00:00 Let's move on to flucytosine. 00:03 Now flucytosine is a different class of medication. 00:07 It also an antimetabolite that's used in cancer chemotherapy. 00:11 It's eliminated in the urine. 00:13 So dose adjustments going to be necessary in patients who are, who have renal disease. 00:20 It is relatively narrow spectrum agent. 00:22 And it's used almost exclusively in cryptococcus neoformans infections. 00:28 The mechanism of action, it's actually included into the -- through the cell wall by a membrane permease. 00:39 And then that concentration inside the cell is actually increasing and accumulative. 00:44 It's converted by cytosine deaminase from flucytosine to 5-FU. 00:49 So 5-FU is 5 flourocytosine. 00:52 5-FU then blocks the production of thymidine through inhibiting thymidylate synthase. 00:59 So now you're starting to interfere with actual production of DNA fragments and RNA fragments. 01:06 When combined with amphotericin B or itraconazole, synergy occurs. 01:11 So you actually get a very strong combination effect with these two agents together. 01:16 In terms of toxicity there is a reversible bone marrow depression that you sometimes see, you can sometimes see alopecia as well. 01:26 So hair loss and of course liver dysfunction.
The lecture Flucytosine (5-Fluorocytosine/5-FC) – Antifungals by Pravin Shukle, MD is from the course Antimicrobial Pharmacology.
What toxicity is associated with flucytosine administration?
Which drug may be combined with flucytosine to create a synergistic antifungal effect?
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