Antifungals

Question 1

What are the different types of Antifungals?

Answer 1

-Triazole antifungals

-Imidazole antifungals

-Polyene antifungals

-Other antifungals

Question 2

Why is ORAL ketoconazole no longer used to treat fungal infection?

Answer 2

Because the risk of hepatoxicity is greater than the benefit of treating.
Reserved only for specialists to treat cushings syndrome.

Question 3

What patient n carer advice must be given with oral use?

Answer 3

• Recognise signs of liver disease (anorexia, nausea, vomiting, fatigue)
• Dizziness may affect performance

Question 4

What patient n carer advice must be given with Voriconazole?

Answer 4

• Avoid exposure to direct sunlight or use of sun beds
• Seek medical help if any sunburn or severe skin reactions following exposure to light or sun
• Keep alert cards with you at all times

Question 5

What monitoring must be done for Voriconazole?

Answer 5

Monitor liver function before starting treatment. Then at least weekly for 1 month, then monthly during treatement.

Question 6

What are the side effects of Voriconazole?

Answer 6

• Hepatoxicity
• Phototoxic

Question 7

What are dermatophyte infections?

Answer 7

Skin, hair and nail infections

Question 8

What is the referral criteria for someone with a nail infection?

Answer 8

Can only be a max of 2 nails
Anything more than two nails, is referral.

Max strength of nail lacquer amorolfine 5% and a pack size of 3 mL

Question 9

What are some examples of fungal infections?

Answer 9

• Tinea pedis
• Tinea corporis (ringworm)
• Tinea carpitis
• Oral thrush

Question 10

Which patients are risk factors for tinea infections?

Answer 10

• Diabetic
• Immuno compromised (e.g. HIV)
• Poor circulation
• Peripheral arterial disease

Question 11

When are topical antifungals given?

Answer 11

• When area of infected skin is localised

Question 12

When are oral antifungals given?

Answer 12

• When topical falls
• When many or wide areas are infected
• When site of infection is difficult to reach (nails n scalps)

Question 13

What is the preferred oral antifungal?

Answer 13

• Oral terbinafine
• Oral itraconazole

Can also give oral griseofulvin but less preferred

Question 14

How is tinea capitis treated?

Answer 14

• Systemically - oral antifungal

Question 15

What is the treatment of threadworms?

Answer 15

• Anthelmintics
• Combined use with hygiene measures (cleaning surfaces, utensils, beddings, clothes in high temperatures)

Everyone in the family must be treated

Question 16

What is the common anthelmintic given for threadworms?

Answer 16

Mebendazole
- Single dose use (100mg)
- Second dose may be given after 2 weeks to prevent re-infection

OTC - from 2 years
Rx - from 6 months

Question 17

What is the brand name for Mebendazole? And who can it be given OTC for?

Answer 17

Ovex