Antifungal Drugs and Fungal Infections
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Questions and Answers

What type of antifungal drug is amphotericin B classified as?

  • Allylamine drug
  • Azole derivative
  • Echinocandin drug
  • Polyene antibiotic (correct)
  • What is the term for a dermatophyte infection of the nails?

  • Tinea pedis
  • Onychomycosis (correct)
  • Tinea corporis
  • Ringworm
  • What is the primary causative agent of superficial yeast infections?

  • Epidermophyton spp.
  • Candida albicans (correct)
  • Trichophton spp.
  • Microsporum spp.
  • What type of fungal infection is characterized by soft tissue infections, UTIs, PNA, meningitis, and septicemia?

    <p>Systemic mycoses</p> Signup and view all the answers

    What is the term for a fungal infection of the axilla, groin, or gluteal folds?

    <p>Diaper rash</p> Signup and view all the answers

    Which of the following antifungal drugs is NOT classified as an azole derivative?

    <p>Amphotericin B</p> Signup and view all the answers

    What is the term for a dermatophyte infection of the body?

    <p>Tinea corporis</p> Signup and view all the answers

    What is the primary characteristic of ringworm infections?

    <p>Annular, scaly rash with a clear center</p> Signup and view all the answers

    What type of mycosis is often caused by puncture wounds contaminated with soil fungi?

    <p>Subcutaneous mycoses</p> Signup and view all the answers

    Which of the following is an example of invasive and life-threatening systemic mycosis?

    <p>Candidiasis</p> Signup and view all the answers

    What is the classic triad of symptoms associated with coccidioidomycosis?

    <p>Fever, joint pain, and erythema nodosum</p> Signup and view all the answers

    What is the name of the fungal disease caused by blastomyces dermatitidis?

    <p>Blastomycosis</p> Signup and view all the answers

    Which of the following is NOT an example of a superficial mycosis?

    <p>Coccidioidomycosis</p> Signup and view all the answers

    What is the name of the fungus that causes tinea versicolor?

    <p>Malassezia furfur</p> Signup and view all the answers

    Which of the following regions is endemic for coccidioidomycosis?

    <p>Southwestern United States and northern Mexico</p> Signup and view all the answers

    What percentage of people infected with coccidioidomycosis are asymptomatic?

    <p>60%</p> Signup and view all the answers

    What is the primary organ system affected by histoplasmosis?

    <p>Respiratory</p> Signup and view all the answers

    Which of the following is NOT a characteristic of aspergillosis?

    <p>Typically seen in people with a healthy immune system</p> Signup and view all the answers

    What is the primary mode of transmission for cryptococcosis?

    <p>Inhalation of infectious material from the environment</p> Signup and view all the answers

    Which of the following is a characteristic of mucormycosis?

    <p>Hyphae growing in and around blood vessels</p> Signup and view all the answers

    What is the typical treatment for severe mycoses?

    <p>Amphotericin B</p> Signup and view all the answers

    What is a characteristic of amphotericin B in terms of its pharmacokinetics?

    <p>Not absorbed from the gut</p> Signup and view all the answers

    What is the purpose of combining flucytosine with amphotericin B?

    <p>To treat systemic cryptococcal or candida infections</p> Signup and view all the answers

    What is the biphasic half-life of amphotericin B?

    <p>Initial half-life of 24 hours, terminal half-life of 15 days</p> Signup and view all the answers

    What percentage of people who receive Amphotericin B experience renal toxicity?

    <p>80%</p> Signup and view all the answers

    What is the main advantage of lipid formulations of Amphotericin B?

    <p>Reduced renal toxicity</p> Signup and view all the answers

    Which of the following azole derivatives does not achieve significant concentrations in CSF?

    <p>Ketoconazole</p> Signup and view all the answers

    What is the primary route of elimination of Fluconazole?

    <p>Renal excretion</p> Signup and view all the answers

    Which echinocandin drug has excellent activity against Candida spp. and good coverage of Aspergillus spp.?

    <p>Caspofungin</p> Signup and view all the answers

    What is a common side effect of systemic administration of azole derivatives?

    <p>Skin rash</p> Signup and view all the answers

    What is the primary indication for Itraconazole?

    <p>Treatment of onychomycosis</p> Signup and view all the answers

    Which of the following azole derivatives has a lower activity against fungi?

    <p>Ketoconazole</p> Signup and view all the answers

    What is the mechanism of action of flucytosine in fungal cells?

    <p>Inhibits protein synthesis by binding to fungal RNA</p> Signup and view all the answers

    Why is griseofulvin absorbed more effectively when taken with a high-fat meal?

    <p>Because it is a lipophilic drug that is not very soluble in water</p> Signup and view all the answers

    What happens to the infected cells when griseofulvin is used to treat fungal infections?

    <p>The infected cells are exfoliated and replaced by non-infected tissue</p> Signup and view all the answers

    What is the route of administration for flucytosine?

    <p>Oral</p> Signup and view all the answers

    Which of the following fungal infections is griseofulvin commonly used to treat?

    <p>Tinea capitis</p> Signup and view all the answers

    Why are human cells not affected by flucytosine?

    <p>Because human cells do not have the enzyme to convert flucytosine to 5-FU</p> Signup and view all the answers

    What is the fate of griseofulvin in the body after administration?

    <p>It is metabolized in the liver and excreted in the urine</p> Signup and view all the answers

    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.

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