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What are the polyenes (2)?
  • Nystatin
  • Amphotericin
What is the mechanism of action of polyenes?
Bind to ergosterol in cell membrane, disrupt cell wall permeability, resulting in cell death
What is the Spectrum (6) and Indications (4) for Amphotericin B IV?
Spectrum

CCCBAH
  • Candida
  • Coccidioides
  • Cryptococcus
  • Blastomyces
  • Aspergillus
  • Histoplasma
Indications
  • Aspergillus
  • Cryptococcal meningitis
  • Blastomycosis
  • Coccidiomycosis
What is the Spectrum (1) and Indications (1) for Nystatin (powder, cream, tablet suspension)?
Spectrum
  • Candida
Indications
  • Candidiasis (oral, vaginal)
What are the azoles (4)?
  • Fluconazole
  • Itraconazole
  • Voriconazole
  • Posaconazole
What is the mechanism of action for the azoles?
Inhibit lanosterol C14-demethylase to inhibit ergosterol synthesis
What is the Spectrum (5) and Indications (4) for Fluconazole IV/PO?
Spectrum

CCCBAH - (Aspergillus)
  • Candida
  • Coccidioides
  • Cryptococcus
  • Blastomyces
  • Histoplasma
Indications
  • Invasive C. albicans
  • Esophogeal Candidiasis
  • Severe/unresponsive mucocutaneous candidiasis
  • Cryctococcal meningitis 
What is the Spectrum (6) and Indications (2) for Itraconazole IV/PO?
Spectrum

CCCBAH (same as Amphotericin)
  • Candida
  • Coccidioides
  • Cryptococcus
  • Blastomyces
  • Aspergillus
  • Histoplasma
Indications
  • Oral stepdown for Coccidiomyces, Blastomycosis, Histoplasmosis
  • Alternative for Candida and Aspergillus
What is the Spectrum (8) and Indications (2) for Voriconazole IV/PO?
Spectrum

CCCBAH + (Fusarium, Scedosporium)
  • Candida
  • Coccidioides
  • Cryptococcus
  • Blastomyces
  • Aspergillus
  • Histoplasma
  • Fusarium
  • Scedosporium
Indications
  • Reserved for Aspergillus, Fusarium, Scedosporium
  • Drug-resistant fungal infections
What is the Spectrum (9) and Indications (2) for Posaconazole IV/PO?
Spectrum

CCCBAH + (Fusarium, Scedosporium, Zygomycetes)
  • Candida
  • Coccidioides
  • Cryptococcus
  • Blastomyces
  • Aspergillus
  • Histoplasma
  • Fusarium
  • Scedosporium
  • Zygomycetes
Indications
  • Reserved for Aspergillus, Fusarium, Scedosporium
  • Drug-resistant fungal infections
What are the echinocandins (3)?
  • Anidulafungin
  • Caspofungin
  • Micafungin
What is the mechanism of action of the echinocandins?
Inhibit production of beta-(1,3)-D-glucan, an essential component of cell-wall synthesis
What is the Spectrum (2) and Indications (2) for Anidulafungin IV, Caspofungin IV, Micafungin IV?
Spectrum
  • Candida
  • Aspergillus
Indications
  • Serious non-albicans Candida infections
  • Salvage for Aspergillus
Name 1 Allylamine
Terbinafine
What is the mechanism of action of Terbinafine?
Inhibits squalene epoxidase, which inhibits ergosterol synthesis
What is the Spectrum (1) and Indications (2,4) for Terbinafine PO, cream?
Spectrum
  • Dermatophytes (Trichophyton, microsporum, epidermophyton)
Indications
  • PO for Tinea capitis, onychomycosis
  • Topical for tinea pedis, tinea cruris, tinea corporis, tinea versicolor
Name 3 topical antifungals?
  • Clotrimazole
  • Ciclopirox
  • Tolnaftate
What is the mechanism of action of Clotrimazole?
Inhibits ergosterol synthesis
What is the mechanism of action of Ciclopirox?
Inhibits transport/uptake of essential substrates into the fungal cell
What is the mechanism of action of Tolnaftate?
Inhibits squalene epoxidase, which inhibits ergosterol synthesis
What is the Spectrum (5) and Indications (5) of Clotrimazole cream?
Spectrum
  • Dermatophytes (Trichophyton, microsporum, epidermophyton)
  • Candida
  • Malassezia furfur
Indications
  • Tinea pedis
  • Tinea cruris
  • Tinea corporis
  • Tinea versicolor
  • Cutaneous candidiasis
What is the Spectrum (5) and Indications (5) of Ciclopirox cream/shampoo?
Spectrum

Same as Clotrimazole
  • Dermatophytes (Trichophyton, microsporum, epidermophyton)
  • Candida
  • Malassezia furfur
Indications

Same as Clotrimazole (+ Onychomycosis)
  • Tinea pedis
  • Tinea cruris
  • Tinea corporis
  • Tinea versicolor
  • Cutaneous candidiasis
  • Onychomycosis
What is the Spectrum (4) and Indications (5) of Tolfnaftate cream?
Spectrum

Same as Clotrimazole (- Candida)
  • Dermatophytes (Trichophyton, microsporum, epidermophyton)
  • Malassezia furfur
Indications

Same as Clotrimazole (- cutaneous candiasis)
  • Tinea pedis
  • Tinea cruris
  • Tinea corporis
  • Tinea versicolor
What are the 6 anti-malarials?
  • Chloroquine
  • Mefloquine
  • Atovaquone/proguanil
  • Artesunate
  • Quinine
  • Primaquine
What is the mechanism of action of Chloroquine? What stage(s) does it act on?
Inhibits Hgb utilization by parasites in erythrocyte stage.

Erythrocyte stage. 
What is the Spectrum (5) of activity for Chloroquine?
  • P. falciparum
  • P. vivax
  • P. ovale
  • P. malariae
  • P. knowlesi
What is the mechanism of action of Mefloquine? What stage(s) does it act on?
Inhibits Hgb utilization by parasites in erythrocyte stage.

Erythrocyte stage.
What is the Spectrum (2) of Mefloquine?
  • P. falciparum
  • P. vivax
What is the mechanism of action of Atovaquone/proguanil? What stage(s) does it act on?
Inhibits electron transport and dihydrofolate reductase.

Liver and erythrocyte stages
What is the Spectrum (1) of Atovaquone/proguanil?
P. falciparum
What is the mechanism of action (3) of Artesunate IV? What stage(s) does it act on?
  • Free radicals produced when peroxide bridge cleaved
  • Inhibits parasite metabolism
  • Increases clearance of infected erythrocytes

Erythrocyte stage.
What is the Spectrum (1) of Artesunate IV?
P. falciparum
What is the mechanism of action of Quinine IV/PO?
Intercalates into parasite DNA
What is the spectrum (2) for Quinine IV/PO?
  • P. falciparum
  • P. vivax
What is the mechanism of action (2) of Primaquine? What stage(s) does it act on?
  • Disrupts mitochondria
  • Binds DNA


Liver stage. (P. ovale, P. vivax)
What is the spectrum (2) for Primaquine?
  • P. ovale
  • P. vivax
What are the anti-helminthics (5)?
  • Albendazole
  • Mebendazole
  • Ivermectin
  • Pyrantel pamoate
  • Praziquantel
What is the mechanism of action for Albendazole PO (4)?
  • Inhibits microtubule formation
  • Inhibits glucose uptake
  • Depletes glycogen
  • Decreases ATP production
What is the mechanism of action of Mebendazole PO (4)?

Same as Albendazole:
  • Inhibits microtubule formation
  • Inhibits glucose uptake
  • Depletes glycogen
  • Decreases ATP production
What is the mechanism of action of Ivermectin PO?
Binds and activates glutamate-gated chloride channels
What is the Spectrum (6) and Indications (5) for Albendazole PO?
Spectrum

ATE SAN
d
  • Ascaris lumbricoides
  • Trichuris trichuria
  • Enterobius vermicularis
  • Ancylostoma duodenale
  • Necator americanus
  • Strongyloides stercoralis
Indications 
  • Roundworm 
  • Pinworm
  • Whipworm
  • Hookworm
  • Strongyloidiasis
What is the Spectrum (5) and Indications (5) for Mebendazole PO?
Spectrum

Same as Albendazole (- Strongyloides stercoralis)

ATE sANd
  • Ascaris lumbricoides
  • Trichuris trichuria
  • Enterobius vermicularis
  • Ancylostoma duodenale
  • Necator americanus
Indications 

Same as Albendazole (- Strongyloidiasis)
  • Roundworm 
  • Pinworm
  • Whipworm
  • Hookworm
What is the Spectrum (3) and Indications (3) for Ivermectin PO?
Spectrum

SAT
  • Strongyloides stercoralis
  • Ascaris lumbricoides
  • Trichuris trichuria
Indications
  • Strongyloidiasis
  • Alternative for Roundworm, Hookworm 
What is the mechanism of action for Pyrantel pamoate PO?
Cholinesterase inhibitor
What is the mechanism of action for Praziquantel PO?
Increase schistosome permeability to calcium
What is the Spectrum (2) and Indications (2) for Pyrantel pamoate PO?
Spectrum

A&E
  • Ancylostoma duodenale
  • Enterobius vermicularis
Indications
  • Pinworm
  • Hookworm 
What is the Spectrum (1) and Indications (1) of Praziquantel PO?
Spectrum
  • Cestodes
Indications
  • Intestinal tapeworms 
What are the anti-protozoals (2)?
  • Diiodohydroxyquinolines (Iodoquinol)
  • Paromomycin
What is the mechanism of action of Iodoquinol PO?
Unknown
What is the mechanism of action of Paromomycin PO?
Binds to 30S ribosomal subunit to inhibit protein synthesis
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