Antifungal: Amphotericin, Ketoconazole, Rifampin, Flucytosine, Fluconazole, Itraconazole, Cryptococcus, Candida, Coccidioides, Blastomyces, Histoplasma mnemonic

Antifungal [mushrooms]

Target ergosterol, a cholesterol analog that is present in fungal cell membranes but not human cells
Amphotericin [amphi-terrorizing ] [terrorist kills all types of mushrooms]
- Wide-spectrum
- Creates pores in fungal membranes [shooting holes]
- Administered intravenously [syringe weapon strapped on the back]
- Does not penetrate the brain-blood-barrier [bullets bounce from the skull]
- Strong toxicity,since amphotericin weakly cross-reacts with cholesterol in human cell membranes
  - Nephrotoxic [kidney with a bullet hole]
  - Causes hemolysis [shot through RBC]
- Crosses the placenta [umbilicus & placenta]
- Induces hypercoagulable state [bullets in artery]
Ketoconazole [cat on asshole]
- Wide-spectrum [various types of mushrooms]
- Steroid analog - interferes with host steroid hormone synthesis (e.g. testosterone) [rips off testicles and spills "his" plasma]
- Effective treatment against histoplasma ["his" plasma]
- Causes GI irritation [inflamed stomach]
- Eliminated by the liver in bile [cat liver]
- Not to be taken with food [hamburger], rifampin [reef amplifier], and amphotericin [amphi-terrorist mask]
Flucytosine [flew fluke citing sine]
- Depletes vitamin B6 (pyridoxal) [chipping off the tip of pyramid]
- Effective against:
  - Disseminated and CNS infections due to Cryptococcus and Candida [hidden coccus and candy]
  - chromoblastomycosis [chrome car]
- Eliminated in urine [yellow urine]
- Side effects:
  - Vomiting [orange vomit]
  - Hepatotoxic [severed liver]
  - Depression of bone marrow [flying through bone marrow and clearing it out]
Fluconazole [fluke on asshole]
- Teratogenic [monster baby whipping the mother with fluke on the asshole]
- Causes rash [red blotches from being whipped]
- Used in the treatment of: Cryptococcus [hiding coccus], Candida [candy], and coccidioides [cock diodes]
- Eliminated by urine [yellow urine]
Itraconazole [eye tracks on asshole]
- Effective against:
  - Blastomyces [nuclear blast]
  - Histoplasma [Standing in a lake of his plasma]
- Side effects:
  - Potassium loss [throwing out pot of ass]
  - Vomiting [orange vomit]
  - Rash [from the tracks]

Visual Mnemonic - Antifungal: Amphotericin, Ketoconazole, Rifampin, Flucytosine, Fluconazole, Itraconazole, Cryptococcus, Candida, Coccidioides, Blastomyces, Histoplasma
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