ANTIFUNGAL, CS

Question 1

Terbinafine

Answer 1

• Allylamine

Fungicidal

Question 2

Terbinafine Blocks the biosynthesis of

inhibits

Answer 2

ergosterol, a sterol essential to the integrity
of the fungal cell membrane;

squalene epoxidase (fungal inhibited 4X more than mammalian)

Question 3

Terbinafin AND synthesis of steroid hormones, prostaglandins, and drug metabolism

Answer 3

Does not interfere with

Question 4

Terbinafine with liver dysfunction

Answer 4

slow elimination by 30%

Question 5

Terbinafine lesser degree efficacy

Answer 5

cutaneous candidiasis

Question 6

Terbinafine and ?cytochrome p450 superfamily

Answer 6

does not inhibit

Question 7

Itraconazole, Fluconazole, keto Triazole

• Inhibits

Answer 7

14-α-demethylase, blocking lanosterol conversion to ergosterol

Question 8

Itraconazole is Highly lipophilic
• Bioavailability increased
• Needs environment for absorption

Answer 8

postprandially

acid

Question 9

Itraconazole Adr

Answer 9

hypertriglyceridemia, edema, hypertension, leukopenia, elevated LFTs, nephrotic syndrome

Question 10

Itraconazole , Keto, FLUCO
Inhibits cytochrome P450
→ elevates

Answer 10

inhibits, Small affinity for 
incr digoxin, cyclosporine,
triazolam, 
 fluco Elevates phenytoin, warfarin, nortriptyline, midazolam, triazolam, and
tacrolimus

Question 11

Ketoconazole by interfering with androgen

and glucocorticoid synthesis

Answer 11

gynecomastia and

impotence,

Question 12

acid environment for absorption
enhanced by food intake
lipophilic

Answer 12

Ketoconazole itraconazole

Question 13

Ketoconazole common effects on liver (fulminant hepatitis and transient increases in LFTs)
•

Answer 13

FALSE

Question 14

Fluconazole Rarely elevated LFTs

Answer 14

T

Question 15

Fluconazole for prolonged use at 400 mg

Answer 15

Alopecia

Question 16

Griseofulvin
• Disrupts microtubule mitotic spindle formation
•

Answer 16

causing metaphase arrest

Question 17

Griseofulvin Absorption enhanced

Answer 17

fatty meal

Question 18

Griseofulvin• Indicated for onychomycosis, but

Answer 18

cure rate is low and relapse rate is high

Question 19

Griseofulvin 20-50% experience

Answer 19

severe headaches

Question 20

Griseofulvin
• exacerbator of
contraindicated in

Answer 20

• Photoallergy precipitate LE severe skin reactions
patients with a history of porphyria
acute intermittent porphryia

Question 21

Griseofulvin diff fr azoles in metab

Answer 21

• Induces cytochrome P450

Question 22

Griseofulvin

Answer 22

Ineffective against candidiasis, systemic mycoses, and Pityrosporum species
• Has been reported as a potential

Question 23

atrophy and striae formation,

through suppression of

Answer 23

collagen cross-linking during synthesis

Question 24

Systemic Corticosteroids ?
circulating lymphocytes
T-cell responsiveness to antigens
release of lysosomal enzymes
response of macrophages to lymphokines
antibody production
lymphocytes, eosinophils, and monocytes

number of polymorphonuclear leukocytes

Answer 24

• Decrease

* Increase

Question 25

Short-acting steroids, cortisone and hydrocortisone, mineralcorticoid activity,

cortisone has the____ glucocorticoid activity

Answer 25

greatest

lowest

Question 26

Intermediate and long-acting steroids, methylprednisolone, triamcinalone, dexamethasone, betamethasone

Answer 26

no mineralcorticoid activity,

Question 27

shorter acting CS have higher
but lower
Why we prefer shorter acting CS in treatment? Has lower GC activity, but higher MC activity, less adrenal suppressaion,

Answer 27

MC

GC

Question 28

dexamethasone and

betamethasone have the highest

Answer 28

glucocorticoid activity

Question 29

mimic normal circadian cortisol production

•

Answer 29

single morning dosing,

Risk of HPA axis suppression is minimized in acute disease

Question 30

All complications are believed to be reduced by alternate-day dosing except

Answer 30

the risk of

posterior subcapsular cataracts, osteoporosis, and osteonecrosis

Question 31

sodium retention, potassium

wasting, open-angle glaucoma, myopathy

Answer 31

steroid adr