bomehubo's version from 2016-11-18 16:03

Section 1

Question Answer
antifungals - name the classespolyenes, azoles
antifungal therapy pitfalls1. delay in starting treatment 2. limited activity of availabe antifungal agents 3. fungal "burden" 4. host immune dysfxn 5. physiologic status of host

Section 2

Question Answer
Polyenes - mechanismintercalate into sterol cell membrane; causing leaking of cytoplasmic contents
Polyenes - drugsamphotericin B; nystatin
Polyenes - clinical indicationsaspergillosis; histoplasmosis; blastomycosis
Polyenes:ADE - most seriousnephrotoxicity > virtually every pt develops some decrease in CrCl; direct renal tubular toxin; mostly reversible azotemia (may take months)

Section 3

Question Answer
Azoles - mechanisminhibits enzyme in cell membrane steroid synthesis pathway
Azoles - drugsketo- flu- itra- vori- posa- canazole
Azoles - special propertiesfungistatic; oral and IV preps
Azoles - interactionsnumerous drug interactions; metabolized by CYP450; inhibitors
Azoles - enzyme it inhibits14-alpha-demethylase

Section 4

Question Answer
Allylamines - mechanismreversible, non-competitive inhibitors of squalene epoxidase leading to decrease amounts of lanosterol and ultimately ergosterol
Allylamines -clinical utilitylimited to topical tx of dermatophyte infections
Allylamines - drugsnaftifine, terbinafine, tolnaftate

Section 5

Question Answer
Nucleoside analogues - mechanismconverted to triphosphate form and incorporation with subsequent miscoding of RNA & DNA synthesis
Nucleoside analogues - analogue of what?flucytosine (5-FC) - cytosine analogue
Nucleoside analogues - special noteno indication for monotherapy; rapidly emerging resistance
Nucleoside analogues - AEpotent myelosuppressive

Section 6

Question Answer
Echinocandins - mechanisminhibition of glucan synthase (cell wall)
Echinocandins - drugsmicofungin; caspofungin
Echinocandins - activity against what? no activity for what?excellent coverage for aspergillus and candida. No activity for cryptococcus.