ICARE: ID FINAL Antifungals

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Author:
VASUpharm14
ID:
189244
Filename:
ICARE: ID FINAL Antifungals
Updated:
2012-12-13 00:46:24
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im too cool
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Description:
Finals!!! good luck!!!!
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  1. amphotericin B
    MOA
    binds to ergosterol and alters permeability
  2. amphotericin B
    spectrum
    ADR
    • BROAD (candida, aspergillus) 
    • but bad with toxicities: K, Mg wasting, infusion-related, nephrotoxicity --> developed lipid formulations (Ambisome, Amphotec, from Acelcet?) 
  3. flucytosine (5-FC)
    clinical use
    • COMBO therapy 
    • bone marrow suppression
  4. Azoles
    MOA
    reduction of ergosterol synthesis by inhibition of fungal cyp450 --> potential drug interactions!
  5. Azoles
    spectrum
    • cryptococcus neoforman
    • dermatophytes
    • Aspergillis (itra and vori conazole)
  6. ketoconazole
    clinical use
    • not used much
    • TOO MANY drug interactions!
  7. itraconazole
    clinical use
    Adverse effect
    Drug interactions
    • onychomycosis - nail bed infections
    • CONTRAINDICATED IN CHF
    • CYP3A4 inhibitor/substrate
  8. fluconazole
    spectrum + pk/absorption
    • Widely used
    • Candida ALBICANS
    • not for glabrata or krusei --> don't use if you don't know!!!
    • BA excellent IV:PO
  9. voriconazole
    spectrum
    adverse effects
    disclaimer
    • like itraconazole
    • ASPERGILLOSIS
    • visual effects (wavy lines, flashing, blurry vision)/visual hallucinations
    • IV 200 MG DO NOT USE WITH CRCL <50 ML/MIN
  10. echinocandins
    MOA
    spectrum
    Adverse effects
    • inhibit synthesis of 1-3 glycans of fungal cell walls
    • BROAD - all candida and aspergillus
    • overall extremely well tolerated
  11. caspofungin (echinocandin)
    clinical use
    • used over ampho B
    • disseminated and mucocutaneous candidal infections
    • empiric antifungal therapy during febrile neutropenia
    • invasive aspergillosis
  12. terbinafine
    clinical use
    MOA
    • onychomycosis 
    • like griseofulvin but cidal
    • SQUALENE EPOXIDASE (inhibits ergosterol biosynthesis)

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