Sunday, 3 August 2014

Antifungal Drugs

by Hazim Shafii

1.      Factors causing fungal infections include AIDS, chronic diseases, broad-spectrum antibiotics, damaged skin and moist skin (T)
2.      Amphotericin B, Fluconazole, Ketoconazole, Itraconazole and Flucytosine are drugs to treat cutaneous mycoses. (F)
3.      Nystatin acts by binding to ergosterol (T)
4.      Amphotericin B
a)
Amphotericin B is produced by Streptomyces nodosus.
T
b)
Does not affect mammalian cell membranes because the drug binds to ergosterol rather than cholestrol.
T
c)
Can be safely used for renal failure patients
F

5.      Ketoconazole
a)
First line drug to treat mucocutaneous candidiasis
F
b)
Should not be given along with antacids, H2-receptor blockers, proton-pump inhibitors or Amphotericin B
T
c)
Can be given to pregnant woman
F
d)
Ketoconazole decreases androgen production
T

6.      Fluconazole
a)
Is the drug of choice for cryptococcosis caused by cryptococcus neoformans
T
b)
Eliminated through renal route
T
c)
Does not inhibit CYP450 system responsible for the synthesis of androgens
T
     



6.   Itraconazole
a)
Has endocrinologic side effects like ketoconazole
F
b)
Drug of choice for treatment of  Paracoccidiodimycosis, Blastomycosis, Sporotrichosis, Aspergillosis and Histoplasmosis
T
c)
Major metabolite is Hydroxy-itraconazole
T

7.   Terbinafine
a)
Most often results in hepatotoxicity and neutropenia
F
b)
Eliminated through bile route
F
c)
Decrease the synthesis of ergosterol by inhibiting fungal squaline epoxidase
T

8.   Griseofulvine
a)
A fungicidal drug
F
b)
Given topically to treat dermatophytic infection
T

9.   Flucytosine

a)
Converted to 5-FdUMP to inhibit thymidylate kinase
F
b)
Works poorly with Amphotericin B
F
c)
Metabolized in liver
T
d)
5-FdUMP is incorporated in fungal RNA
F

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