Antifungal/Antiparasitics

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Author:
jknell
ID:
154192
Filename:
Antifungal/Antiparasitics
Updated:
2012-05-16 12:43:48
Tags:
Microbiology Antifungal Antiparasitics
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Description:
Microbiology Antifungals/antiparasitics
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  1. Antifungal Agents
    • -Amphotericin B
    • -5-Flucytosine: (prodrug for 5-FU)
  2. Ampothericin B
    Mechanism: binds ergosterol in fungal membrane increasing permeability of cell wall

    Uses: Prevention and treatment of invasive fungal infection

    Side Effects: Nephrotoxic, IV causes fever, chills, headache, hypoTN, tachypnea, wt loss, hypoK, anemia

    Bioavailability: IV only

    Metabolism: long t1/2
  3. 5-Flucytosine (prodrug for 5-FU)
    Mechanism: fungal deamination to 5-FU, inhibits DNA synthesis

    Uses: treatment of systemic infections due to Candida or cryptococcus neoformans

    Side Effects: depress BM, N/V, diarrhea

    Bioavailability: oral
  4. Azoles
    • -fluconazole
    • -itraconazole
    • -voricazole
  5. Fluconazole
    Mechanism: inhibits cytochrome P450 causing depletion of ergosterol (decrease integrity of fungal wall)

    Uses: candida, cryptococcus, coccidiodal meningitis

    Side Effects: N/V, rash, headache, rare hepatotoxicity, many drug interactions

    Bioavailability: oral

    Metabolism: adjust for renal function
  6. Itraconazole
    Mechanism: inhibits cytochrome P450 causing depletion of ergosterol (decrease integrity of fungal wall)

    Uses: fungal infection in immunocompromised, aspergillus, histoplasma

    Side effects: N/V, rash, headache, rare hepatotoxicity, many drug interactions

    Bioavailability: IV and oral (need acidity for absorption)

    Metabolism: hepatic only (no adjustment for renal fxn)
  7. Voricazole
    Mechanism: inhibits cytochrome P450 causing depletion of ergosterol (decrease integrity of fungal wall)

    Uses: severe aspergillus, fluconazole resistant Candida

    Side Effects: N/V, rash, headache, rare hepatotoxicity, many drug interactions

    Bioavailability: well absorbed (low CSF levels)

    Metabolism: dose adjust for renal and hepatic failure
  8. Echinocandins
    Mechanism: prevent glucan snthesis in fungal cell wall

    Uses: Aspergillus, fluconazole-resistant Candida

    Side Effects: few

    Bioavailability: IV

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