Antifungal

Question 1

Available as a topical cream and oral tablet. Oral form may cause diarrhea and hepatitis. Used to treat skin and nail infections very effective for onchomycosis when given orally. Less active against candida and malassezia furfur (tinea versicolor)

Answer 1

Terbinafine

Question 2

Binds ergosterol in the fungal membrane and forms pores in the membrane that lead to K+ leakage and death of the fungus

Answer 2

Nystatin

Question 3

Topical (cream and shampoo) and oral formulations (requires gastric acidity). Blocks androgen synthesis and causes hepatitis. It is a P450 inhibitor that can cause drug interactions (avoid H2 blockers, PPIs, and antacids)

Answer 3

Ketoconazole

Question 4

MOA: Nystatin

Answer 4

Binds ergosterol and forms pores in the membrane

Question 5

MOA: Ketoconazole, clotrimazole, and miconazole

Answer 5

Blocks ergosterol synthesis

Question 6

Uses: Ketoconazole

Answer 6

Tinea skin infections

Question 7

Uses: Amphotericin B

Answer 7

Broad spectrum used for systemic fungal infections

Question 8

Uses: Nystatin

Answer 8

Skin infections and mucosal candida (oral and vaginal but not esophageal)

Question 9

Uses: Terbinafine

Answer 9

Skin and nail infections very effective for onchomycosis when given orally. Less active against candida and malassezia furfur (tinea versicolor)

Question 10

Binds ergosterol in the fungal membrane, forming a transmembrane channel that leads to monovalent ion (K+, Na+, H+ and Cl?) leakage, which is the primary effect leading to fungal cell death

Answer 10

Amphotericin B

Question 11

Topical cream, powder, and vaginal suppository. IV form can cause anaphylaxis. Used to treat tinea skin infections and candida vaginitis

Answer 11

Miconazole

Question 12

MOA: Amphotericin B

Answer 12

Binds ergosterol and forms channels in the membrane

Question 13

Uses: Miconazole

Answer 13

Tinea skin infections and candida vaginitis

Question 14

Topical cream, lotion, solution, lozenge, and vaginal suppository with no significant toxicities. Used to treat tinea skin infections (creams and lotions), oral thrush (lozenge) and candida vaginitis (suppository)

Answer 14

Clotrimazole

Question 15

Blocks ergosterol synthesis, a constituent of fungal cell membranes. It works principally by inhibiting the enzyme cytochrome P450 14-alpha-demethylase. This enzyme participates in the sterol biosynthesis pathway that leads from lanosterol to ergosterol

Answer 15

Ketoconazole, clotrimazole, and miconazole

Question 16

Uses: Clotrimazole

Answer 16

Tinea skin infections (creams and lotions), oral thrush (lozenge) and candida vaginitis (suppository)

Question 17

Topical and oral suspensions (no systemic absorption from GI tract, skin, or vagina) with no significant toxicities. Used for skin infections and mucosal candida (oral and vaginal but not esophageal)

Answer 17

Nystatin

Question 18

Renal toxicity: decreased GFR, increased creatinine, distal renal tubular acidosis (decreased K &Mg). lipid formulations w/ decreased renal toxicity

Answer 18

Amphotericin B

Question 19

Cream, powder, aerosol powder, and topical solution. It can cause skin irritation. Used mainly for tinea cruris (jock itch) and tinea pedis (athlete’s foot). Not effective against candida

Answer 19

Tolnaftate

Question 20

Uses: Tolnaftate

Answer 20

Used mainly for tinea cruris (jock itch) and tinea pedis (athlete’s foot). Not effective against candida