Hosam Mohamed-
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
