Antifungal Therapy Quiz

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Questions and Answers

What is the loading dose for itraconazole?

100 mg three times daily for 3 days
400 mg three times daily for 3 days
200 mg three times daily for 3 days (correct)
300 mg three times daily for 3 days

What is the standard formulation of amphotericin B?

Liposomal amphotericin B
Amphotericin B cholesteryl sulfate complex
Amphotericin B lipid complex
Amphotericin B with deoxycholate (correct)

What is the preferred agent for treating oropharyngeal and esophageal Candida?

Voriconazole
Itraconazole
Fluconazole (correct)
Posaconazole

What is the recommended target trough drug level for voriconazole after 1 week of therapy?

1 to 5.5 mg/L (C) Signup and view all the answers

What is the mechanism of action of Amphotericin B?

It interacts with cell membrane sterols, resulting in toxic side effects in both human and fungal cells (B) Signup and view all the answers

What is the mechanism of action of echinocandins?

Inhibition of fungal cell wall glucan synthesis (B) Signup and view all the answers

What is the standard therapy for systemic mycoses and what are its drawbacks?

Amphotericin B, which has multiple toxicities (D) Signup and view all the answers

What is the spectrum of activity of Isavuconazole?

Active against all Candida species, Aspergillus, Paecilomyces, and Scedosporium apiospermum, with variable, but good, activity against Mucor spp. (A) Signup and view all the answers

What is the mechanism of action of flucytosine?

Flucytosine deaminates to 5-fluorouracil and incorporates into fungal RNA, leading to faulty protein synthesis and growth inhibition (A) Signup and view all the answers

What is the recommended dose of posaconazole for prophylaxis?

200 mg tid (A) Signup and view all the answers

What is the mechanism of action of triazoles?

They inhibit the synthesis of ergosterol by blocking the enzyme C-14 alpha-demethylase (D) Signup and view all the answers

What is the primary route of excretion for posaconazole?

Feces (B) Signup and view all the answers

Which fungal infections is itraconazole the preferred agent for?

Histoplasmosis and Blastomycosis (D) Signup and view all the answers

What is the loading dose of Isavuconazole?

200 mg q8h for 2 days (A) Signup and view all the answers

What is the main advantage of azoles over amphotericin B?

They are less toxic (D) Signup and view all the answers

What is the percentage of peak serum concentration of fluconazole that can penetrate the cerebrospinal fluid?

70%–90% (D) Signup and view all the answers

What is the duration of therapy for amphotericin B?

14 days (C) Signup and view all the answers

Which antifungal has the best global availability?

Itraconazole (B) Signup and view all the answers

What is the most frequent adverse event associated with voriconazole?

Visual disturbances (C) Signup and view all the answers

Which organisms are sensitive to flucytosine?

Cryptococcus neoformans and Candida albicans (A) Signup and view all the answers

Which echinocandin is metabolized by slow peptide hydrolysis?

Caspofungin (C) Signup and view all the answers

Which of the following is not a sensitive organism to Amphotericin B?

Pseudallescheria boydii (D) Signup and view all the answers

Which of the following is true about Isavuconazole?

It is non-inferior to voriconazole in invasive aspergillosis with fewer side effects (B) Signup and view all the answers

What is the daily price range for amphotericin B deoxycholate in surveyed countries?

<$1 to $171 (A) Signup and view all the answers

What is the recommended treatment for cryptococcal meningitis?

A combination of Amphotericin B and flucytosine (C) Signup and view all the answers

What is the percentage of patients who can develop alteration of renal function with AMBD?

80% (D) Signup and view all the answers

What is the standard dosage of flucytosine?

100 mg/kg/day divided into four doses (C) Signup and view all the answers

What is the recommended approach to treating azole-resistant infections?

Switching to combination therapy with an echinocandin and an azole (D) Signup and view all the answers

What is the target trough serum level for prophylaxis and treatment with itraconazole?

<0.5 ug/ml for prophylaxis and 1.0–2.0 ug/ml for treatment (B) Signup and view all the answers

What is the recommended dose adjustment of fluconazole for patients with a CrCl of less than 50 mL/min?

25% (A) Signup and view all the answers

What is the recommended oral dose of voriconazole for a patient weighing less than 40 kg?

100 mg every 12 hours (D) Signup and view all the answers

Which of the following is a potential adverse effect of posaconazole?

Mucositis (C) Signup and view all the answers

Which echinocandin is excreted in an inactive form in the bile and urine?

Micafungin (C) Signup and view all the answers

Which echinocandin is recommended for the treatment of esophageal candidiasis with a loading dose of 100mg followed by 50mg daily?

Anidulafungin (D) Signup and view all the answers

What are the infusion-related toxicities of amphotericin B?

Fever, rigors, headaches, anorexia, nausea, vomiting, dyspnea, and hypotension (C) Signup and view all the answers

What is the most common hematologic adverse event associated with flucytosine use?

Neutropenia (D) Signup and view all the answers

What is the dose of ABLC for empiric therapy?

3 mg/kg/day (A) Signup and view all the answers

What is the therapeutic indication for the combination of amphotericin B and flucytosine?

Treatment of cryptococcal meningitis and disseminated disease (A) Signup and view all the answers

Which echinocandin is fungicidal against Candida spp. but only fungistatic against Aspergillus?

Caspofungin (D) Signup and view all the answers

What is the reduction of hematocrit units that one-third of patients may experience with amphotericin B?

15 units (D) Signup and view all the answers

What is the biphasic excretion of amphotericin B?

A rapid elimination half-life of 24 hours, followed by a prolonged terminal half-life of 15 days (C) Signup and view all the answers

Is amphotericin B safe to use during pregnancy?

Yes, it is safe with no evidence of teratogenesis or toxicity in infants (C) Signup and view all the answers

Study Notes

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Description

"Test Your Knowledge on Antifungal Therapy for Systemic Mycoses" - Take this quiz to assess your understanding of the properties and usage of major antifungal drugs such as amphotericin B, flucytosine, triazoles, and echinocandins. Learn about the clinical challenges posed by systemic mycoses and the relative non-toxicity of azole antifungals. Sharpen your knowledge and stay up-to-date with the latest treatments for