57 Questions
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
How is Amphotericin B primarily eliminated from the body?
Renal excretion
What percentage of Amphotericin B is bound by serum proteins in the bloodstream?
More than 90%
What is the main mechanism of action of amphotericin B?
Binding to ergosterol and causing pore formation
Why does resistance to amphotericin B arise?
Decrease in ergosterol membrane concentration
Which fungal infection is NOT commonly treated with amphotericin B?
Streptococcus
What is a common toxic effect associated with amphotericin B colloidal formulations?
Nephrotoxicity
How can infusion-related toxicity with amphotericin B be reduced?
AOTA
What is the reason for using lipid formulations of amphotericin B?
To decrease toxicity to mammalian cells
What is the mechanism by which flucytosine exerts its antifungal activity?
It inhibits fungal DNA and RNA synthesis
What is the primary reason for combining flucytosine with amphotericin B during initiation treatment?
To reduce the risk of resistance developing to flucytosine
How is flucytosine primarily excreted from the body?
Unchanged in the urine
What is the mechanism of resistance to flucytosine?
Altered metabolism of the drug
Which of the following is NOT a potential toxicity associated with flucytosine?
Nephrotoxicity
For which fungal infection is flucytosine commonly used in combination with other antifungal agents?
Cryptococcal meningitis
Which class of azoles includes fluconazole?
Triazoles
What is a characteristic feature of fluconazole's bioavailability?
High bioavailability
For which fungal infection is fluconazole NOT effective according to the text?
Aspergillosis
What makes fluconazole the azole of choice for Cryptococcal meningitis and mucocutaneous candidiasis?
High degree of water solubility
Which fungal infection can high doses of fluconazole help obviate the need for intrathecal amphotericin B?
Cryptococcal meningitis
What is a distinguishing factor of fluconazole's effect on hepatic microsomal enzymes compared to other azoles?
No effect
Which of the following statements about voriconazole is correct?
It has a broader spectrum than fluconazole.
Which of the following is NOT a potential toxicity associated with voriconazole?
Nephrotoxicity
Which of the following statements about itraconazole is correct?
It does not affect mammalian steroid synthesis.
Which of the following statements about posaconazole is correct?
It is effective against mucormycosis.
Which of the following statements about isavuconazole is correct?
It is licensed for treatment of invasive mucormycosis and invasive aspergillosis.
Which of the following statements about ketoconazole is correct?
It is too toxic for systemic use, so it is only available as topical preparations.
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
Which of the following is a potential toxicity associated with caspofungin?
Infusion-related effects like headache and flushing
What is a distinguishing characteristic of micafungin compared to caspofungin?
It increases the levels of cyclosporine and sirolimus
Which echinocandin has the longest half-life?
Anidulafungin
Which echinocandin is used for the treatment of esophageal and invasive candidiasis?
Anidulafungin
Which of the following statements about echinocandins is correct?
They have minimal drug interactions
Which antifungal drug is keratophilic and requires administration for 2-6 weeks for skin and hair infections?
Griseofulvin
Which toxicity is specifically associated with griseofulvin use?
AOTA
Why must griseofulvin be administered for months in the case of nail infections?
To allow regrowth of the new protective nail
Which drug has an unclear mechanism of action at the cellular level but binds to newly forming skin?
Griseofulvin
What is the mechanism of action of griseofulvin?
It binds to keratin in newly forming skin, protecting it from infection
Which of the following statements is true regarding the absorption of griseofulvin?
It is improved when taken with fatty foods
What is the mechanism of action of terbinafine at the cellular level?
Inhibits squalene epoxidase
Which of the following statements about terbinafine is true?
It is a keratophilic drug, effective for dermatophytosis
How does terbinafine exert its antifungal effect?
By inhibiting the fungal enzyme squalene epoxidase
What is a potential adverse effect associated with terbinafine?
Gastrointestinal upset
What is the mechanism of action of nystatin?
It binds to ergosterol, disrupting fungal membranes
Which of the following is an advantage of nystatin?
It has low toxicity when used topically
Which of the following is a common indication for nystatin?
Oropharyngeal thrush
Which of the following statements about clotrimazole and miconazole is correct?
They can be used over-the-counter for vulvovaginal candidiasis
What is a common use of topical ketoconazole?
Treatment of seborrheic dermatitis
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
What is the most common indication for the use of nystatin?
Oral thrush
Which antifungal agent is used as a pleasant-tasting alternative to nystatin for the treatment of oral thrush?
Clotrimazole
Which topical antifungal is effective against tinea cruris and tinea corporis?
Terbinafine
Which topical antifungal is specifically useful for dermatophytic infections?
Clotrimazole
Which topical antifungal is most commonly used for intertriginous candidal infections?
Nystatin
This quiz covers the classifications of systemic antifungal drugs, focusing on Amphotericin B as a fungicidal drug with a broad spectrum. It discusses its administration, resistance, and effectiveness. Test your knowledge on systemic antifungal agents with this quiz!
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