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Antifungals

Antifungals. Amphotericin B Mech. Pores in ergosterol membrane. Use. Wide spectrum Aspergillus , Mucor , Candida, Cryptococcus (w/ flucytosine ), Histo , blasto , Sporothrix schenki Doesn’t cross BBB. SE. Nephrotoxicity Fever/chills, hypotension w/ IV rxn. Nystatin mech.

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Antifungals

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  1. Antifungals

  2. Amphotericin B Mech

  3. Pores in ergosterol membrane

  4. Use

  5. Wide spectrum • Aspergillus, Mucor, • Candida, • Cryptococcus (w/ flucytosine), Histo, blasto, Sporothrixschenki • Doesn’t cross BBB

  6. SE

  7. Nephrotoxicity • Fever/chills, hypotension w/ IV rxn

  8. Nystatinmech

  9. polyene pores • Not for systemic use

  10. USE

  11. Candidiasis • Swish and swallow • Diaper rash • Vaginal infection

  12. AZOLE MECH

  13. Keto, flucona, itraconazole • Fungicidal, inhibit 14 alpha demethylase, which converts lanosterol to ergosterol

  14. USE of fluconazole

  15. candidasis all types- DOC • Coccidiomycoses • Cyptococcal meningitis

  16. Keto Use

  17. Blasto, histo, coccidio • Mucocutaneous Candida • determatophytoses • hypercortisolism

  18. ItraconazoleUSE

  19. DOC for blasto and sporotrichoses

  20. Clotrimazole and Miconazole

  21. Candida and dermatophytes

  22. SE

  23. Liver – inhibits cyp 450 • Decrease syn of steroids: cortisol, testosterone

  24. FlucytosineMech

  25. Inhibits DNA synthesis via conversion to 5FU, which competes w/ uracil • Also 5FU becomes 5fd-UMP which inhibits thymidylatesynthase

  26. Use

  27. w/ amph B for candidal and cryptoccocal infection

  28. SE

  29. Bone marrow suppresion

  30. GriseofulvinMech

  31. Disrupts microtubules fxn, deposits in keratin

  32. use

  33. Oral tx of dermatophytes

  34. SE

  35. Increase p450 and warfarin metabolism • Potentiates ethanol • Avoid w/ history of porphyria • teratogen

  36. TerbinafineMech

  37. Inhibiting squaleneepoxidase, decreasing ergosterol

  38. use

  39. Dermatophytesesponchomysosis

  40. CapsofunginMech

  41. Inhibits cell wall syn

  42. Use

  43. Invasive aspergillosis

  44. SE

  45. GI, flushing

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