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Pharm 1 > Anti-fungals > Flashcards

Anti-fungals Flashcards

1
Q

how do azoles affect the metabolism of statins and CCBs?

A

they are substrates and dramatically increase serum levels of statins and CCBs (resulting in bradycardia and hypotension)

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2
Q

fungal infx in groin area including scrotum: tinea cruris or candida?

A

candida

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3
Q

groin fungal infx with satellite papules or pustules that extend beyond redness: tinea cruris or candida?

A

candida

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4
Q

what class: Ketoconazole (topical)
Miconazole
Clotrimazole

A

imidazoles

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5
Q

what class: Fluconazole (Diflucan®)
Itraconazole (Sporanox®)
Voriconazole (Vfend®)
Posaconazole (Noxafil®)

A

triazoles

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6
Q

which triazole has good CNS penetration?

A

Fluconazole (Diflucan®)

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7
Q

what class: Terbinafine (Lamisil®)

A

allyalamine

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8
Q

what class: Caspofungin (Cancidas), Micafungin (Mycamine), Anidulafungin (Eraxis)

A

echinocandins

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9
Q

imidazoles contraindications

A

no systemic azoles in pregnancy (esp 1st trimester). Liver disease

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10
Q

azoles adverses effects

A

GI upset, rash, photosensitivity, hepatoxicity

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11
Q

fluconazole is mainly for what?

A

candida

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12
Q

AE of long term triazole use

A

peripheral neuropathy

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13
Q

monitor what for all triazoles?

A

LFTs, serum drug concentration/theraputic drug monitoring

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14
Q

Itraconazole (Sporanox®)

contraindication

A

ventricular dysfunction, CHF

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15
Q

which azole treats endemic mycoses?

A

Itraconazole (Sporanox®)

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16
Q

Treatment of choice for Aspergillosis and Environmental molds(black mold).

A

Voriconazole (Vfend®)

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17
Q

SE: Rash, Hepatic enzymes, Visual disturbances (IV), Photosensitivity (oral) that is severe and can lead to skin cancers

A

Voriconazole (Vfend®)

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18
Q

what antifungal can lead to cardiomyopathy w/ long term use?

A

Itraconazole (Sporanox®)

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19
Q

least drug interactions and largest Therapeutic Index of all azoles

A

Fluconazole (Diflucan®)

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20
Q

Broadest spectrum Azole:

A

Posaconazole (Noxafil®)

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21
Q

OTC 1st line for athlete’s foot

A

Terbinafine (Lamisil®)

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22
Q

most effective Onychomycosis treatment

A

Terbinafine (Lamisil®)

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23
Q

contraindication for terbinafine

A

Avoid in hepatic and renal impairment

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24
Q

monitor what for terbinafine?

A

LFTs before initiation and monthly

25
Q

pt counseling for terbinafine topical

A

put on 1 inch of surrounding skin and continue for 1 wk after resolution.

26
Q

how must amphotericin B be given?

A

central line IV

27
Q

Mainstay of treatment of patients with severe endemic fungal infection.

A

amphotericin B

28
Q

Broadest spectrum of all antifungals

A

amphotericin B

29
Q

main SE of amphotericin B

A

Nephrotoxicity (preceded by hypokalemia and hypomagnesemia)

30
Q

monitoring for amphotericin B

A

Monitor serum electrolytes and renal function carefully. amphoTERRIBLE for kidneys

31
Q

nystatin treats

A

candida

32
Q

Vaginal candidiasis OTC

A

clotrimazole, miconazole

33
Q

Vaginal candidiasis Rx topical

A

butoconazole, terconazole

34
Q

vaginal candidiasis Rx PO

A

fluconazole

35
Q

first-line treatment for recurrent VVC

A

oral fluconazole 100-, 150-, or 200-mg weekly for 6 months

36
Q

oral fluconazole stays in vaginal secretions for __ hrs

A

72

37
Q

preferred treatment for pregnant vaginal candidiasis

A

clotrimazole

38
Q

1st line for Oropharyngeal Candidiasis

A

topical clotrimazole, miconazole, nystatin

39
Q

1st line for esophageal candidasis

A

PO fluconazole

40
Q

causes of oraal candidasis

A

from broad-spectrum antibiotic use, tissue damage (due to chemotherapy, catheter tubing, trauma, or smoking), hyposalivation (anti-cholinergics), or immune deficiency

41
Q

most common opportunitis infx in pts w/ HIV

A

oropharyngeal candidiasis

42
Q

most common acquired immunodeficiency syndrome (AIDS)–defining disease

A

Esophageal candidiasis

43
Q

counseling for Oropharyngeal & Esophageal Candidiasis

A

counseling: Medication should provide relief in 2-3 days and resolution at 7-10 days

44
Q

1st line for tinea capitis

A

oral Griseofulvin for 6-8 weeks OR terbinafine

45
Q

contras for Griseofulvin

A

hepatic failure or pregnancy

46
Q

counseling for oral Griseofulvin

A

Take with a fatty meal to decrease upset stomach and increase absorption

47
Q

onychomycosis treatmetn

A

PO Itraconazole (BID for 1 week/month OR daily x 12 weeks) OR terbinafine (daily x 12 weeks)

48
Q

treatment for Candida intertrigo

A

nystatin powder

49
Q

treatment for Non-candida intertrigo

A

Topical azole antifungal cream (eg,ketoconazole,clotrimazole,miconazole,econazole)

50
Q

treatment for Diaper rash secondary fungal infx

A

Topical Nystatin, Clotrimazole (Lotrimin), Miconazole. Greer’s Goo (nystatin cream, Zinc oxide paste, hydrocortisone cream 1%)

51
Q

treatment for endemic mycoses

A

“Mild: intraconazole

Severe: amphotericin B”

52
Q

treatments for PJP

A

Bactrim, dapsone

53
Q

most common opportunistic fungal pathogens encountered in hospitals

A

candida

54
Q

does an asymptomatic urinary candidiasis req treatment

A

no

55
Q

main treatment for candida

A

fluconazole

56
Q

Aspergillosis treatment

A

voriconazole IV or PO; isavuconazole

57
Q

what dz is fatal unless caught early?

A

Aspergillosis

58
Q

“Cryptococcus neoformans treatment

A

6-12 months of PO/IV fluconazoleif it does not resolve on its own
If meningitis: Amphotericin B followed by 10 weeks of oral fluconazole “

Pharm 1 (17 decks)

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