Antifungal Medications Quiz

<p>Patients with renal insufficiency (C)</p> Signup and view all the answers

<p>Effective against Candida species (B)</p> Signup and view all the answers

<p>Minor gastrointestinal upset (C)</p> Signup and view all the answers

<p>Voriconazole (D)</p> Signup and view all the answers

<p>They are highly teratogenic. (B)</p> Signup and view all the answers

<p>Renal elimination (B)</p> Signup and view all the answers

<p>Aspergillus terreus (A), Scedosporium spp (B), Candida lusitaniae (D)</p> Signup and view all the answers

<p>Blastomycosis (D)</p> Signup and view all the answers

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

<p>Decrease its bioavailability (C)</p> Signup and view all the answers

<p>IV is the main route of administration. (B)</p> Signup and view all the answers

<p>Voriconazole (B)</p> Signup and view all the answers

<p>No dosage adjustment is needed (A)</p> Signup and view all the answers

<p>Visual and auditory hallucinations (B)</p> Signup and view all the answers

<p>Fever and chills (B)</p> Signup and view all the answers

<p>Blastomycosis (C)</p> Signup and view all the answers

<p>High doses over extended periods (A)</p> Signup and view all the answers

<p>Increases the plasma levels of certain drugs (B)</p> Signup and view all the answers

<p>1.5 mg/kg/d (A)</p> Signup and view all the answers

<p>Wider spectrum of antifungal activity (D)</p> Signup and view all the answers

<p>Enhances penetration into body fluids (B)</p> Signup and view all the answers

<p>Toxicity or clinical failure due to interactions (C)</p> Signup and view all the answers

<p>Rifampin (C)</p> Signup and view all the answers

<p>Ketoconazole (D)</p> Signup and view all the answers

<p>With high-fat meals (B)</p> Signup and view all the answers

<p>Licensed for salvage therapy (C)</p> Signup and view all the answers

<p>It has an antifungal spectrum similar to posaconazole (B)</p> Signup and view all the answers

<p>800 mg per day (B)</p> Signup and view all the answers

<p>Less effective in systemic use (D)</p> Signup and view all the answers

<p>Nystatin has no reported toxicity. (C)</p> Signup and view all the answers

<p>Oropharyngeal thrush (B)</p> Signup and view all the answers

<p>Management of oral thrush and vulvovaginal candidiasis. (C)</p> Signup and view all the answers

<p>Tinea corporis and tinea cruris (C)</p> Signup and view all the answers

<p>Unpleasant taste (D)</p> Signup and view all the answers

<p>Concentration dependent fungicidal activity (C)</p> Signup and view all the answers

<p>1 g/d (B)</p> Signup and view all the answers

<p>Patients with hepatic failure (D)</p> Signup and view all the answers

<p>It is used only in topical formulations (A)</p> Signup and view all the answers

<p>One tablet daily for 12 weeks (B)</p> Signup and view all the answers

<p>It is effective against azole-resistant Candida species (C)</p> Signup and view all the answers

<p>Hydroxylation followed by glucuronidation and sulfation (A)</p> Signup and view all the answers

<p>It decreases the serum concentration of warfarin (B)</p> Signup and view all the answers

Amphotericin B is a medication used to treat severe fungal infections. It is given intravenously, usually as a slow infusion. It's important to know that amphotericin B has a narrow therapeutic index, meaning there's a small margin between a safe dose and a toxic dose.

Amphotericin B is administered intravenously (IV) as a slow infusion. It's not easily dissolved in water and needs to be combined with other substances, like sodium deoxycholate (conventional method) or artificial lipids to form liposomes. The liposomal versions have the advantage of causing less kidney damage and infusion-related side effects.

While Amphotericin B travels throughout the body, it doesn't penetrate well into certain areas like the cerebrospinal fluid (CSF), the fluid inside the eye, or the fluid surrounding a baby in the womb. This means it's not always effective in treating infections in these areas.

Amphotericin B can cause a range of side effects, some immediate and others that develop over time. Immediate side effects include fever, chills, muscle spasms, vomiting, headache, and inflammation in the veins. These can be lessened by pre-treating with medications like corticosteroids, heparin, or antipyretics.

Long-term use of Amphotericin B can lead to kidney damage, affecting kidney function and changing blood test results. This usually happens after repeated use and is generally reversible once the medication is stopped.

Amphotericin B is not recommended for oral use because it's poorly absorbed through the gut. Taking it by mouth is only useful for treating fungal infections within the intestines, not systemic infections that spread throughout the body.

The dosage of Amphotericin B needs to be adjusted based on the type of formulation used. The conventional form has a maximum daily dose of 1.5 mg/kg, while the lipid formulations can be given up to 10 mg/kg.

Amphotericin B is not adjusted for people with liver problems, however, if kidney problems develop due to conventional amphotericin B, the daily dose is reduced by 50%.

Azole antifungal drugs are divided into two main groups: Imidazoles and Triazoles.

Imidazoles are typically used topically for skin infections, while Triazoles are administered systemically for both skin and internal fungal infections.

Azoles primarily target fungal cells by inhibiting the synthesis of ergosterol, a vital component of fungal cell membranes. This inhibition occurs by disrupting fungal cytochrome P450 enzymes.

Azoles are generally considered fungistatic, meaning they suppress fungal growth rather than killing the fungus.

Azoles are effective against a wide range of fungal infections, including Candida species, Cryptococcus neoformans, endemic mycoses like blastomycosis, and dermatophytes (tinea infections).

Itraconazole and voriconazole are particularly useful for treating Aspergillus infections, with voriconazole demonstrating fungicidal activity against this specific fungus.

Azole medications, while relatively nontoxic, can cause gastrointestinal upset, liver enzyme abnormalities, and rarely, clinical hepatitis.

Ketoconazole, a specific azole, can interfere with the production of adrenal and gonadal steroids, potentially leading to gynecomastia, menstrual irregularities, and infertility. Therefore, it's advised to avoid azole use during pregnancy.

A class of antifungal medications that work by inhibiting the synthesis of ergosterol, a vital component of fungal cell membranes. This disruption leads to cell death and prevents the fungus from growing and spreading.

The first triazole antifungal drug, known for its effectiveness against yeasts and some dimorphic fungi.

An antifungal medication with a broader spectrum of activity compared to fluconazole, effective against a wider range of fungal infections.

The triazole with the widest antifungal spectrum, effective against a broad range of fungal infections, including those resistant to other triazoles.

A condition caused by the fungus Cryptococcus neoformans, often affecting the brain and meninges, the membranes surrounding the brain and spinal cord.

A fungal infection affecting the esophagus, the tube connecting the mouth to the stomach.

A fungal infection affecting the mouth and throat, characterized by white patches and sores.

A fungal infection affecting the vagina, commonly known as a yeast infection.

Voriconazole is an antifungal drug that can interact with other medications, affecting their effectiveness or causing toxic side effects.

Ketoconazole, an older antifungal medication, was the first oral azole to be used clinically. However, it has been largely replaced by newer, more selective azoles due to its tendency to inhibit mammalian enzymes.

Posaconazole is a broad-spectrum triazole antifungal drug that works against a wide variety of fungal infections, including Candida, Aspergillus, and even some rarer infections like mucormycosis.

Posaconazole's absorption is enhanced when taken with meals high in fat, meaning it's absorbed more effectively in the presence of fatty foods.

Isavuconazole, a newer triazole, is available in both oral and intravenous formulations and exhibits a similar antifungal spectrum to posaconazole.

Coadministration of isavuconazole with strong CYP3A4 inhibitors (eg, ritonavir) or inducers (eg, rifampin) is not recommended due to potential interactions that can affect drug levels in the body.

Azole antifungal medications are often used to treat fungal infections. However, they have a narrow therapeutic index, meaning a small difference exists between an effective dose and a toxic dose. Therefore, monitoring for adverse effects and adjusting dosages is critical for safe and effective treatment.

Ibrexafungerp is a new class of antifungal with fungicidal action. It targets fungal cell walls - similar to echinocandins, but works with a different mechanism.

It can treat various Candida species including Azole-resistant isolates and Aspergillus species.

Griseofulvin interrupts the formation of keratin, protecting newly growing skin and preventing infection in the new skin structures.

It's administered for 2-6 weeks for skin and hair infections, but nail infections require therapy for months to allow new nail growth.

Terbinafine is an allylamine antifungal, available in oral form, commonly prescribed for dermatophytoses, particularly onychomycosis.

Terbinafine treatment for onychomycosis typically lasts 12 weeks and can achieve a cure rate of up to 90%.

Nystatin is a polyene macrolide antifungal, similar to Amphotericin B. Due to toxicity, it's only used topically.

Nystatin is a polyene macrolide antifungal, similar to Amphotericin B. Due to toxicity, it's only used topically.

Azoles are a class of antifungal medications widely used for both topical and systemic fungal infections. They work by inhibiting the production of ergosterol, which is essential for fungal cell membrane integrity.

Clotrimazole and Miconazole are two commonly used azole medications available over-the-counter (OTC). They are often employed for vulvovaginal candidiasis (yeast infections) and oral thrush.

Ketoconazole is an azole medication used topically for conditions like seborrheic dermatitis, tinea capitis (scalp fungal infection), and pityriasis versicolor (skin fungal infection).

Terbinafine and Naftifine are allylamines, another class of antifungal medications. They are available as topical creams and treat conditions like tinea cruris (groin fungal infection), tinea corporis (ringworm), and tinea pedis (athlete's foot).