Anti-fungal Flashcards
Dermatophyte (tinea) Infections - areas effected
Skin, hair, and nails
Dermatophyte (tinea) Infections - type
Filamentous fungi in the generaTrichophyton,Microsporum,andEpidermophyton
Dermatophyte (tinea) Infections - subtypes
Tinea corporis– Infection of body surfaces other than the feet, groin, face, scalp hair, or beard hair
Tinea pedis– Infection of the foot
Tinea cruris– Infection of the groin
Tinea capitis– Infection of scalp hair
Tinea unguium (dermatophyte onychomycosis)– Infection of the nail
Treatment is either
Topical or systemic
most can be treated with
Most can be treated with topical therapy with agents such as azoles, allylamines,butenafine,ciclopirox, andtolnaftate
Nystatin - effective
Nystatin – effective for Candida infections but not dermatophytes
Oral agents used for
Oral agents used for extensive for refractory cutaneous infections
Tinea Pedis - What is common
Athlete foot – common
Tinea Pedis - common causes
Common causes areTrichophyton rubrum,Trichophyton interdigitale(formerlyTrichophyton mentagrophytes), andEpidermophyton floccosum
Tinea Pedis topical drugs
Topical drugs - azoles, allylamines,butenafine,ciclopirox,tolnaftate, and amorolfine
Tinea Pedis Topical is applied
Topical – applied once or twice daily, continue for 4 weeks
Tinea Pedis oral therpaies
Oral therapy –
Terbinafine: 250 mg per day for two weeks
Itraconazole: 200 mg twice daily for one week
Fluconazole: 150 mg once weekly for two to six weeks
Tina Corporis - Occurs in the sites other than the
Occurs in sites other than the feet, groin, face, or hand
Tina Corporis common cause
T. rubrumis the most common cause of tinea corporis. Other notable can includeTrichophyton tonsurans,Microsporum canis,T. interdigitale(formerlyT. mentagrophytes),Microsporum gypseum,Trichophyton violaceum, andMicrosporum audouinii.
Tina Corporis topical
Topical - azoles, allylamines,butenafine,ciclopirox, andtolnaftate
Tina Corporis - Topicl once or twice
Systemic – extensive skin involvement and patients with fail topical
Terbinafine and itraconazole are common
Tina Corporis - systemic
Systemic – extensive skin involvement and patients with fail topical
Terbinafine and itraconazole are common
Tinea Cruris - example
Jock itch
Tinea Cruris - common cause
Common cause – T. rubrum. Other – E. floccosumandT. interdigitale(formerlyT. mentagrophytes)
Tinea Cruris topical
Topical drugs - azoles, allylamines,butenafine,ciclopirox,and tolnaftate
Tina Capitis - common
Scalp hair – often small children
Tina Capitis - oral
Oral anti-fungal therapy
Tina Capitis - cause
TrichophytonandMicrosporumspecies of dermatophyte fungi
Tina Capitis systemic
Systemic therapy - griseofulvin,terbinafine,fluconazole, anditraconazole
Candida Infections - example
Oropharyngeal infections (thrush)
Candida Infections - infants
Infants, older adults, ICS use
Candida Infections HIV NEG
HIV negative –
Clotrimazole troches
Nystatin swish and swallow
Candida Infections - HIV POS
HIV positive
Topical agents – mild
Oral fluconazole – moderate to severe
Candida Vulvovaginitis
Inflammation in the setting of Candida Species
Antifungals: Precautions - Topical
Few contraindications because of minimal absorption
Most are pregnancy category B
Antifungals: Precautions - Systemic
All should be used cautiously in patients with liver problems.
Griseofulvin has possible cross-sensitivity with penicillin
Topical Antifungals - ADR
Skin irritation, itching, burning, rash
Gentian violet: may cause staining of skin and clothing
Topical Antifungals - Interactions
Few interactions with topical antifungals
Theoretical interaction with azoles and amphotericin B
Clotrimazole intravaginal preparations: should not be administered concurrently with nonoxynol-9 and octoxynol
Systemic antifungals: have a number of interactions
