fungal

what are the four characteristics of all fungi

eukaryotic, nonmotile, aerobic, and saprophytic

saprophytic meaning

feed on decaying or dead matter

what are the common fungal habitats

decaying organic matter, fecal matter, soil, skin or GI tract

what type of fungus is aspergillus

mould

give an example of septate hyphae

aspergillus

give an example of aseptate hyphae

zygomycetes - mucor

what type of fungus is mucor

mould

what are the important fungal structures of moulds

hyphae and conidia

what does it mean for a fungi to be dimorphic

can look like either a yeast or a mould depending on the temperature of the environment

in the state of kentucky, which fungi are dimorphic

histoplasma and blastomyces

what type of fungus is the candida species

yeast

what type of fungus is cryptococcous neoformans

yeast

which disease is cryptococcous neoformans related to

advanced HIV

what is the most common type of yeast

candida albicans

what type of fungi is candida albicans

yeast

what type of antifungal is a DNA synthesis inhibitor

flucytosine

echinocandinas MOA

inhibit glucan synthesis

azoles MOA

inhibit ergosterol synthesis

polyenes MOA

bind to ergosterol to form pores in cell membrane and increase permeability

what two drugs are polyenes

amphotericin B and nystatin

where does nystatin target

topical and mucous membranes

conventional amphotericin concerns

severe kidney injury and infusion related reactions

how did they modify the amphotericin formulation

added lipid products

what is the dosage form of amphotericin B

IV only

which adverse reaction did the lipid formulation of amphotericin B limit

nephrotoxicities

what drugs are echinocandins

micafungin, anidulafungin, caspofungin

dosage form of echinocandins

all are IV only

fluconazole dosage form

IV and oral

fluconazole spectrum of activity

candida spp and cryptococous

what are the PK considerations of fluconazole

moderate DDI

both renal elimination and hepatic metabolism

fluconazole toxicities

occasional liver injury

itraconazole dosage form

oral only

itraconazole spectrum of activity

candida spp, cryptococcous + aspergillus + dimorphic

toxixcities of fluconazole

liver injury

PK considerations of itraconazole

solution better absorbed than capsule

lots of DDI

voriconazole dosage form

IV and oral

voriconazole spectrum of acyivity

itraconazole but MUCH better aspergillus coverage

voriconazole toxicities

melanoma (long-term use)

visual disturbances

PK considerations of voriconazole

fully metabolized by liver (3 enzymes), LOTS of DDI

non-linear elimination

posaconazole spectrum of activity

voriconazole + zygomycetes

isavuconazole spectrum of activity

voriconazole + zygomycetes

cryptococcous is NOT covered by which group

echinocandins

what drugs covers all fungi

amphotericin B and isavuconazle

which drugs cover zygomycetes

posaconazole, isavuconazole, amphotericin

which fungi are covered by all the drugs

candida albicans, candidia parapsilosis, candida tropicalis

aspergillus is covered by what

itraconazole, voriconazole, posaconazole, isavuconazole, amphotericin, caspogunfin, micafungin, anidulafungin

what drug does not cover aspergillus

fluconazole