Miscellaneous antifungal medications
9,540views
00:00 / 00:00
Videos
Notes
Miscellaneous antifungal medications
Medicine and surgery
Allergy and immunology
Antihistamines for allergies
Glucocorticoids
Cardiology, cardiac surgery and vascular surgery
Coronary artery disease: Clinical (To be retired)
Heart failure: Clinical (To be retired)
Syncope: Clinical (To be retired)
Hypertension: Clinical (To be retired)
Hypercholesterolemia: Clinical (To be retired)
Peripheral vascular disease: Clinical (To be retired)
Leg ulcers: Clinical (To be retired)
Adrenergic antagonists: Alpha blockers
Adrenergic antagonists: Beta blockers
ACE inhibitors, ARBs and direct renin inhibitors
Thiazide and thiazide-like diuretics
Calcium channel blockers
Lipid-lowering medications: Statins
Lipid-lowering medications: Fibrates
Miscellaneous lipid-lowering medications
Antiplatelet medications
Dermatology and plastic surgery
Hypersensitivity skin reactions: Clinical (To be retired)
Eczematous rashes: Clinical (To be retired)
Papulosquamous skin disorders: Clinical (To be retired)
Alopecia: Clinical (To be retired)
Hypopigmentation skin disorders: Clinical (To be retired)
Benign hyperpigmented skin lesions: Clinical (To be retired)
Skin cancer: Clinical (To be retired)
Endocrinology and ENT (Otolaryngology)
Diabetes mellitus: Clinical (To be retired)
Hyperthyroidism: Clinical (To be retired)
Hypothyroidism and thyroiditis: Clinical (To be retired)
Dizziness and vertigo: Clinical (To be retired)
Hyperthyroidism medications
Hypothyroidism medications
Insulins
Hypoglycemics: Insulin secretagogues
Miscellaneous hypoglycemics
Gastroenterology and general surgery
Gastroesophageal reflux disease (GERD): Clinical (To be retired)
Peptic ulcers and stomach cancer: Clinical (To be retired)
Diarrhea: Clinical (To be retired)
Malabsorption: Clinical (To be retired)
Colorectal cancer: Clinical (To be retired)
Diverticular disease: Clinical (To be retired)
Anal conditions: Clinical (To be retired)
Cirrhosis: Clinical (To be retired)
Breast cancer: Clinical (To be retired)
Laxatives and cathartics
Antidiarrheals
Acid reducing medications
Hematology and oncology
Anemia: Clinical (To be retired)
Anticoagulants: Warfarin
Anticoagulants: Direct factor inhibitors
Antiplatelet medications
Infectious diseases
Pneumonia: Clinical (To be retired)
Urinary tract infections: Clinical (To be retired)
Skin and soft tissue infections: Clinical (To be retired)
Protein synthesis inhibitors: Aminoglycosides
Antimetabolites: Sulfonamides and trimethoprim
Miscellaneous cell wall synthesis inhibitors
Protein synthesis inhibitors: Tetracyclines
Cell wall synthesis inhibitors: Penicillins
Miscellaneous protein synthesis inhibitors
Cell wall synthesis inhibitors: Cephalosporins
DNA synthesis inhibitors: Metronidazole
DNA synthesis inhibitors: Fluoroquinolones
Herpesvirus medications
Azoles
Echinocandins
Miscellaneous antifungal medications
Anti-mite and louse medications
Nephrology and urology
Chronic kidney disease: Clinical (To be retired)
Kidney stones: Clinical (To be retired)
Urinary incontinence: Pathology review
ACE inhibitors, ARBs and direct renin inhibitors
PDE5 inhibitors
Adrenergic antagonists: Alpha blockers
Neurology and neurosurgery
Stroke: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Headaches: Clinical (To be retired)
Migraine medications
Pulmonology and thoracic surgery
Asthma: Clinical (To be retired)
Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)
Lung cancer: Clinical (To be retired)
Antihistamines for allergies
Bronchodilators: Beta 2-agonists and muscarinic antagonists
Bronchodilators: Leukotriene antagonists and methylxanthines
Pulmonary corticosteroids and mast cell inhibitors
Rheumatology and orthopedic surgery
Joint pain: Clinical (To be retired)
Rheumatoid arthritis: Clinical (To be retired)
Lower back pain: Clinical (To be retired)
Anatomy clinical correlates: Clavicle and shoulder
Anatomy clinical correlates: Arm, elbow and forearm
Anatomy clinical correlates: Wrist and hand
Anatomy clinical correlates: Median, ulnar and radial nerves
Anatomy clinical correlates: Bones, joints and muscles of the back
Anatomy clinical correlates: Hip, gluteal region and thigh
Anatomy clinical correlates: Knee
Anatomy clinical correlates: Leg and ankle
Anatomy clinical correlates: Foot
Acetaminophen (Paracetamol)
Non-steroidal anti-inflammatory drugs
Glucocorticoids
Opioid agonists, mixed agonist-antagonists and partial agonists
Antigout medications
Non-biologic disease modifying anti-rheumatic drugs (DMARDs)
Osteoporosis medications
Assessments
Miscellaneous antifungal medications
Flashcards
0 / 16 complete
Flashcards
Miscellaneous antifungal medications
of complete
Memory Anchors and Partner Content
External References
First Aid
2022
2021
2020
2019
2018
2017
2016
Amphotericin B p. 195
Candida albicans p. , 150, 723
clinical use p. 196
Naegleria fowleri p. , 153
opportunistic fungal infections p. 150
systemic mycoses p. 149
Anemia
amphotericin B p. 196
Arrhythmias
amphotericin B p. 196
Blastomyces spp.
amphotericin B p. 196
Candida spp.
amphotericin B p. 196
Fever
amphotericin B p. 196
Hypotension
amphotericin B p. 196
Mucor spp.
amphotericin B for p. 196
Nephrotoxicity
amphotericin B p. 196
Phlebitis
IV amphotericin B p. 196
Potassium
amphotericin B p. 196
External Links
Transcript
Content Reviewers
Yifan Xiao, MDContributors
Ursula Florjanczyk, MScBMC
Maria Emfietzoglou, MD
Evan Debevec-McKenney
Tanner Marshall, MS
Antifungal agents are a class of medications used to treat mycoses, or fungal infections.
Mycoses can be superficial, meaning they are localized on the skin, or develop into systemic infections in immunodeficient patients.
Antifungals work either through fungistatic action, meaning that they inhibit fungal growth, or through fungicidal action, meaning they kill the fungi.
Now, antifungals include the azole family and a novel class of medications, echinocandins; but there are also many other antifungals with similar or different mechanisms that we’ll talk about in this video.
Okay, 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.
The precursor of lanosterol is squalene.
The conversion of squalene to lanosterol is catalyzed by an enzyme called squalene epoxidase.
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.
Okay, let’s start with polyenes, which are naturally-derived antifungal antibiotics that alter cell membrane permeability.
They include amphotericin, also called amphotericin B, and nystatin.
Polyenes have both hydrophilic, meaning they love water, and lipophilic, meaning they love fats, characteristics.
They bind to ergosterol, and the hydrophilic core causes the formation of artificial pores in the cell membrane, thereby creating a leaky membrane.
Summary
There are a few different types of antifungal medications, but they all work in similar ways. Most of them work by disrupting the formation of the fungal cell wall, which eventually kills the fungus. Some common antifungal medications include azoles (such as fluconazole and itraconazole), polyenes (such as amphotericin B and nystatin), and echinocandins (such as caspofungin and anidulafungin).
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)
- "The antifungal pipeline: a reality check" Nature Reviews Drug Discovery (2017)
- "Onychomycosis" Journal of the American Academy of Dermatology (2019)
- "New Antifungal Agents and New Formulations Against Dermatophytes" Mycopathologia (2016)
Copyright © 2023 Elsevier, except certain content provided by third parties
Cookies are used by this site.
USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). COMLEX-USA® is a registered trademark of The National Board of Osteopathic Medical Examiners, Inc. NCLEX-RN® is a registered trademark of the National Council of State Boards of Nursing, Inc. Test names and other trademarks are the property of the respective trademark holders. None of the trademark holders are endorsed by nor affiliated with Osmosis or this website.
