Classifications of Antifungal Agents: Systemic Antifungal Drugs for Systemic Infections

What is the main mechanism of action of Amphotericin B?

Disrupting fungal membrane permeability and transport properties

How is Amphotericin B usually administered for systemic infections?

Intravenously as a nonlipid colloidal suspension or in a liposomal formulation

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

Effective only on fungi within the gastrointestinal tract lumen

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

It cannot penetrate the blood-brain barrier effectively Signup and view all the answers

How is Amphotericin B primarily eliminated from the body?

Renal excretion Signup and view all the answers

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

More than 90% Signup and view all the answers

What is the main mechanism of action of amphotericin B?

Binding to ergosterol and causing pore formation Signup and view all the answers

Why does resistance to amphotericin B arise?

Decrease in ergosterol membrane concentration Signup and view all the answers

Which fungal infection is NOT commonly treated with amphotericin B?

Streptococcus Signup and view all the answers

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

Nephrotoxicity Signup and view all the answers

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

AOTA Signup and view all the answers

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

To decrease toxicity to mammalian cells Signup and view all the answers

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

It inhibits fungal DNA and RNA synthesis Signup and view all the answers

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

To reduce the risk of resistance developing to flucytosine Signup and view all the answers

How is flucytosine primarily excreted from the body?

Unchanged in the urine Signup and view all the answers

What is the mechanism of resistance to flucytosine?

Altered metabolism of the drug Signup and view all the answers

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

Nephrotoxicity Signup and view all the answers

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

Cryptococcal meningitis Signup and view all the answers

Which class of azoles includes fluconazole?

Triazoles Signup and view all the answers

What is a characteristic feature of fluconazole's bioavailability?

High bioavailability Signup and view all the answers

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

Aspergillosis Signup and view all the answers

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

High degree of water solubility Signup and view all the answers

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

Cryptococcal meningitis Signup and view all the answers

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

No effect Signup and view all the answers

Which of the following statements about voriconazole is correct?

It has a broader spectrum than fluconazole. Signup and view all the answers

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

Nephrotoxicity Signup and view all the answers

Which of the following statements about itraconazole is correct?

It does not affect mammalian steroid synthesis. Signup and view all the answers

Which of the following statements about posaconazole is correct?

It is effective against mucormycosis. Signup and view all the answers

Which of the following statements about isavuconazole is correct?

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

Which of the following statements about ketoconazole is correct?

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

Which of the following is a characteristic of echinocandins?

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

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

Infusion-related effects like headache and flushing Signup and view all the answers

What is a distinguishing characteristic of micafungin compared to caspofungin?

It increases the levels of cyclosporine and sirolimus Signup and view all the answers

Which echinocandin has the longest half-life?

Anidulafungin Signup and view all the answers

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

Anidulafungin Signup and view all the answers

Which of the following statements about echinocandins is correct?

They have minimal drug interactions Signup and view all the answers

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

Griseofulvin Signup and view all the answers

Which toxicity is specifically associated with griseofulvin use?

AOTA Signup and view all the answers

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

To allow regrowth of the new protective nail Signup and view all the answers

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

Griseofulvin Signup and view all the answers

What is the mechanism of action of griseofulvin?

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

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

It is improved when taken with fatty foods Signup and view all the answers

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

Inhibits squalene epoxidase Signup and view all the answers

Which of the following statements about terbinafine is true?

It is a keratophilic drug, effective for dermatophytosis Signup and view all the answers

How does terbinafine exert its antifungal effect?

By inhibiting the fungal enzyme squalene epoxidase Signup and view all the answers

What is a potential adverse effect associated with terbinafine?

Gastrointestinal upset Signup and view all the answers

What is the mechanism of action of nystatin?

It binds to ergosterol, disrupting fungal membranes Signup and view all the answers

Which of the following is an advantage of nystatin?

It has low toxicity when used topically Signup and view all the answers

Which of the following is a common indication for nystatin?

Oropharyngeal thrush Signup and view all the answers

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

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

What is a common use of topical ketoconazole?

Treatment of seborrheic dermatitis Signup and view all the answers

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

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

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

Oral thrush Signup and view all the answers

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

Clotrimazole Signup and view all the answers

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

Terbinafine Signup and view all the answers

Which topical antifungal is specifically useful for dermatophytic infections?

Clotrimazole Signup and view all the answers

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

Nystatin Signup and view all the answers

Classifications of Antifungal Agents: Systemic Antifungal Drugs for Systemic Infections

Questions and Answers

What is the main mechanism of action of Amphotericin B?

How is Amphotericin B usually administered for systemic infections?

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

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

How is Amphotericin B primarily eliminated from the body?

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

What is the main mechanism of action of amphotericin B?

Why does resistance to amphotericin B arise?

Which fungal infection is NOT commonly treated with amphotericin B?

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

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

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

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

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

How is flucytosine primarily excreted from the body?

What is the mechanism of resistance to flucytosine?

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

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

Which class of azoles includes fluconazole?

What is a characteristic feature of fluconazole's bioavailability?

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

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

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

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

Which of the following statements about voriconazole is correct?

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

Which of the following statements about itraconazole is correct?

Which of the following statements about posaconazole is correct?

Which of the following statements about isavuconazole is correct?

Which of the following statements about ketoconazole is correct?

Which of the following is a characteristic of echinocandins?

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

What is a distinguishing characteristic of micafungin compared to caspofungin?

Which echinocandin has the longest half-life?

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

Which of the following statements about echinocandins is correct?

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

Which toxicity is specifically associated with griseofulvin use?

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

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

What is the mechanism of action of griseofulvin?

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

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

Which of the following statements about terbinafine is true?

How does terbinafine exert its antifungal effect?

What is a potential adverse effect associated with terbinafine?

What is the mechanism of action of nystatin?

Which of the following is an advantage of nystatin?

Which of the following is a common indication for nystatin?

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

What is a common use of topical ketoconazole?

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

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

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

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

Which topical antifungal is specifically useful for dermatophytic infections?

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

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