filamentous
-species that infect topical tissues such as skin, hair, and nails.
-termed "tinea"
yeast
-infect more tissue types such as mouth, bladder, CNS
-mostly opportunistic
dimorphic
-dependent on condition; can be filamentous or yeast
- common in aids patients
filamentous systemic
- filamentous, but broader activity in the body.
epidermophyton, microsporum, trichophyton
What are the Filamentous species? (3)
cryptococcus, candida
What are the Yeast species? (2)
blastomyces, histoplasma, coccidioses
What are the Dimorphic species? (3)
aspergillus
What are Filamentous systemic species?
mdr efflux, altered membrane sterols
What are methods of anti-fungal resistance?
a
Which anti-fungal agent is used 1st line for systemic fungal infections?
a) Polyenes
b) Allylamines
c) imidazoles
d) triazoles
e) echinocandins
Amphotericin B, nystatin
What are our Polyenes? (2)
slow iv infusion
How are Amphotericin anti-fungals administered?
c
Which anti-fungal is mostly used for skin infections or vaginal yeast infections?
a) Polyenes
b) Allylamines
c) imidazoles
d) triazoles
e) echinocandins
binds to ergosterol on the fungal membranes; forms pores that allow influx of ions; cidal
Explain the MOA of Polyenes.
inhibits lanosterol 14-a; reduced levels of ergosterol ; increase in precursors that alters membrane fluidity causing cell to rupture.
Explain the MOA of Azoles.
b
Allylamines are used on what kind of species?
a) yeast
b) filamentous
c) systemic filamentous
d) dimorphic
inhibits squalene epoxidase; cidal or static depending on concentration
Explain the MOA of Allylamines?
inhibits glucan synthase; enzyme required for cell wall formation
Explain the MOA of Echinocandins & Ibrexafungerp
-fungin suffix
How can you identify Echinocandin drugs?
e
Which class of anti-fungal is used to treat esophageal candida and is 2nd line for asperigillus?
a) Polyenes
b) Allylamines
c) imidazoles
d) triazoles
e) echinocandins
-fine suffix ; except tolnaftate
How can you identify Allylamines drugs?
Flucytosine
-first line in combination with amphotericin to treat cryptococcus
a
Which misc. anti-fungal agent has a MOA that involves it being a prodrug and being converted to 5-fluorouracil, replacing uracil in RNA to act as an antimetabolite and blocking DNA synthesis and RNA chain formation?
a) Flucytosine
b) griseofulvin
c) ciclopirox
d) clioquinol
all except a
Which misc. anti-fungal agent is used to treat dermatophytes?
a) Flucytosine
b) griseofulvin
c) ciclopirox
d) clioquinol
e) undecyclenic acid
e
Which misc. antifungal agent's MOA is interfering with fungal membrane and causing leakage?
a) Flucytosine
b) griseofulvin
c) ciclopirox
d) clioquinol
e) undecyclenic acid
d
Which misc. antifungal agent's MOA is to inhibit proteasome and induce apoptosis?
a) Flucytosine
b) griseofulvin
c) ciclopirox
d) clioquinol
e) undecyclenic acid
c
Which misc. antifungal agent's MOA is to inhibit protein synthesis and chelate polyvalent cations?
a) Flucytosine
b) griseofulvin
c) ciclopirox
d) clioquinol
e) undecyclenic acid
b
Which misc. antifungal agent's MOA is anti-mitotic ?
a) Flucytosine
b) griseofulvin
c) ciclopirox
d) clioquinol
e) undecyclenic acid
patients on long-term therapy, treating yeast infections with agents for serious infections, fungicides in agriculture
What are causes for increased resistance ?
a
Which class of antifungals have drug interactions with digitalis?
a) Polyenes
b) Allylamines
c) imidazoles
d) triazoles
e) echinocandins
c
Which class of anti-fungals can inhibit CYP450 enzymes?
a) Polyenes
b) Allylamines
c) azoles
e) echinocandins
c
Which class of anti-fungals can cause gynecomastia?
a) Polyenes
b) Allylamines
c) azoles
e) echinocandins
e
Which class of anti-fungals have no effect against dimorphic fungi or cryptococcus?
a) Polyenes
b) Allylamines
c) imidazoles
d) triazoles
e) echinocandins