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Paper II — 2025 March (Supplementary (SAY)) (2019 Scheme) — Q2

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Paper II
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min

Question

Classify antifungal drugs. Explain the mechanism of action, uses, and adverse effects of Amphotericin B. Add a note on the various liposomal formulations of Amphotericin B (2+6+2)

Q210 marksEssays

Answer

Classification of antifungal drugs

ClassExamples
PolyenesAmphotericin B, Nystatin
AzolesFluconazole, Itraconazole, Ketoconazole
EchinocandinsCaspofungin, Micafungin
OthersFlucytosine, Terbinafine, Griseofulvin

Amphotericin B — mechanism, uses, adverse effects Mechanism: binds ergosterol directly in the fungal cell membrane, forming pores that disrupt membrane integrity and cause leakage of intracellular contents — fungicidal. Selectivity depends on ergosterol-versus-cholesterol binding preference, real but imperfect (residual cholesterol affinity, particularly renal tubular cells).

Uses: severe systemic/invasive fungal infections (invasive candidiasis, aspergillosis, cryptococcal meningitis), visceral leishmaniasis.

Adverse effects: nephrotoxicity (dose-limiting), infusion-related reactions (fever, chills, rigors), hypokalemia, hypomagnesemia, anemia.

Note on liposomal formulations Lipid-based formulations (liposomal amphotericin B, amphotericin B lipid complex, amphotericin B colloidal dispersion) encapsulate the drug in a lipid carrier, substantially reducing off-target renal tubular binding while preserving — and in visceral leishmaniasis, actually improving via preferential reticuloendothelial uptake — antifungal efficacy. This favorable safety profile allows higher doses and shorter treatment courses, at significantly higher cost than conventional amphotericin B.

  1. 1Antifungal Drugs

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  5. 5Fluconazole2015 February (2010 Scheme)Short Note · 3 marks
  6. 6Griseofulvin2020 February (Supplementary) (2010 Scheme)Short Note · 3 marks
  7. 7Itraconazole2018 July (Supplementary) (2010 Scheme)Short Note · 3 marks
  8. 8Azole antifungals2023 July (Supplementary) (2010 Scheme)Short Note · 3 marks
  9. 9Amphotericin B.2017 February (2010 Scheme)Short Note · 3 marks
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  13. 13Two differences between ketoconazole and fluconazole2016 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
  14. 14Amphotericin B2021 February (Supplementary) (2010 Scheme)Short Answer · 1 mark
  15. 15Griseofulvin2022 October (Supplementary) (2010 Scheme)Short Answer · 1 mark
  16. 16Topical antifungal agents2017 August (Supplementary) (2010 Scheme)Short Answer · 1 mark
  17. 17Dermatophytosis.2015 September (Supplementary) (2010 Scheme)Short Answer · 1 mark
  18. 18Systemic antifungal drugs2013 April (2010 Scheme)Short Answer · 1 mark
  19. 19Topical anti fungals2014 March (2010 Scheme)Short Answer · 1 mark
  20. 20Azole antifungals2025 March (Supplementary) (2010 Scheme)Short Answer · 0.3 marks
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