Fungi are_______, eukaryotic microorganisms that exist as yeast,_______, combination of the two as _________.
Free living,
Molds,
Dimorphic fungi
T/F. Fungi and humans have many metabolic pathways in common?
TRUE
What are the three susceptible populations of concern for an increase risk of mycoses.
Immunocompromised,
ICU Patients
Patients w/prostheses
Diagnosis has been problematic due to slow growth. What new methods have evolved to improve diagnosis?
PCR,
Western blot,
ag detection
mammals use _______as a structural component of their cell membrane and fungi use _________.
Cholesterol,
Ergosterol
Egrosterol is synthesized in _________.
microsomes
Are antifunal inhibitors typically fungistatic or fungicidal?
Fungstatic
Squaline epoxidase is inhibited by _______and __________.
Allylamines Benzylamines,
Imidazoles Triazoles
14 alpha sterol demethylase is inhibited by ________ _______.
Imidazoles Triazoles
What four things compose the cell wall of fungi?
Chitin
B(1,3)D-glucan
B(1,6)D-glucan
Mannose containing protiens (mannoproteins)
Which one of the four components of the cell wall of fungi make a barrier around the cell?
Mannose containing proteins
What is a linear polysaccharide composed of 2000 N-acetylglucosamine units bundled into microfilbrils forming the basic structure of the cell wall.
Chitin
Glycan polymer are ________ linked to the microfibril.
covalently
These are five types of Mycoses?
Superficial
Cutaneous
Subcutaneous
Opportunistic
Primary or Systemic
T/F: Many types of mycoses are opportunistic.
TRUE
T/F Few fungi have sufficient virulence to be a primary pathogen in normal individuals.
TRUE
Classic fungal infections including Tinea pedis and Tinea cruris are ________ and are caused by ____________.
Superficial
Dermatophytes
Candidiasis (thrush) is whitish fungal growth located on the _____ with _______ underneath.
Tongue
Erosions
_________ _____ ______ is deep seated and difficult to clear. It walls it self off from the ________ ______.
Aspergillus Lung Infection,
Immune system
What are the medications listed that inhibit ergosterol synthesis.
Allylamines benzylamines,
Imidazoles triazoles
Where in the cell is ergosterol synthesis inhibited?
Endoplasmic reticulum
Flucytosine inhibits what kind of synthesis and where?
DNA, Nucleus
Echinocandins inhibit the cell membrane or cell wall?
Cell Wall
The plasma membrane is inhibited by _______ __________.
amphotericin B (Polyenes)
The mitotic spindle is located in the _______ and inhbited by ______.
Cytoplasm,
Griseofulvin
Amphotericin B is a polyene _____ antibioic.
Macrolide
Amphotericin B is __________ in water, and is formulated with this detergent ___________.
Insoluble,
Deoxycholate (C-AMB, FUNGIZONE)
Once amphotercin B is formulated with deoxycholate it is put in to a unilamellar vesicle called ________ and colloid dispersion occurs and reduces ___________
Ambizome,
size(Amphotec)
Amphtericin binds to ________ _______ withing fungal plasma membrane.
Ergosterol moieties
Once amphotercin b is bound by the ergosterol moieties forms _________ through the PLASMA MEMBRANE.
pore/channel
T/F: Amphotericin B is fungicidal.
TRUE
30% of Amphotericin is bound to ______ and not readily removed. Causing it to be good at binding membranes causing a long _____ ______
Tissue,
Half life
T/F Amphpotericin B is good for fungal infections in the CNS, vitreous humor or amniotic fluid?
FALSE
T/F: Amphotericin B is good for meningitis due to COCCIDIOIDES.
TRUE
A major Adverse reaction is __________ C-AMB treated patents for deep mycoses. (kidney damage)
Azotemia
Hypochromic mormocytic anemia is generally seen due to decreased ___________.
Erythropoietin production
__________ inhibits fungi replication by conversion to a metabolite that inhibits Thymidylate synthetase.
Flucytosine
Mammallian cells do not posses the ________ transporter that allows for cellular uptake.
Permease
Flucytosine is used for _________, neoformans and _________.
Crytococcus
Candida spp
T/F: Cytosine permease in cell membrane allows for Flucytosine to be transported through the cell membrane.
TRUE
T/F: Flucytosine is good for initial treatments for branin fungi.
TRUE
Flucytosine in combination with ___________ can be used for crytococcal meningitis.
Amphotericin B (Polyenes)
Egrosterol synthase inhibitors imidazole and triazole are metabolized and inhibitor of what CYP?
CYP3A4
Itraconazole (ketoconazole) inhibits what enzyme _________.
14 alpha sterol dehydrogenase
Is Itraconazole the problem with renal insufficiency or is the excipent?
Excipient
The problematic itraconzale excipient is ________________.
Hydroxypropyl-B- Cyclodextrin
T/F: Itraconzole is used for aspergillosis out side the CNS.
TRUE
Whiat is the primary ADR for itraconzole?
GI distress
Fluconzale is a strong inhibitor of CYP3A4 and _______.
CYP2C9
Fluconzaole penetrates most compartments with _______.
CSF
Fluconzole is especially effective against Candidiasis and esy for deep Candidiasis mycosis of ______ _______ transplantion.
Bone Marrow
Fluconzole is the drug of choice for ______________.
coccidioidal meningitis
Usually an _________ is prescribed with fluconzole to relieve________.
Anti-emetic,
Nausea and vomiting
Gristeofulvin inhibits fungal mitosis by binding _______ and disrupting mitotic spindle formation.
Tublin
Gristeofulvin binds to keratin in __________and stays in high concentrations in the skin. Not allowing for _________.
keratinocyte precursor cells, recolonization
T/F Gristeofulvin is good for subcutaneous or deep mycotic infections.
FALSE
Terbinafine is a synthetic _________ which inhibits ________ synthesis by inhibiting _________ epoxidase.
Allylamine
Ergosterol
Squalene
Tebinafine is used for nail _____________(nail bed infection)
Onychomycosis
T/F Topical antifungal agents are effective against onychomycosis, tinea capitis, subcutaneous infections.
FALSE
Topical antifungal agents effectiveness is influenced by ________.
ability to penetrate stratum corneum.
Clotrimazole is used primarly for _________ infections
Vaginal
Naftifine is an _____________________ which is effective against tinea cruris and tinea corporis.
