Classifications of Antifungal Agents: Systemic Antifungal Drugs for Systemic Infections
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Questions and Answers

What is the main mechanism of action of Amphotericin B?

  • Blocking fungal cell division
  • Disrupting fungal membrane permeability and transport properties (correct)
  • Inhibiting fungal cell wall synthesis
  • Preventing fungal nucleic acid synthesis

    • How is Amphotericin B usually administered for systemic infections?

  • Orally as an effective treatment for systemic disease
  • Intramuscularly for rapid action
  • Intravenously as a nonlipid colloidal suspension or in a liposomal formulation (correct)
  • Under the skin (subcutaneously) for slow release

    • What is the bioavailability of oral Amphotericin B for systemic disease treatment?

  • Effective only on fungi within the gastrointestinal tract lumen (correct)
  • Low, making it unsuitable for systemic disease treatment
  • High, leading to rapid and effective systemic fungal infection treatment
  • Moderate, requiring frequent dosing for optimal effects

    • Why is Amphotericin B not suitable for treatment of central nervous system (CNS) fungal infections?

    <p>It cannot penetrate the blood-brain barrier effectively</p> Signup and view all the answers

    How is Amphotericin B primarily eliminated from the body?

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

    What percentage of Amphotericin B is bound by serum proteins in the bloodstream?

    <p>More than 90%</p> Signup and view all the answers

    What is the main mechanism of action of amphotericin B?

    <p>Binding to ergosterol and causing pore formation</p> Signup and view all the answers

    Why does resistance to amphotericin B arise?

    <p>Decrease in ergosterol membrane concentration</p> Signup and view all the answers

    Which fungal infection is NOT commonly treated with amphotericin B?

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

    What is a common toxic effect associated with amphotericin B colloidal formulations?

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

    How can infusion-related toxicity with amphotericin B be reduced?

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

    What is the reason for using lipid formulations of amphotericin B?

    <p>To decrease toxicity to mammalian cells</p> Signup and view all the answers

    What is the mechanism by which flucytosine exerts its antifungal activity?

    <p>It inhibits fungal DNA and RNA synthesis</p> Signup and view all the answers

    What is the primary reason for combining flucytosine with amphotericin B during initiation treatment?

    <p>To reduce the risk of resistance developing to flucytosine</p> Signup and view all the answers

    How is flucytosine primarily excreted from the body?

    <p>Unchanged in the urine</p> Signup and view all the answers

    What is the mechanism of resistance to flucytosine?

    <p>Altered metabolism of the drug</p> Signup and view all the answers

    Which of the following is NOT a potential toxicity associated with flucytosine?

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

    For which fungal infection is flucytosine commonly used in combination with other antifungal agents?

    <p>Cryptococcal meningitis</p> Signup and view all the answers

    Which class of azoles includes fluconazole?

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

    What is a characteristic feature of fluconazole's bioavailability?

    <p>High bioavailability</p> Signup and view all the answers

    For which fungal infection is fluconazole NOT effective according to the text?

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

    What makes fluconazole the azole of choice for Cryptococcal meningitis and mucocutaneous candidiasis?

    <p>High degree of water solubility</p> Signup and view all the answers

    Which fungal infection can high doses of fluconazole help obviate the need for intrathecal amphotericin B?

    <p>Cryptococcal meningitis</p> Signup and view all the answers

    What is a distinguishing factor of fluconazole's effect on hepatic microsomal enzymes compared to other azoles?

    <p>No effect</p> Signup and view all the answers

    Which of the following statements about voriconazole is correct?

    <p>It has a broader spectrum than fluconazole.</p> Signup and view all the answers

    Which of the following is NOT a potential toxicity associated with voriconazole?

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

    Which of the following statements about itraconazole is correct?

    <p>It does not affect mammalian steroid synthesis.</p> Signup and view all the answers

    Which of the following statements about posaconazole is correct?

    <p>It is effective against mucormycosis.</p> Signup and view all the answers

    Which of the following statements about isavuconazole is correct?

    <p>It is licensed for treatment of invasive mucormycosis and invasive aspergillosis.</p> Signup and view all the answers

    Which of the following statements about ketoconazole is correct?

    <p>It is too toxic for systemic use, so it is only available as topical preparations.</p> Signup and view all the answers

    Which of the following is a characteristic of echinocandins?

    <p>They inhibit the synthesis of β(1-3)glucan, a critical component of fungal cell walls</p> Signup and view all the answers

    Which of the following is a potential toxicity associated with caspofungin?

    <p>Infusion-related effects like headache and flushing</p> Signup and view all the answers

    What is a distinguishing characteristic of micafungin compared to caspofungin?

    <p>It increases the levels of cyclosporine and sirolimus</p> Signup and view all the answers

    Which echinocandin has the longest half-life?

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

    Which echinocandin is used for the treatment of esophageal and invasive candidiasis?

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

    Which of the following statements about echinocandins is correct?

    <p>They have minimal drug interactions</p> Signup and view all the answers

    Which antifungal drug is keratophilic and requires administration for 2-6 weeks for skin and hair infections?

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

    Which toxicity is specifically associated with griseofulvin use?

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

    Why must griseofulvin be administered for months in the case of nail infections?

    <p>To allow regrowth of the new protective nail</p> Signup and view all the answers

    Which drug has an unclear mechanism of action at the cellular level but binds to newly forming skin?

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

    What is the mechanism of action of griseofulvin?

    <p>It binds to keratin in newly forming skin, protecting it from infection</p> Signup and view all the answers

    Which of the following statements is true regarding the absorption of griseofulvin?

    <p>It is improved when taken with fatty foods</p> Signup and view all the answers

    What is the mechanism of action of terbinafine at the cellular level?

    <p>Inhibits squalene epoxidase</p> Signup and view all the answers

    Which of the following statements about terbinafine is true?

    <p>It is a keratophilic drug, effective for dermatophytosis</p> Signup and view all the answers

    How does terbinafine exert its antifungal effect?

    <p>By inhibiting the fungal enzyme squalene epoxidase</p> Signup and view all the answers

    What is a potential adverse effect associated with terbinafine?

    <p>Gastrointestinal upset</p> Signup and view all the answers

    What is the mechanism of action of nystatin?

    <p>It binds to ergosterol, disrupting fungal membranes</p> Signup and view all the answers

    Which of the following is an advantage of nystatin?

    <p>It has low toxicity when used topically</p> Signup and view all the answers

    Which of the following is a common indication for nystatin?

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

    Which of the following statements about clotrimazole and miconazole is correct?

    <p>They can be used over-the-counter for vulvovaginal candidiasis</p> Signup and view all the answers

    What is a common use of topical ketoconazole?

    <p>Treatment of seborrheic dermatitis</p> Signup and view all the answers

    Which of the following statements about the absorption of topical antifungals is correct?

    <p>Absorption of these agents from the skin and mucous membranes is negligible</p> Signup and view all the answers

    What is the most common indication for the use of nystatin?

    <p>Oral thrush</p> Signup and view all the answers

    Which antifungal agent is used as a pleasant-tasting alternative to nystatin for the treatment of oral thrush?

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

    Which topical antifungal is effective against tinea cruris and tinea corporis?

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

    Which topical antifungal is specifically useful for dermatophytic infections?

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

    Which topical antifungal is most commonly used for intertriginous candidal infections?

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

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