Azoles
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Azoles
Prerequisite basic sciences
Prerequisite basic sciences
Childhood and early-onset psychological disorders: Pathology review
Prerequisite basic sciences
Attributable risk (AR)
Bias in interpreting results of clinical studies
Bias in performing clinical studies
Clinical trials
Confounding
DALY and QALY
Direct standardization
Disease causality
Incidence and prevalence
Indirect standardization
Interaction
Mortality rates and case-fatality
Odds ratio
Positive and negative predictive value
Prevention
Relative and absolute risk
Selection bias
Sensitivity and specificity
Study designs
Test precision and accuracy
Acyanotic congenital heart defects: Pathology review
Adrenal masses: Pathology review
Bacterial and viral skin infections: Pathology review
Bone tumors: Pathology review
Coagulation disorders: Pathology review
Congenital neurological disorders: Pathology review
Cyanotic congenital heart defects: Pathology review
Extrinsic hemolytic normocytic anemia: Pathology review
Eye conditions: Inflammation, infections and trauma: Pathology review
Eye conditions: Refractive errors, lens disorders and glaucoma: Pathology review
Headaches: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Leukemias: Pathology review
Lymphomas: Pathology review
Macrocytic anemia: Pathology review
Microcytic anemia: Pathology review
Mixed platelet and coagulation disorders: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Nephritic syndromes: Pathology review
Nephrotic syndromes: Pathology review
Non-hemolytic normocytic anemia: Pathology review
Pediatric brain tumors: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Platelet disorders: Pathology review
Renal and urinary tract masses: Pathology review
Seizures: Pathology review
Viral exanthems of childhood: Pathology review
Pharmacodynamics: Agonist, partial agonist and antagonist
Pharmacodynamics: Desensitization and tolerance
Pharmacodynamics: Drug-receptor interactions
Pharmacokinetics: Drug absorption and distribution
Pharmacokinetics: Drug elimination and clearance
Pharmacokinetics: Drug metabolism
Prerequisite basic sciences
Adrenal masses: Pathology review
Cystic fibrosis: Pathology review
Diabetes mellitus: Pathology review
HIV and AIDS: Pathology review
Intrinsic hemolytic normocytic anemia: Pathology review
Leukemias: Pathology review
Nasal, oral and pharyngeal diseases: Pathology review
Obstructive lung diseases: Pathology review
Papulosquamous and inflammatory skin disorders: Pathology review
Pediatric brain tumors: Pathology review
Renal and urinary tract masses: Pathology review
Seizures: Pathology review
Prerequisite basic sciences
Developmental and learning disorders: Pathology review
Prerequisite basic sciences
Growth hormone and somatostatin
Prerequisite basic sciences
Ectoderm
Endoderm
Human development days 1-4
Human development days 4-7
Human development week 2
Human development week 3
Mesoderm
Cell cycle
DNA damage and repair
DNA mutations
DNA replication
DNA structure
Epigenetics
Gene regulation
Mitosis and meiosis
Nuclear structure
Transcription of DNA
Translation of mRNA
Hardy-Weinberg equilibrium
Independent assortment of genes and linkage
Inheritance patterns
Mendelian genetics and punnett squares
Acyanotic congenital heart defects: Pathology review
Autosomal trisomies: Pathology review
Congenital neurological disorders: Pathology review
Cyanotic congenital heart defects: Pathology review
Cystic fibrosis: Pathology review
Disorders of sex chromosomes: Pathology review
Miscellaneous genetic disorders: Pathology review
Prerequisite basic sciences
Breastfeeding
Prerequisite basic sciences
Baroreceptors
Cardiac preload
Chemoreceptors
Renin-angiotensin-aldosterone system
Adrenal insufficiency: Pathology review
Central nervous system infections: Pathology review
Congenital gastrointestinal disorders: Pathology review
Diabetes mellitus: Pathology review
Electrolyte disturbances: Pathology review
Environmental and chemical toxicities: Pathology review
Gastrointestinal bleeding: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Inflammatory bowel disease: Pathology review
Medication overdoses and toxicities: Pathology review
Obstructive lung diseases: Pathology review
Pediatric brain tumors: Pathology review
Pediatric musculoskeletal disorders: Pathology review
Pneumonia: Pathology review
Psychiatric emergencies: Pathology review
Seizures: Pathology review
Shock: Pathology review
Supraventricular arrhythmias: Pathology review
Traumatic brain injury: Pathology review
Ventricular arrhythmias: Pathology review
Prerequisite basic sciences
Androgens and antiandrogens
Estrogens and antiestrogens
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Antihistamines for allergies
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Antimetabolites: Sulfonamides and trimethoprim
Antituberculosis medications
Cell wall synthesis inhibitors: Cephalosporins
Cell wall synthesis inhibitors: Penicillins
DNA synthesis inhibitors: Fluoroquinolones
DNA synthesis inhibitors: Metronidazole
Miscellaneous cell wall synthesis inhibitors
Miscellaneous protein synthesis inhibitors
Protein synthesis inhibitors: Aminoglycosides
Protein synthesis inhibitors: Tetracyclines
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Glucocorticoids
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Azoles
Glucocorticoids
Pulmonary corticosteroids and mast cell inhibitors
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Antimetabolites: Sulfonamides and trimethoprim
Cell wall synthesis inhibitors: Cephalosporins
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Pharmacodynamics: Agonist, partial agonist and antagonist
Pharmacodynamics: Desensitization and tolerance
Pharmacodynamics: Drug-receptor interactions
Pharmacokinetics: Drug absorption and distribution
Pharmacokinetics: Drug elimination and clearance
Pharmacokinetics: Drug metabolism
Cell wall synthesis inhibitors: Cephalosporins
Glucocorticoids
Miscellaneous protein synthesis inhibitors
Anticonvulsants and anxiolytics: Barbiturates
Anticonvulsants and anxiolytics: Benzodiazepines
Nonbenzodiazepine anticonvulsants
Cell wall synthesis inhibitors: Cephalosporins
Cell wall synthesis inhibitors: Penicillins
Miscellaneous cell wall synthesis inhibitors
Assessments
Azoles
Flashcards
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Flashcards
Azoles
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External References
First Aid
2022
2021
2020
2019
2018
2017
2016
Ketoconazole p. 195, 196, 682
cytochrome P p. -473, 253
gynecomastia from p. 673
PCOS p. 669
reproductive hormones and p. 679
Transcript
Content Reviewers
The “azole” antifungals are a family of medications used to treat mycoses, or fungal infections.
Mycoses can be superficial, like on the skin or hair, or develop into systemic infections in immunodeficient people.
Antifungals work either through fungistatic action, meaning that they inhibit fungal growth, or through fungicidal action, meaning they kill the fungi.
Azoles are divided into two major families of antifungals: imidazoles and triazoles.
Most fungal cells have a tough outer cell wall and an inner cell membrane.
The cell membrane is mostly made of phospholipids with some sterol or modified steroid molecules mixed in.
Humans have cholesterol, while fungi have ergosterol.
Both sterol molecules help keep the cell membrane stable at a wide range of temperatures.
Now, the precursor to both molecules is lanosterol.
Fungi have a cytochrome p450 enzyme called fourteen-alpha-demethylase in their mitochondria and endoplasmic reticulums, which converts lanosterol to ergosterol.
Without ergosterol, the structure of the cell membrane will be disrupted.
This will cause membrane-bound proteins, like ion channels, to stop working properly.
The membrane also becomes fragile, which eventually leads to inhibition of fungal growth.
The azole antifungals include imidazoles, like clotrimazole, isoconazole, miconazole, butoconazole, fenticonazole, and ketoconazole; as well as triazoles like fluconazole, itraconazole and voriconazole.
The only difference between the two groups is the imidazoles contain an imidazole ring, while triazoles contain triazole rings.
These medications work by inhibiting the fourteen-alpha-demethylase enzyme.
However, they also inhibit human cytochrome P450 enzymes to a lesser degree.
Summary
Azoles are synthetic antifungals with broad spectrum activity against various fungal infections. Azoles bind to the ergosterol molecule in the fungal cell membrane and cause holes to form, which damages the cell membrane and eventually kills the fungus. Examples of azoles include drugs like clotrimazole, fluconazole, and itraconazole. Some of the side effects of azoles include nausea and vomiting, gynecomastia, and hepatotoxicity.
Sources
- "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
- "Rang and Dale's Pharmacology" Elsevier (2019)
- "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
- "Therapeutic tools for oral candidiasis: Current and new antifungal drugs" Medicina Oral Patología Oral y Cirugia Bucal (2019)
- "Adverse interactions between antifungal azoles and vincristine: review and analysis of cases" Mycoses (2011)
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