels, potentially life-threatening in diabetic or severely immunocompromised individuals
Treating Fungal Infections
- Amphotericin B: typically used to treat severe mycoses
- Azoles: used for less severe infections
- New agents (e.g., voriconazole and caspofungin): used to treat invasive Candida and Aspergillus infections
- Flucytosine: usually given with amphotericin B to treat systemic cryptococcal or candida infections
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Description
This quiz covers the classification of antifungal drugs, including polyene antibiotics, azole derivatives, and more. It also discusses fungal infections, including systemic mycoses and other types of infections.
