Antifungal Flashcards
Trichopyton
Infect skin nail & hair
Trichopyton rubrum
Epidermophyton
Infect skin & nails
Epidermophyton floccosum
Microsporum
Affect hair and skin
Classified by habitat
Tinea pedis
T. Interdigitale (t.mentagrophytes complex)
Erythrasma
Gram positive bacterial infection
- corynebacterium minutissmum
Improve foot hygiene, topical fusion acdinor clindamycin lotion
Will show up pink under woods light
Pure tic slow spreading brown scale and maceration
Erythrasma
What is te only type of onychomycosis to affect the dorsal aspect of the nail plate
Superficial white onychomycosis
Usually a result of t.mentagrophytes
Cause of proximal white onychomycosis
Most commonly caused by trichophyton rubrum
Unicellular round or oval fungal mycosis
True yeasts
Malassezia fur fur
Cryptococcus neoformans
Long non-branching stands of fungal infection
Candidia spp.
Long branching filaments of fungi that intertwine forming mycelium causing mycosis
Moulds
Trichophyton is classified as a
Dermatophyte
Dermatophytes digest
Keratin in hair, skin & nails
Amorolfine is the active ingredient in
Loceryl 5% paint
Nystatin (topical)
Mycostatin
Terbinafine is the active ingredient in
Lamisil 1%
Lamisil tablets in specific circumstances
Griseofulvin is the active ingredient in
Grisovin
Oral in specified circumstances
Broad spectrum antifungals
Azoles
Narrow spectrum of antifungal
Griseofulvin
Cell wall synthesis inhibiting antifungals
Azoles
Allylamines
Amorolfine
Echinocandins
Predominant component of fungal cell wall
Ergosterol
Antifungals that interfere with cell wall function
Amphotericin
Nystatin
DNA synthesis inhibiting antifungals
Pyrimides - flucytosine
Benzofurines - griseofulvin
Miconazole is available as a tincture for use on nails what drug class is it and what is the MOA & brand names
Daktarin, Resolve
Azoles - imidazoles
Inhibit enzyme, impairing synthesis of ergosterol in cell wall
Imidazoles
All administered topically for 2-4 weeks
- Miconazole
- clotrimozole
- econazole
- bifonazole
- ketoconazole
Triazoles
All given orally
- Fluconazole
- Itraconazole
- Voriconazole
- Posaconazole (v serious cases)
Canestan oral once-daily, mycospor
Bifonazole (cream1%)
Azoles - imidazole
Inhibit cell wall synthesis
Canesten, clonea
Clotrimozole (cream & lotion 1%)
Azoles - imidazole
Inhibit cell wall synthesis
Pevaryl
Econazole (cream 1%)
Azoles - imidazole
Inhibit cell wall synthesis
Nizoral cream
Daktagold
Ketoconazole (cream 1%)
Azoles - imidazole
Inhibit cell wall synthesis
Fluconazole interacts with
Warfarin - increase INR
Anti- arrhytmics (amidarone) increase QT interval
Macrolides
What Azoles would you use in a severe systemic fungal infection
Voriconazole
Posaconazole
In pregnancy the safe Azoles are
Clotrimozole
Miconazole
And econazole
Allylamines
Terbinafine - Lamisil
Inhibit an enzyme (squalene epoxidase) preventing ergosterol synthesis
Fungicidal against dermatophytes
Fungistatic against Candida albicans
Terbinafine interactions
Venlafaxine
Triglyclic antidepressants
Rifampicin
Do not use Lamisil for
Longer than 4weeks
Moccasin/plantar type tinea pedis
Loceryl
Amorolfine targets 2 enzyme points in synthesis of ergosterol which compromises cell wall
Broad coverage for dermatophytes and candida spp (high affinity for keratin)
Bifonazole
Urea ointment - softens nail
Bifonazole cream
