Anti-fungal Chemotherapy Flashcards Preview

Drugs > Anti-fungal Chemotherapy > Flashcards

Flashcards in Anti-fungal Chemotherapy Deck (18)
Loading flashcards...
1
Q
Voriconazole
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Triazole antifungal

Newer drug used to treat serious aspergillosis infections and some rarer infections in immunocompromised patients

2
Q

Ringworm caused by what family?

A

Trichophyton family

3
Q
Fluconazole
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Triazole antifungal
Synthetic product - inhibits CYP450-14-alpha-demethylase
Can be taken orally, absorption good at any pH
Widely distributed in the body, including the brain
Most active drug in triazole class
Treats cryptococcal infections (including cryptococcal meningitis) and severe oral and oesophageal candidiasis
High doses inhibit androgen synthesis in men

4
Q
Griseofulvin
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Interferes with microtubule assembly
Used to treat skin infections in particular, but taken orally instead of topically
Natural product produced by strains of Penicillum fungi
Does not inhibit Candida
Used rarely nowadays, therapy can last a year

5
Q

Pneumocystis pneumonia. When is it important? What is it treated with?

A

Rarely important unless AIDs patients, where it is VERY important
Treated with co-trimoxazole and anti-leishmaniasis drugs

6
Q
Posaconazole 
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Triazole antifungal
Normally used 2nd line
Tends to be used in immunocompromised patients

7
Q
Azole drug class 
Mechanism of action 
Examples
A

Antifungal
Inhibits CYP450-14-alpha-demethylase enzyme
Imidazoles - ketoconazole, miconazole, ticonazole
Triazoles - only these are licensed for use in UK: fluconazole, intraconazole, voriconazole, posaconazole
Azores and polyene can’t be given together as polyene rely on ergosterol binding to work
CYP450-14-a-demethylase is an enzyme used in the conversion of squealing to ergosterol

8
Q

Candida infections caused by what organism?

A

The yeast Candida, especially Candida albicans

9
Q
Terbinafine 
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Polyene
On WHO list of essential medicines
Used topically/orally for skin infections
Inhibits squalne epoxidase, a rate limiting step in ergosterol synthesis
Accumulates in skin, nails and fatty tissue as hydrophobic drug

10
Q

Cryptococcosis or cryptococcal meningitis, what group does this cause a lot of death in? Treatment?

A

Leading cause of death in AIDs patients, in whom nearly always untreatable

11
Q
Amphotericin B 
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Polyene antifungal
produced by Streptomyces nodosus
Treats oral infections by local application (not absorbed by mouth)
Used IV for systemic infections
Active against most fungi + yeasts, including cryptococcosis
Toxic - especially to kidneys, and side effects common
Lipid-based formulations are less toxic

12
Q
Flucocytosine
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Antimetabolic antifungal
Targets DNA+RNA synthesis
Transported into fungus via fungal cytosine permeate
Converted to 5-flurouracil by cytosine de-amidase
inhibits DNA+RNA synthesis
Mainly used in combination therapy with amphotericin B

13
Q

Blastomycosis

A

Affects lungs of the healthy, mainly young men

14
Q
Caspofungin
Drug class
How is it made? 
What does it treat?
Pros
Cons
Similar to
A

Broad range, minimal drug interactions
Toxic to embroys
Hepatotoxic
Similar to anidulafungin and micafungin
They are actually fungal products produced by Aspergillus strains
They have minor semi-synthetic modifications
Active against bio films on catheters

15
Q
Nystatin
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Polyene antifungal
Produced by Streptomyces noursei
Treats Candida albicans infections of skin - ointments and creams

16
Q
Itraconazole
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Triazole antifungal
Broad spectrum of activity
Given orally for candiasis (2nd line) and also aspergillosis
Licensed in cats and also to treat guinea. Pigs

17
Q

Echinocandin antifungals

Target/mechanism

A

1,3-beta-glucan synthesis
Beta-glucans are carbohydrate polymers that provide cross-links to other cell wall components - a bit like peptidoglycan in bacteria

18
Q
Ketoconazole 
Drug class
How is it made? 
What does it treat?
Pros
Cons
A

Imidazole antifungal
Manufacture is a secret
Shampoo for treatment of dandruff
Cream for athlete’s foot
Better absorbed by mouth than other imidazoles, and WAS once used for treatment of systemic infections
Hepatotoxicity is a known side effects - need LFTs
Recently withdrawn from systemic use