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Pharm 3 > Antifungal > Flashcards

Antifungal Flashcards

1
Q

Three forms of fungal infections

A

Superficial, subcutaneous, systemic

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2
Q

Griseofulvin- source

A

Penicillin

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3
Q

Griseofulvin method-

A

Fungistatic

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4
Q

Griseofulvin- effective against

A

Dermatophytosis- Microsporum, epidermophyton, trichophyton- no effect on others!

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5
Q

Most common fungal disease in cats

A

Dermatophytosis

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6
Q

Griseofulvin- mechanism

A

Active on growing cells, binds to intracellular microtubules to inhibit mitosis, nucleic acid and protein synthesis, chitin synthesis

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7
Q

Griseofulvin- how does it reach skin

A

In sweat, incorporated in keratin loosely- undetectable in skin 2-3 days

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8
Q

Griseofulvin- time to reach skin after admin’n

A

4-8 hours

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9
Q

Griseofulvin- absorption dependent on

A

Formulation (microsize or ultramicrosize particles in polyethylene glycol) and food (increase absorption with fatty meal)

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10
Q

Griseofulvin- metabolism

A

Oxidation by hepatic enzyme; 6 times faster than in people

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11
Q

Griseofulvin- duration of tx

A

min 4 weeks, sometimes over 3 months

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12
Q

Griseofulvin- interactions

A

phenobarb decreases absorption

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13
Q

Griseofulvin- adverse

A

Bad taste- nausea, V, D; bone marrow suppression in cats with FIV or persians/himalayans/siamese/abyss - CBC q 2 weeks

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14
Q

Griseofulvin- Contraindications

A

HIGHLY teratogenic- DO NOT GIVE TO PREGNANT ANIMALS - brain and skeletal malformations, eye issues, absence of nostrils, soft palate

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15
Q

Amphotericin B- method

A

static or cidal depending on dose; Punches holes in cell membrane by binding to sterols (fungal and mammalian = not specific)- leakage until death

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16
Q

Amphotericin B- uses

A

Cryptococcosis, blasto, histoplasmosis, coccidiomycosis - only in serious cases due to possible toxicity due to lack of sterol specificity (Think ampho blasto histo, cocco)

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17
Q

Amphotericin B- route

A

IV only- no oral absorption

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18
Q

Amphotericin B- cautions

A

Dehydration increases toxicity so administer in 5% dextrose after saline diuresis; max cumulative dose before danger

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19
Q

Amphotericin B- metabolism

A

KIDNEY- high protein binding, 24 hour half life

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20
Q

Amphotericin B- limit

A

4-8 mg/kg (higher if done subcutaneous)

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21
Q

Amphotericin B-best formulations

A

liposomal- better brain penetration and longer half life leads to less dose needed

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22
Q

Amphotericin B- side effects

A

Thrombophlebitis, nephrotixicity (vasoconstriction and renal tubule toxicity), hypokalemia, resistance over time

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23
Q

Ketoconazole- method

A

static/cidal

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24
Q

Ketoconazole- mechanism

A

Inhibit lanosterol 12-demethylase; suppresses p450!!!!!

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25
Q

All azoles do what?

A

Interfere with p450- ex. cyclosporin dose lowered when on azole

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26
Q

Ketoconazole- cautions-

A

inhibits p450; affinity but not 100% specificity for fungal vs mammalian

27
Q

Ketoconazole- uses

A

Broad - systemic, dematophytosis, malassezia,

28
Q

Ketoconazole- administration

A

Oral with acidic environment (with food!)

29
Q

Ketoconazole- metabolize

A

LIVER, halflife 2 hours, peak level in 2 hours, lipophilic

30
Q

Ketoconazole- speed of action

A

5-10 days

31
Q

Itraconazole- specificity

A

more affinity for fungal enzyme

32
Q

Itraconazole- effective against

A

Broad spectrum

33
Q

Itraconazole- metabolism

A

LIVER, high skin and fat concentration (lipo and ketratophilic), poor CSF and eye penetration

34
Q

Itraconazole- half life

A

8-12 hours dogs, 40-120 hours in cats; stays in nails for 6 months

35
Q

Itraconazole- administration

A

Oral with food

36
Q

Itraconazole- side effects

A

Better in cats than ketocon

37
Q

Fluconazole- effective against

A

Broad spectrum

38
Q

Safest most specific azole

A

Fluconazole

39
Q

Fluconazole- metabolism

A

No liver, long half life, good absorption, excellent brain penetration

40
Q

Fluconazole- administration

A

oral, lasts 10 days after administration

41
Q

Fluconazole- side effects

A

ok for cats, safe for liver

42
Q

What drug is best for patients with immune compromise

A

Vfend- voriconazole

43
Q

What drug is best for aspergillus

A

Vfend- voriconazole

44
Q

Vfend- voriconazole- metabolism

A

LIVER - p450 suppression

45
Q

Which azoles are safe in cats

A

itraconazole and fluconazole (think FIC)

46
Q

Which antifungals are metabolized by the liver

A

most azoles- (Itraconazole, ketoconazole, vfend- not fluconazole) and griseofulvin

47
Q

Which antifungal is metabolized by the kidney

A

amphotericin b

48
Q

Which azole does not get metabolized by the liver

A

Fluconazole

49
Q

Terbinafine (lamisil) - mechanism

A

Inhibition of ergosterol synthesis via squalene epoixdase- HIGHLY fungal specific

50
Q

Terbinafine (lamisil) - uses

A

Dermatophytosis, malassezia

51
Q

Iodides- uses

A

Sporotrichosis in horses

52
Q

Iodides- Side effects

A

GI (give with food), twitching, hypothermia, alopecia/scaling

53
Q

Caspofungin- uses

A

Aspergillus, candida, **oomyces (think O-fungin)

54
Q

Caspofungin- administration

A

IV

55
Q

Ketoconazole shampoo- uses

A

dermatophytes, malassezia

56
Q

Chlorhexadine- uses

A

Limited antifungal topical, can be irritating

57
Q

Miconazole- uses

A

Topical for Malassezia dermatitis, yeast otitis

58
Q

Chlortrimazole- uses

A

topical for yeasts and dermatophytes

59
Q

Enizconazle- uses

A

Dermatophytes, malassezia, aspergillus

60
Q

Selenium disulfide (selsun)- uses

A

Malassezia

61
Q

Selenium disulfide (selsun)- contraindications

A

cats, can be drying

62
Q

Lyme sulfur- uses

A

VERY effective against dermatophytosis

63
Q

Thiabendazole (tresaderm) - type

A

Antihelmintic imidazole

64
Q

Thiabendazole (tresaderm) - uses

A

Malassezia otitis, ear mites

Pharm 3 (8 decks)

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