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

How is Amphotericin B primarily eliminated from the body?

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

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

<p>More than 90% (C)</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 (D)</p> Signup and view all the answers

Why does resistance to amphotericin B arise?

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

Which fungal infection is NOT commonly treated with amphotericin B?

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

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

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

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

<p>AOTA (D)</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 (B)</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 (B)</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 (A)</p> Signup and view all the answers

How is flucytosine primarily excreted from the body?

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

What is the mechanism of resistance to flucytosine?

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

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

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

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

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

Which class of azoles includes fluconazole?

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

What is a characteristic feature of fluconazole's bioavailability?

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

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

<p>Aspergillosis (D)</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 (D)</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 (C)</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 (B)</p> Signup and view all the answers

Which of the following statements about voriconazole is correct?

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

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

<p>Nephrotoxicity (A)</p> Signup and view all the answers

Which of the following statements about itraconazole is correct?

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

Which of the following statements about posaconazole is correct?

<p>It is effective against mucormycosis. (D)</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. (A)</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. (A)</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 (B)</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 (D)</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 (D)</p> Signup and view all the answers

Which echinocandin has the longest half-life?

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

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

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

Which of the following statements about echinocandins is correct?

<p>They have minimal drug interactions (D)</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 (B)</p> Signup and view all the answers

Which toxicity is specifically associated with griseofulvin use?

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

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

<p>Inhibits squalene epoxidase (A)</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 (D)</p> Signup and view all the answers

How does terbinafine exert its antifungal effect?

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

What is a potential adverse effect associated with terbinafine?

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

What is the mechanism of action of nystatin?

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

Which of the following is an advantage of nystatin?

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

Which of the following is a common indication for nystatin?

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

What is a common use of topical ketoconazole?

<p>Treatment of seborrheic dermatitis (B)</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 (A)</p> Signup and view all the answers

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

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

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

<p>Terbinafine (A)</p> Signup and view all the answers

Which topical antifungal is specifically useful for dermatophytic infections?

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

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

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

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