188 - ANTIFUNGALS

Question 1

systemic antifungals are indicated in what?

Answer 1

onychomycosis and tinea capitis

Question 2

the main target of both systemic and topical antifungals

Answer 2

Ergosterol - which is the fundamental mycotic cell membrane sterol

Question 3

what are the 3 main antifungal categories targeting ergosterol?

Answer 3

(1) allylamines and benzylamines,
(2) azoles (imidazole and triazoles), and
(3) polyenes.

Question 4

examples of allylamines

Answer 4

Terbinafine

Naftifine

Question 5

What is the first line of treatment of dermatophytosis?

Answer 5

Terbinafine

Question 6

MOA of Terbinafine

Answer 6

inhibits squalene epoxidase enzyme leading to accumulation of squalene (fungicidal) and deficiency of ergosterol (fungistatic)

Question 7

the only FDAapproved drugs for the treatment of tinea capitis in children

Answer 7

Terbinafine and griseofulvin

Question 8

mechanism of action of azoles

Answer 8

inhibition of lanosterol demethylase enzyme (14α-demethylase), a fungal cytochrome P450 (CYP)–dependent enzyme that catalyzes the conversion step of lanosterol into ergosterol, thereby blocking the biosynthesis of ergosterol.

Question 9

considered the best choice in treatment of Candida and nondermatophyte onychomycosis

Answer 9

Itraconazole

Question 10

the only FDA-approved treatment for pediatric onychomycosis,

Answer 10

Griseofulvin