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Antifungal Drugs and Fungal Infections
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Antifungal Drugs and Fungal Infections

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Questions and Answers

What is the primary mechanism of action of echinocandin antifungal drugs?

  • Inhibition of beta-1,3-glucan synthase (correct)
  • Inhibition of squalene epoxidase
  • Inhibition of lanosterol 14-alpha-demethylase
  • Inhibition of fungal cell membrane ergosterol synthesis

    • Which type of fungal infection is characterized by infections of nails, skin, and mucous membranes caused by dermatophytes and yeasts?

  • Superficial mycoses (correct)
  • Subcutaneous mycoses
  • Systemic mycoses
  • Cutaneous mycoses

    • What is the term for dermatophyte infection of the nails?

  • Onychomycosis (correct)
  • Tinea corporis
  • Tinea cruris
  • Tinea pedis

    • Which of the following is NOT a type of superficial yeast infection?

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

    What is the name of the azole antifungal drug commonly used to treat fungal infections such as athlete's foot and ringworm?

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

    Which type of fungal infection is characterized by soft tissue infections, UTIs, pneumonia, and meningitis?

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

    What is the term for fungal infection of the body characterized by an annular, scaly rash with a clear center?

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

    Which of the following is an example of a subcutaneous mycosis?

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

    What is the name of the polyene antifungal drug commonly used to treat systemic fungal infections?

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

    Which of the following fungal infections is characterized by a rash with pruritus and erythema?

    <p>Dermatophyte infections</p> Signup and view all the answers

    Which fungal infection is caused by blastomyces dermatitidis and endemic to North America?

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

    What is the classic triad of symptoms seen in coccidioidomycosis?

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

    Which of the following fungi is NOT a cause of subcutaneous mycoses?

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

    What is the name of the fungal infection caused by coccidioides immitis or coccidioides posadasii?

    <p>All of the above</p> Signup and view all the answers

    Which of the following fungi causes tinea versicolor?

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

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

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

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

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

    What is the name of the fungal disease that causes skin lesions, bony lytic lesions, and flu-like symptoms?

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

    Which of the following is NOT a systemic mycosis?

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

    What percentage of people infected with coccidioides immitis or coccidioides posadasii are asymptomatic?

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

    What is the primary organ affected by Histoplasmosis?

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

    Which of the following fungal infections is characterized by hyphae growing in and around blood vessels?

    <p>Mucormycosis</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 the main route of infection for Cryptococcosis?

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

    What is the primary use of Flucytosine?

    <p>Treating systemic cryptococcus or candida infections</p> Signup and view all the answers

    What is the characteristic of Amphotericin B's half-life?

    <p>Biphasic half-life, with an initial half-life of 24 hours and a terminal half-life of 15 days</p> Signup and view all the answers

    What is the main reason for Amphotericin B's low concentration in CSF?

    <p>It doesn't penetrate the blood-brain barrier well</p> Signup and view all the answers

    What is the common term for Histoplasmosis?

    <p>All of the above</p> Signup and view all the answers

    Which of the following is NOT a type of Aspergillosis?

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

    What is the main use of Natamycin?

    <p>Treating fungal infections in the eyes</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

    Which of the following antifungal medications is available in ocular formulations?

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

    Which of the following azole derivatives achieves significant concentration in CSF?

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

    What is the main route of elimination for fluconazole?

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

    Which of the following antifungal medications is particularly useful in the treatment of blastomycosis and histoplasmosis?

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

    What is the oral bioavailability of itraconazole?

    <p>95%</p> Signup and view all the answers

    Which of the following antifungal medications can cause skin rash, elevated LFTs, and hepatic injury?

    <p>Azole derivatives</p> Signup and view all the answers

    What is the main route of administration for nystatin?

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

    Which of the following antifungal medications requires gastric acid for absorption?

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

    What is the elimination half-life of voriconazole?

    <p>dose-dependent</p> Signup and view all the answers

    Which antifungal drug is effective against both dermatophytes and yeasts?

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

    What is the main difference between systemic mycoses and subcutaneous mycoses?

    <p>Location of infection</p> Signup and view all the answers

    Which type of fungal infection is characterized by infections of the hair, skin, and mucous membranes?

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

    What is the term for fungal infection of the groin area?

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

    Which antifungal drug is effective against Candida spp. and dermatophytes?

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

    What is the term for fungal infection of the nails?

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

    Which type of fungal infection is characterized by sporotrichosis?

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

    Which antifungal drug is effective against dermatophytes, yeasts, and molds?

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

    What is the common characteristic of blastomycosis, coccidioidomycosis, and histoplasmosis?

    <p>They are all chronic and indolent</p> Signup and view all the answers

    What is the primary difference between chromomycosis and pseudallescheriasis?

    <p>Chromomycosis is a subcutaneous mycosis, while pseudallescheriasis is a systemic mycosis</p> Signup and view all the answers

    What is the typical progression of symptoms in blastomycosis?

    <p>Acute illness resembling bacterial pneumonia, followed by chronic illness mimicking tuberculosis or lung cancer</p> Signup and view all the answers

    What is the primary route of infection for coccidioidomycosis?

    <p>Inhalation of spores from contaminated soil</p> Signup and view all the answers

    What is the characteristic of the rash seen in coccidioidomycosis?

    <p>Annular, scaly, and erythematous</p> Signup and view all the answers

    What is the primary difference between sporotrichosis and chromomycosis?

    <p>Sporotrichosis causes skin lesions, while chromomycosis causes respiratory infections</p> Signup and view all the answers

    What is the primary organ affected in Mucormycosis?

    <p>Blood vessels</p> Signup and view all the answers

    What is the route of administration for Flucytosine?

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

    What is the primary characteristic of furfur?

    <p>It causes tinea versicolor</p> Signup and view all the answers

    What is the typical percentage of people infected with coccidioides immitis or coccidioides posadasii who are asymptomatic?

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

    What is the main use of Amphotericin B?

    <p>Treating severe mycoses</p> Signup and view all the answers

    What is the characteristic of the half-life of Amphotericin B?

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

    What is the main reason for Amphotericin B's low concentration in CSF?

    <p>It does not penetrate the blood-brain barrier well</p> Signup and view all the answers

    What is the primary reason for the reduced toxicity of lipid formulations of Amphotericin B?

    <p>Altered pharmacokinetics</p> Signup and view all the answers

    What is the common term for Histoplasmosis?

    <p>All of the above</p> Signup and view all the answers

    Which azole derivative is particularly useful in the treatment of onychomycosis?

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

    What is the primary route of elimination for Ketoconazole?

    <p>Biliary and fecal excretion</p> Signup and view all the answers

    What is the route of infection for Cryptococcosis?

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

    What is the typical treatment for less severe fungal infections?

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

    Which antifungal medication requires gastric acid for absorption?

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

    What is the elimination half-life of Posaconazole?

    <p>28 hours</p> Signup and view all the answers

    Which antifungal medication is used to treat vulvovaginal candidiasis?

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

    What is the oral bioavailability of Voriconazole?

    <p>96%</p> Signup and view all the answers

    Which echinocandin drug is the first to be approved in the US?

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

    What is the mechanism of action of Flucytosine?

    <p>It gets converted to 5-FU inside fungal cells, gets incorporated into fungal RNA, and interferes with protein synthesis</p> Signup and view all the answers

    What is the typical use of Griseofulvin?

    <p>To treat superficial fungal infections of the skin, hair, and nails</p> Signup and view all the answers

    What is a characteristic of Griseofulvin?

    <p>It is lipophilic and not very soluble in water</p> Signup and view all the answers

    How is Griseofulvin eliminated from the body?

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

    What is the effect of Griseofulvin on fungal cells?

    <p>It gets deposited in keratin precursor cells of skin, hair and nails, infected cells are exfoliated and replaced by non-infected tissue</p> Signup and view all the answers

    What is the standard treatment for tinea capitis?

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

    What is the effect of a high-fat meal on Griseofulvin absorption?

    <p>It increases absorption</p> Signup and view all the answers

    Against which type of fungi is Griseofulvin NOT active?

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

    Study Notes

    Classification of Antifungal Drugs

    • Polyene antibiotics: amphotericin B, natamycin, nystatin
    • Azole derivatives: clotrimazole, fluconazole, ketoconazole, itraconazole, posaconazole, voriconazole
    • Allylamine drugs: terbinafine
    • Echinocandin drugs: caspofungin
    • Other antifungal agents

    Fungal Infections

    • Divided into three main groups:
      • Systemic mycoses: soft tissue infections, UTIs, PNA, meningitis, septicemia
      • Subcutaneous mycoses: sporotrichosis
      • Superficial mycoses: infections of nails, skin, and mucous membranes caused by dermatophytes and yeasts

    Superficial Dermatophyte Infections

    • Causative agents: Epidermophyton, Microsporum, Trichophyton spp.
    • Manifest as rash with pruritus and erythema
    • Ringworm presents as annular, scaly rash with clear center
    • Examples:
      • Onychomycosis (tinea unguium): dermatophyte infection of nails
      • Tinea pedis (athlete's foot): infection of feet
      • Tinea corporis (ringworm of the body): infection of body
      • Tinea cruris (jock itch): infection of groin area

    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, M. ovalis
      • M. furfur causes tinea versicolor (pityriasis versicolor)
      • Both yeasts cause seborrheic dermatitis

    Subcutaneous Mycoses

    • Often caused by puncture wounds contaminated with soil fungi
    • Examples:
      • Chromomycosis
      • Pseudallescheriasis
      • Sporotrichosis

    Systemic Mycosis

    • Chronic and indolent: blastomycosis, coccidioidomycosis, histoplasmosis
    • Invasive and life-threatening: aspergillosis, candidiasis, cryptococcosis, mucormycosis

    Blastomycosis

    • Fungal infection of humans and other animals 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:
      • 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 diseases caused by fungi from 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 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 of Mucorales
    • Characterized by hyphae growing in and around blood vessels; potentially life-threatening in diabetic or severely immunocompromised individuals

    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 echinocandin drugs, as well as types of fungal infections, such as systemic mycoses. Test your knowledge of these medicines and diseases.

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