Anti-Fungals

Question 1

Topical imidazoles (MOA, examples, uses, & adverse reactions)

Answer 1

MOA: blocks ergosterol synthesis (cholesterol in cell membrane of yeast)

Examples: miconazole, clotrimazole, efinaconazole, and ketoconazole

Uses: wide range of activity against dermatophytes and yeasts

Adverse reactions: stinging, puritis, erythema, & local irritation; allergic contact dermatitis uncommon

Question 2

Miconazole (class & uses)

Answer 2

Topical imidazole

Used as vaginal cream or suppository for vulvovaginal candidiasis

Question 3

Clotrimazole (class & uses)

Answer 3

Topical imidazole

Used as cream, lotion, or tablet for vulvovaginal candidiasis

Question 4

Efinaconazole (class & uses)

Answer 4

Topical imidazole

Used for onychomycosis but complete cure in only 15-18%

Question 5

Ketoconazole (class & uses)

Answer 5

Topical imidazole

Uses: cream for dermatophytosis or candidiasis, or shampoo/foam for seborrheic dermatitis (inhibits cyp450)

Question 6

Ciclopirox (MOA, uses, adverse reactions)

Answer 6

MOA: prescription broad-spectrum, disrupts macromolecular synthesis

Uses: against dermatophytes, Candida, and Malassezia

Adverse rxns: low

Question 7

Terbinafine (MOA, uses, adverse reactions)

Answer 7

MOA: Allylamine, selectively inhibits sequalene epoxidase (key enzyme for systhesis of ergosterol)

Uses: highly active against dermatophytes but less active against yeasts

Adverse rxns: local irritation, avoid contact with mucous membranes

Question 8

Tolnaftate (MOA, uses, adverse reactions)

Answer 8

MOA: Unknown but distorts hyphae/stunts mycelial growth

Uses: Topical use against various dermatophytes and malesszia infections but not Candida

Adverse rxns: Rare

Question 9

Nystatin (MOA, uses, adverse reactions)

Answer 9

MOA: binds to fungal sterols, alters membrane permeability

Uses: cutaneous and mucosal candida infections (narrow spectum & negligable absorption from GI tract)

Adverse rxns: mild nausea & diarrhea if swallowed

Question 10

Amphotericin B (MOA, uses, adverse reactions)

Answer 10

MOA: binds fungal sterols, alters membrane permeability

Uses: Topical treatment of cutaneous candida infections

Adverse rxns: temp yellow staining of skin

Question 11

Fluconazole

Answer 11

Broad spectrum, treats tinea versicolor

Question 12

Itraconazole

Answer 12

Broad spectrum, treats tineae versicolor

Question 13

Terbinafine

Answer 13

Oral tx for onychomycosis

Question 14

Griseofulvin

Answer 14

given orally to tx dermatophyte infections of scalp & non-hairy skin caused by Epidermophyton, Microsporum, & Trichophyton

MOA unclear

Question 15

Acyclovir (MOA, uses)

Answer 15

***ANTI-VIRAL***

MOA: guanine analog with inhibitory activity against HSV 1 & 2

Uses: recurrent orolabial HSV infection in immunocompitent adults