Antifungal Drugs
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Questions and Answers

What is the main component of fungal cell walls?

  • Ergosterol
  • Peptidoglycan
  • Chitin (correct)
  • Cholesterol

    • What is the term given to fungal infections?

  • Bacteriosis
  • Viralosis
  • Parasitosis
  • Mycosis (correct)

    • What is the characteristic of fungal cell membranes that differs from mammalian cell membranes?

  • Presence of peptidoglycan
  • Presence of cholesterol
  • Presence of ergosterol (correct)
  • Presence of chitin

    • What type of fungal infections affect internal organs?

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

    What type of fungi causes infections of skin, hair, and nails?

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

    How can antifungal drugs be classified?

    <p>Based on their site of action</p> Signup and view all the answers

    What is the primary route of excretion for fluconazole?

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

    Which of the following antifungal medications is the preferred treatment for blastomycosis?

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

    What is the effect of food on the absorption of itraconazole capsules?

    <p>Increases absorption</p> Signup and view all the answers

    Which enzyme is inhibited by itraconazole?

    <p>CYP3A4</p> Signup and view all the answers

    What is a common adverse effect of both fluconazole and itraconazole?

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

    Which tissue does itraconazole distribute well into?

    <p>Bone tissue</p> Signup and view all the answers

    What is the recommended preventative measure for fever and chills during IV administration?

    <p>Premedication with a corticosteroid or antipyretic</p> Signup and view all the answers

    What can exacerbate azotemia when using certain antifungal drugs?

    <p>Combination with other nephrotoxic drugs</p> Signup and view all the answers

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

    <p>Disrupting nucleic acid and protein synthesis</p> Signup and view all the answers

    What can occur when amphotericin B is administered, requiring potassium supplementation?

    <p>Hypotension accompanied by hypokalemia</p> Signup and view all the answers

    What is the purpose of adding heparin to the infusion of amphotericin B?

    <p>To alleviate thrombophlebitis</p> Signup and view all the answers

    What is the effect of amphotericin B on the action of flucytosine?

    <p>Increasing cell permeability, allowing more 5-FC to penetrate</p> Signup and view all the answers

    What is the effect of Isavuconazole on CYP3A4?

    <p>It inhibits the enzyme, leading to increased concentrations of other drugs</p> Signup and view all the answers

    What is the mechanism of action of Echinocandins?

    <p>Inhibiting β(1,3)-d-glucan synthesis</p> Signup and view all the answers

    What is a common adverse effect of Echinocandins?

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

    Why is slow IV infusion of Echinocandins recommended?

    <p>To prevent histamine-like reactions</p> Signup and view all the answers

    What is a unique feature of Micafungin?

    <p>It does not require a loading dose</p> Signup and view all the answers

    What is Caspofungin used as a first-line treatment for?

    <p>Invasive candidiasis</p> Signup and view all the answers

    For which condition has griseofulvin been largely replaced by oral terbinafine?

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

    What is the mechanism of action of griseofulvin?

    <p>It inhibits fungal mitosis by disrupting the mitotic spindle</p> Signup and view all the answers

    Why is nystatin not administered parenterally?

    <p>Due to its potential systemic toxicity</p> Signup and view all the answers

    How does griseofulvin affect drug metabolism?

    <p>It induces hepatic CYP450 activity</p> Signup and view all the answers

    What is the characteristic of griseofulvin that necessitates a prolonged treatment duration?

    <p>It is fungistatic</p> Signup and view all the answers

    For which type of infections is nystatin employed?

    <p>Cutaneous and oral Candida infections</p> Signup and view all the answers

    Which of the following drugs is not recommended as a first-line treatment for invasive candidiasis?

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

    What is the primary concern when co-administering this antifungal with CYP450 enzyme inducers?

    <p>Elevated hepatic transaminases</p> Signup and view all the answers

    Which of the following antifungal drugs is used for prophylaxis against invasive Candida infections in patients undergoing hematopoietic stem cell transplantation?

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

    What is the characteristic of Micafungin and Anidulafungin that reduces the risk of drug interactions?

    <p>They are not substrates for CYP450 enzymes</p> Signup and view all the answers

    What is the term used to describe fungal infections of the skin, hair, and nails?

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

    Which of the following fungi is often responsible for skin infections?

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

    What is the primary concern when using concurrent therapy with cyclosporine and this antifungal?

    <p>Elevated hepatic transaminases</p> Signup and view all the answers

    Which of the following is a characteristic of Echinocandins?

    <p>They are used for systemic mycotic infections</p> Signup and view all the answers

    What is the term used to describe round red patches with clear centers on the skin?

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

    Which of the following antifungal drugs is not classified as an Echinocandin?

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

    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.

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