antifungals (daniels)

amphotericin b brand

amphocin, fungizone, ambisome

brand fluconazole

diflucan

brand voriconazole

vfend

brand caspofungin

cancidas

brand micafungin

mycamine

brand ketoconazole

nizoral

brand nystatin

nystop

brand terbinafine

lamisil

brand clotrimazole/betamethason

lotrizone

what sterol are fungal cell membranes made of

ergosterol

what sterol are mammalian cell membranes made of

cholesterol

what class are the membrane disruptors

polyenes

for polyenes what correlates directly with antifungal activity and degree of toxicity

number of conjugated double bonds

what class binds to ergosterol in the fungal cell membrane through the lipolphilic portion

polyenes

what class causes nephrotoxicity by pulling cholesterol out of kidney cell membranes

polyenes

what are the polyenes

nystatin, amphotericin B

what drug is broad spectrum that can be used as initial tx for many invasive fungal infections

amphotericin B

which drug can cause fever, malaise, rigors, changes in BP, thromoplebitis, nephrotoxicity and anmeia

amphortericin b

whihc drugis associated with severe back/chest pain with the first dose?

ambisome (amphotericin)

which drug has a BW for usee primarily for life threatening fungal infections and also for med errors confusings lipid-based and conventional forms of the drug

amphotericin B

what should the dose be for conventional amp b

1.5mg/kg/d

what drug must be mixed with D5W for admin

amp b

which drug requires premedication to reduce infusion related reactions

amp b

which drug causes and increased risk of digoxin toxicity d/t hypokalemia

amp b

what class ard the squalene epoxidase inhibitors

allylamines (ergosterol biosyn inhib)

which antifungals are affective against dermatophytes

allylamines (butenafine, naftifine, terbinafine)

which class works by inhibiting cell membrane synthesis by blocking epoxidation of squalene

allylamines

what anti-fungal agent is used for onychomycosis

terbinafine

which drug is CI in chronic or active liver dx

terbinafine

what class are 14∂ sterol demethylase inhib

azoles (ergosterol biosyn inhib)

which class are five-membered aromatic reings containing 2-4 nitrogen atoms

azoles

what is the pharmacophore for azoles

the 5 membered N ring

what is essential for azole binding to heme

basic N3N4

what was the first tetrazole antifungal with four nitrogen atoms in the azole ring

oteseconazole

what is oteseconazole used for ?

vulvovaginal candidiasis

what azole can only be used in females who are not of reproductive potential

oteseconazole

what can lead to azole resistance?

dec binding to heme, incr efflux pump activity, and incr production of demethylase (heme)

what do iv voriconazole and posaconazole require for solubility?

cyclodextrin

what is cyclodextrin associated with? (se)

nephrotoxicity

which azoles require low stomach pH for oral abs

ketoconazole and itraconazole

what SE can voricanazole and isavuconazonium vause

SJS/TEN

which azole can cause visual changes, hallucinations, and photosensitivity

voriconazole

which azole has a BW for worsening HF, do not use for onychomycosis in pts with ventricular dysfunction of hx of HF

itraconazole

which azole can particulate in an IV, requires a filter diuring admin

isavuconazole

2 main SE with azoles

QT prolongation, hepatotoxicity

which azole causes short QT

isavuconazole

what enzyme do azoles inhib

3A4

what does itraconazole and ketoconazole inhib

pGp

how must azoles be taken?

separate from antacids

with which azole can concentrations increase dangerously when given with 2C19, 2C9, or 3A4 inhibors

voriconazole

what is the only azole iwht renal dose adjustment

fluconazole

what azola can cause hepatotoxicity that leads to liverr transplant

ketoconazole

what azole can cause HF

itraconazole

what azole can cause visual changes, phototox, and hallucinations

voriconazole

what azole’s tab≠suspension dose and should be taken with food

posaconazole

what 2 classes are the cell wall biosynthesis inhibitors

echinocandins & triterpenoids

what are the echinocandin antifungals

caspofungin, andulafungin, micafungin

which classes inhibit 1,3-ß-D-glucan synthase adn reduce cell wall integrty leading to cell lysis

echinocandins & triterpenoids

which echinocandin can cause SJS/TEN

caspofungin

which class can cause histamine-mediated symptoms

echinocandins

which echino should be protected from light during admin

micafungin

which echino should be reserved fror pts with limited or no alternative options

rezafungin

which echin has a DDI with rifampin

caspofungin

which echino raises sirolimus and nifedipine levels

michafungin

what is the only triterpenoid

ibrexafungerp

what has a BW for embryo-fetal toxicity and is CI in preg

ibrexafungerp

what drug is taken up by fungi and metabolised to 5-fluorouracil by fungal cytosine deaminase

flucytosine

which drug has a BW for use in renal dysfunction to monitor hematologic renal and hepatic staus

flucytosine

which drug is CI in complete DPD deficieincy because of toxicity risk

flucytosine