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Questions and Answers
What is the main component of fungal cell walls?
What is the term given to fungal infections?
What is the characteristic of fungal cell membranes that differs from mammalian cell membranes?
What type of fungal infections affect internal organs?
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What type of fungi causes infections of skin, hair, and nails?
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How can antifungal drugs be classified?
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What is the primary route of excretion for fluconazole?
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Which of the following antifungal medications is the preferred treatment for blastomycosis?
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What is the effect of food on the absorption of itraconazole capsules?
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Which enzyme is inhibited by itraconazole?
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What is a common adverse effect of both fluconazole and itraconazole?
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Which tissue does itraconazole distribute well into?
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What is the recommended preventative measure for fever and chills during IV administration?
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What can exacerbate azotemia when using certain antifungal drugs?
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What is the mechanism of action of flucytosine in fungal cells?
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What can occur when amphotericin B is administered, requiring potassium supplementation?
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What is the purpose of adding heparin to the infusion of amphotericin B?
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What is the effect of amphotericin B on the action of flucytosine?
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What is the effect of Isavuconazole on CYP3A4?
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What is the mechanism of action of Echinocandins?
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What is a common adverse effect of Echinocandins?
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Why is slow IV infusion of Echinocandins recommended?
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What is a unique feature of Micafungin?
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What is Caspofungin used as a first-line treatment for?
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For which condition has griseofulvin been largely replaced by oral terbinafine?
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What is the mechanism of action of griseofulvin?
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Why is nystatin not administered parenterally?
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How does griseofulvin affect drug metabolism?
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What is the characteristic of griseofulvin that necessitates a prolonged treatment duration?
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For which type of infections is nystatin employed?
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Which of the following drugs is not recommended as a first-line treatment for invasive candidiasis?
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What is the primary concern when co-administering this antifungal with CYP450 enzyme inducers?
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Which of the following antifungal drugs is used for prophylaxis against invasive Candida infections in patients undergoing hematopoietic stem cell transplantation?
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What is the characteristic of Micafungin and Anidulafungin that reduces the risk of drug interactions?
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What is the term used to describe fungal infections of the skin, hair, and nails?
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Which of the following fungi is often responsible for skin infections?
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What is the primary concern when using concurrent therapy with cyclosporine and this antifungal?
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Which of the following is a characteristic of Echinocandins?
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What is the term used to describe round red patches with clear centers on the skin?
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Which of the following antifungal drugs is not classified as an Echinocandin?
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Study Notes
Antifungal Drugs
- Fungi are eukaryotic and have rigid cell walls composed largely of chitin rather than peptidoglycan.
- Fungal cell membrane contains ergosterol rather than cholesterol found in mammalian membranes.
- Fungal infections are generally resistant to antibiotics, and bacteria are resistant to antifungal agents.
- Fungal infection is termed mycosis.
Types of Fungal Infections
- Mucocutaneous (Superficial) Infections: caused by dermatophytes, infecting skin, hair, and nails (e.g., tinea capitis, tinea cruris, tinea pedis, onychomycosis).
- Yeasts cause infections of moist skin and mucous membranes (e.g., Candida albicans causing oral, pharyngeal, vaginal, & bladder infections).
- Systemic Mycoses: fungal infections affecting internal organs, occurring in immune-compromised patients (e.g., cryptococcosis, aspergillosis).
Antifungal Classification
- Antifungals can be grouped into three classes based on their site of action:
- Ergosterol biosynthesis inhibitors
- Cell membrane disruptors
- Nucleic acid synthesis inhibitors
Drugs for Subcutaneous and Systemic Mycotic Infections
- Fluconazole:
- Pharmacokinetics: well absorbed after oral administration, distributes widely to body fluids and tissues.
- Adverse effects: nausea, vomiting, headache, and skin rashes.
- Itraconazole:
- Broad antifungal spectrum, preferred treatment for blastomycosis, sporotrichosis, paracoccidioidomycosis, and histoplasmosis.
- Adverse effects: nausea, vomiting, diarrhea, rash, hypokalemia, hypertension, edema, and headache.
- Amphotericin B:
- Mechanism of action: binds to ergosterol in fungal cell membranes, forming pores that disrupt membrane function.
- Effective against a broad spectrum of fungi, including Candida albicans, Histoplasma capsulatum, Cryptococcus neoformans, Coccidioides immitis, Blastomyces dermatitidis, and various strains of Aspergillus.
- Adverse effects: low therapeutic index, hypotension accompanied by hypokalemia, and thrombophlebitis.
Antimetabolite Antifungals
- Flucytosine (5-FC):
- Fungistatic, effective in combination with itraconazole for treating chromoblastomycosis and meningitis caused by C.neoformans and C.albicans.
- Pharmacokinetics: efficiently absorbed orally, widely distributed in the body, and excreted primarily in urine.
- Adverse effects: gastrointestinal disturbances, hepatic dysfunction, and bone marrow suppression.
Echinocandins
- Caspofungin, Micafungin, and Anidulafungin:
- Disrupt fungal cell wall synthesis by inhibiting β(1,3)-d-glucan synthesis, leading to cell lysis and death.
- Administered intravenously once daily, effective against Aspergillus and various Candida species, including those resistant to azoles.
- Adverse effects: fever, rash, nausea, and phlebitis.
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Description
This quiz covers antifungal drugs used to treat various mycotic infections, including subcutaneous and systemic infections, as well as cutaneous infections. It delves into the characteristics of fungal cell walls and membranes, and how they differ from bacterial cells. Test your knowledge of pharmacology and antifungal therapy.
