NBME 21 Answers ↦
(20.8 difficulty score)
A 47-year-old woman with aplastic anemia is ...
Cell Membrane = Amphotericin & Nystatin
Cell WALL = Capsofungin
To not mix them up I say to myself "IT's the FUNGIN CELL WALL"
Terbinafine/Tolnaftate - inhibit squalene epoxidase/sterol biosynthesis. Squalene builds interfere with fungal membrane function and cell wall synthesis.
Rule of thumb/shortcut:
Nonserious fungal infections: treat with _conazole
Serious fungal infection (eg, immunocompromised patients with disseminated infection): treat with amphotericin B
The main classes of antifungal medications for usmle include:
Polyenes (eg, amphotericin B, nystatin) - Bind to ergosterol molecules in fungal cell membranes, creating pores and causing cell lysis
Triazoles (eg, _conazole) - Prevent the synthesis of ergosterol, a component of fungal cell membranes
Echinocandins (eg, capsofungin, micafungin) - Inhibit the synthesis of glucan, a polysaccharide component of fungal cell walls
Pyrimidines (eg, Flucytosine) - Converted to 5-fluoruracil, which then inhibits fungal RNA and protein synthesis
Ripppp the formatting, but hopefully the idea gets across