Anti-fungal agents

Consider the following questions.

(References : 1.Essentials of Medical Pharmacology Tripathi.K.D
2.Pharmacology and Therapeutics Goodman & Gillman
3.Pharmacology Rang & Dale
4.Foyes Principles Of Medicinal Chemistry William Foye)

1. Lanosterol-14--demethylase inhibitors are popularly known as?
a) Allyl amines
b) Echinocandins
c) Azoles
d) Cell wall disruptors

2. Find out the FALSE statement regarding Amphotericin-B.
a) It is nephrotoxic
b) It is given as a complex with deoxycholic acid for i.v
c) It cannot cross Blood-Brain-Barrier hence given intra-thecally for CNS infections
d) It is a fungal cell membrane disruptor with four conjugated double bonds

3. Echinocandins inhibit the fungal cell wall synthesis by inhibiting the enzyme?
a) 7- Sterol isomerase
b) Lanosterol-14--demethylase
c) 1,3- glucan synthase
d) Fungal transpeptidase

4. Following are the STATEMENTS regarding Griseofulvin.
P) It is obtained from fungus Penicillium griseofulvum
Q) It binds to -tubulin and prevents mitosis
R) It is an orally active agent useful to treat skin and nail infections
S) It is chemically a Benzofuran derivative and a Spiro compound

Choose the correct answer
a) P and Q are true but R and S are false
b) P,Q and R are true but S is false
c) P,Q,R and S are true
d) Q is true but P,R and S are false
5. Nystatin is obtained from?
a) Candida albicans
b) Streptomyces nodosus
c) Streptomyces noursei
d) Penicillium notatum

6. Assertion (A) : Flucytosine is a pyrimidine anti-metabolite useful to treat Cryptococcus
neoformans infection.
Reason (R) : The drug once inside the fungal cell gets metabolized and can be
incorporated either to DNA or RNA
a) A is true but R is false
b) A & R are true ; R is the correct explanation for A
c) A is false but R is true
d) A & R are true ; R is NOT the correct explanation for A

7. Amphotericin-B is obtained from?
a) Streptomyces noursei
b) Streptomyces nodosus
c) Penicillium notatum
d) Streptomyces amphotericus

8. Find the FALSE statement about Ketoconazole.
a) It is hepatotoxic
b) H
+
K
+
ATPase inhibitors DECREASE its bioavailability
c) H
2
Receptor antagonists INCREASE its bioavailability
d) It is a CYP3A4 enzyme inhibitor

9. The sugar attached to the polyene macrolide ring of Amphotericin-B is ?
a) 4-amino-3,6-dideoxy hexose
b) 3,6-dideoxy glucosamine
c) 3-amino-3,6-dideoxy mannose
d) 6-amino-3,6-dideoxy mannose

10. Allylamines act by inhibiting ?
a) Squalene epoxide
b) Lanosterol isomerase
c) Squalene epoxidase
d) Fungal Transpeptidase


11. Assertion (A) : Flucytosine is selectively active only to fungal cells and not human cells
Reason (R) : Flucytosine gets converted to 5-fluorouracil in fungal cells and inhibits
Thymidylate synthase via 5-fluorodeoxyuridylic acid.
a) A is true but R is false
b) A is false but R is true
c) Both A and R are false
d) Both A and R are True and R is the correct explanation for A

12. The topical anti-fungal agent obtained as a degradative product of castor oil is?
a) Haloprogin
b) Caprylic acid
c) Undecylenic acid
d) Ricinoleic acid

13. Orally efficacious Squalene epoxidase inhbitor is?
a) Terbinafine
b) Naftifine
c) Butenafine
d) Tolnaftate

14. Which of the following structural features are noticed in Ketoconazole?
a) Piperazine , Tetrahydrofuran , Imidazole
b) Pyridine , Dioxolan , Imidazole
c) Pyridine , Tetrahydrofuran , Imidazole
d) Piperazine , Dioxolan , Imidazole

15. Assertion (A) : Amphotericin-B is a polyene anti-fungal that is Amphoteric in nature.
Reason (R) : It has COOH group and NH
2
group on the Polyene macrolide ring.
a) A & R are true and R is the correct explanation for A
b) A is true but R is false
c) A & R both are false
d) A & R are true but R is NOT the correct explanation for A

16. Itraconazole intravenously is given as a complex with?
a) Hydroxypropyl--cyclodextrin
b) Hydroxypropyl--cyclodextrin
c) Hydroxyethyl--cyclodextrin
d) Hydroxyethyl--cyclodextrin


17. Match correctly.

P) Thiocarbamate 1) Naftifine
Q) Hydroxypyridine 2) Haloprogin
R) Halogenated Phenolic ether 3) Butenafine
S) Benzylamine 4) Ciclopirox
5) Tolnaftate

a) P-1 ; Q-2 ; R-4 ; S-5
b) P-1 ; Q-4 ; R-2 ; S-3
c) P-3 ; Q-5 ; R-2 ; S-4
d) P-5 ; Q-4 ; R-2 ; S-3

18. Find the false statement regarding Nystatin.
a) It is useful for Candidiasis
b) It is a Tetra-ene anti-fungal
c) It is less toxic than Amphotericin-B
d) It is effective as topical cream.

19. The drug which is a fluorinated bistriazole is?
a) Voriconazole
b) Fluconazole
c) Itraconazole
d) Miconazole

20. Find the TRUE statement regarding Amphotericin-B.
a) It has both COOH and NH
2
groups in macrolide ring
b) It has COOH in macrolide ring and NH
2
in sugar moiety
c) It has both COOH and NH
2
in sugar moiety
d) It has COOH in sugar and NH
2
in macrolide ring





21. Match correctly.
P) Topical Imidazole 1) Terconazole
Q) Topical Triazole 2) Itraconazole
R) Systemic Imidazole 3) Clotrimazole
S) Systemic Triazole 4) Mebendazole
5) Ketoconazole
a) P-3 ; Q-1 ; R-2 ; S-5
b) P-4 ; Q-1 ; R-5 ; S-3
c) P-1 ; Q-3 ; R-5 ; S-2
d) P-3 ; Q-1 ; R-5 ; S-2

22. White fields ointment is used topically for Corn treatment.It contains?
a) Benzoic acid and Ricinoleic acid
b) Undecylenic acid and Salicylic acid
c) Salicylic acid and Benzoic acid
d) Benzocaine and Benzoic acid

23. Atheletes foot is a fungal infection caused by?
a) Candida albicans
b) Cryptococcus neoformans
c) Trichophyton rubrum
d) Malassezia globosa

24. Read the statements.
P) Thrush is fungal infection caused by Candida species especially C.albicans
Q) Thrush is infection and inflammation of mucous membrane.
R) Thrush is also called as candidiasis.

a) P & R are true but Q is false
b) P is true but Q & R are false
c) Q is true but P & R are false
d) P,Q & R are true



25. Important side effect associated with Griseofulvin is?
a) Hypersensitivity
b) Photosensitivity
c) Enzyme induction
d) Both b and c

26. Match correctly.
P) Echinocandins 1) Dusting powder
Q) Benzocaine 2) Malassezia globosa
R) Hamycin 3) Squalene epoxidase
S) Dandruff 4) Streptomyces pimprina
5) Caspofungin
a) P-3 ; Q-2 ; R-4 ; S-1
b) P-5 ; Q-1 ; R-4 ; S-2
c) P-3 ; Q-4 ; R-2 ; S-1
d) P-5 ; Q-3 ; R-2 ; S-1

27. Match correctly.
P) Amphotericin-B 1) Powder
Q) Clotrimazole 2) Oral tablets
R) Griseofulvin 3) 8% Nail laquer
S) Ciclopirox olamine 4) Ointment
5) Liposomal formulations
a) P-5 ; Q-3 ; R-1 ; S-4
b) P-2 ; Q-1 ; R-5 ; S-4
c) P-5 ; Q-4 ; R-2 ; S-3
d) P-5 ; Q-3 ; R-2 ; S-4

28. CYP-450 enzymes inhibiting Azole anti-fungals can cause RHABDOMYOLYSIS
when repeatedly co-administered with?
a) Cisapride
b) Lovastatin
c) Warfarin
d) Saquinavir

29. Amorolfine inhibits?
a) D7 - D8 isomerase
b) D14 reductase
c) Both a and b
d) Glucan synthase

30. With the increase in the number of conjugated double bonds of POLYENE anti-
fungals,the toxicity__________________?
a) Increases
b) Decreases
c) Has no effect
d) Depends on route of administration

31. The IUPAC name of undecylenic acid is?
a) Undec-4-enoic acid
b) Undec-10-enoic acid
c) Undec-6-enoic acid
d) Undec-8-enoic acid

32. The drug amorolfine contains which of the following nucleus?
a) Piperidine
b) Morpholine
c) Pyran
d) Dioxane





The KEY for Anti-Fungal questions:

Solutions.
1. C 9. C 17. D 25. D
2. D 10. C 18. C 26. B
3. C 11. D 19. B 27. C
4. C 12. C 20. B 28. B
5. C 13. A 21. D 29. C
6. B 14. D 22. C 30. B
7. B 15. B 23. C 31. B
8. C 16. B 24. D 32. B