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Antifungals and Antiparasitics - Coggle Diagram

- - - - Mechanism
        
        Disrupts fungal cell membrane
        
        Binds selectively to ergosterol
      - Therapeutic uses
        
        Used for most systemic fungal infections
        
        Broad spectrum
        
        Must be given by IV
        
        Basically no resistance, ergostol is essential and they can't come up with something new
      - Adverse effects
        
        Permanent nephrotoxicity due to it's lipid soluability
    - - Mechanism
        
        Inhibits cell wall polysacharides
      - Therapeutics
        
        Alternate therapy for serious systemic fungal infections
        
        Must be given by IV
    - - Mechanism
        
        Prodrug that is activated to 5-fluorouracil by a fungal specific enzyme
        
        blocks DNA synthesis
      - Therapeutics
        
        Synergistic with Amphotericin B
      - Adverse effects
        
        Enterocolitis
        
        High prolonged serum levels may cause bone marrow suppression cuz it's legit 5-fluorouracil
    - - Mechanism
        
        Inhibits CYP450 mediated synthesis of ergosterol
      - Therapeutics
        
        Extended to broad spectrum
      - Drug interactions
        
        CYP450 inhibitor can increase plasma levels of other drugs by way of decreased metabolism of those drugs
  - - - Same mechanism as Amphotericin B
      - Only useful for candidiasis
      - Not orally bioavailable
    - - Inhibits synthesis of ergosterol
    - - Mechanism
        
        inhibits ergosterol synthesis by a different mechanism than miconazole
      - Therapeutic uses
        
        Tken orally for treatment of severe or extensive superficial infections (because it's lipophilic, so it really likes fatty things like skin - also really takes a long time to be completely excreted, so only small doeses are needed)
        
        Can be used topically
- - - - Selectively activated in anaerobic parasites and bacteria (C. diff)
      - Disulfiram affect - Inhibits metabolism of alcohol and other drugs
    - - Selectively concentrated in infected erythrocytes
      - Useful for prophylaxis and treatment of erythrocytic forms of parasite
      - Inhibits polymerization of heme into unreactive form (hemozoin) in the parasite
    - - Mechanism
        
        Atovaquone inhibits mitochondrial electron transport in parasite
        
        Proguanil inhibits purine and pyrimidine synthesis
      - Active against erythrocytic form of parasite, but not latent hepatic form
      - Used for treatment and prophylaxis
    - - Mechanism
        
        Tetracycline drug
        
        Inhibits bacterial-like mitochondrial protein synthesis in parasite
      - Only active against erythrocytic form of parasite
      - Useful for prophylaxis of malaria
    - - Mechanism unclear
      - Only effective against hepatic form of parasite
      - Drug of choice for Plasmodia vivax or ovale - used in combination with chloroquine to effect a "radical cure"
      - Can cause hemolytic anemia in patients with G6D deficiency (like sulfonamides)
  - - - Pyrantel
        
        Cholinomimetic drug that causes paralysis
        
        Toxic to humans, but not absorbed
      - Mebendazole
        
        Inhibits microtubule function - selective for nematode tubulin
        
        Prevents endocytosis of food
    - - Praziquantel
        
        Is absorbed
        
        Causes massive calcium relsease in worms which paralyzes them and changes the surface of their bodies to allow antibodies to bind
        
        Toxic to humans - near 100% first- pass metabolism :D (so it doesn't actually get into us)