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Pharmacology - Antifungals (dropped image link (dropped image link…

- - - - *Azoles
        
        "Azooles = AK+ 47s, metal AMMO, and NIGHT vision blow holes in the Fungi with Mg++ and K+ bullets "
        --> "AK+ 47" = Azoles / 450 enzyme inhibition
        --> "metal AMMO, and NIGHT vision" = poke holes for K+ and Mg++ ions
        --> "CYP450 SICKFACES" = KF = ketoconazole and fluconazole / ALL AZOLES are big CYP inhibitors
        
        end in azole
        
        CYP 450 normally converts lanosterol to ergosterol for cell membrane
        --> side effect of liver dysfunction
        --> effects our liver P450 enzymes
        
        Side Effects
        
        MOA = inhibit the P450 enzyme
        --> normally converts lanosterol to ergosterol for cell membrane
        --> side effect of liver dysfunction
        --> effects our liver P450 enzymes
        
        testosterone inhibition
        --> leads to gynecomastea due to testosterone shunting to estrogen
        --> ketoconazole high risk of gynecomastia
        --> **ketocon is a CUTIE with his new BOOBS
        
        Pyrimidine analogue = Flucytosine
        
        "FLU the CYTE of DNA synthesis"
        
        prodrug converted to 5-Flurouracil
        
        interferes with fungal RNA and protein synthesis
        
        Cell membrane = Polyenes
        
        target ergosterol in the cell wall
        
        poke holes in cell wall
        
        allow leakage of K+ ions and Mg+
        --> think my favourite things in USMLE mornings
        --> I was taking Nystatin for candidiasis
        --> Mg++ water drink, coffee bananas
        --> MUST supplement K+ and Mg+ with Polyenes
        
        IV systemic = Amphotericin B
        
        topical / oral candidiasis = Nystatin
        
        "Azoes = AK+ 47s, metal AMMO, and NIGHT vision blow holes in the Fungi with Mg++ and K+ bullets "
        --> "AK+ 47" = Azoles / 450 enzyme inhibition
        --> "metal AMMO, and NIGHT vision" = poke holes for K+ and Mg++ ions
        
        *Amphotericin B
        
        used by IV, poor oral bioavailability
        
        tx for cryptococcus neoformins
        
        Side effects of Amphotericin
        Nephrotoxicity
        
        number 1 side effect for Amphotericin B
        --> Amphotericin TEARS holes in the kidney
        --> this is where the K+ and Mg+ leakage happens
        --> this then can cause the K+ loss effects =
        
        2 more items...
        
        *Nystatin
        
        oral and vaginal candidiasis
        
        swish and swallow for oral
        
        too toxic to be taken IV
        
        Echinocandins
        
        ECHO what is UNIQUE to FUNGI = GLUCAN
        --> glucan
        
        end in fungin
        --> since glucan is specific to FUNGI
        
        Griseofulvin
        
        "GREASY mitotic microtubules"
        
        targets mitosis of fungi
        --> think of GREASY mitosis fingers (microtubules) extending from the dipoles of the cell
        
        Terbinafine
        
        stops lanosterol synthesis
        
        "a FINE SEXY LADY"
        
        Terbinafine = lanosterol epoxidase inhibitor