Antifungals

Question 1

What can fungus be divided into?

Answer 1

Yeast and mold

Question 2

What are the types of yeast?

Answer 2

Candida, cryptococcus, pneumocycstis

Question 3

What are the types of molds?

Answer 3

Dermatophytes, aspergillus, and rhizopus

Question 4

What are the traits of yeast?

Answer 4

Ovoid or spherical, and single cells multiply by budding and division. (Histoplasma)

Question 5

What are the traits of mold?

Answer 5

Filamentous fungi grow as a multinucleate branching, hyphae forming mycelium like ringworm

Question 6

What are mycotic infections?

Answer 6

Cutaneous dermatophytosis or opportunistic infections caused by fungus on the skin.

Question 7

What types of fungus can cause cutaneous dermatophytosis (ringworm)

Answer 7

The tineas

Question 8

What types of fungus can cause opportunistic infections?

Answer 8

Candida aspergillus cryptococcosis Coccidioidomycosis and histoplasmosis

Question 9

What is the most common type of fungus that causes skinfold infections or thrush?

Answer 9

Candida

Question 10

What is Tinea incognito?

Answer 10

It is Tania that has a clinical appearance that has been altered by inappropriate treatment like a topical steroid cream, and it causes the original infection to slowly extend. These should be treated with an inappropriate antifungal medication and give the patient and antipruritic agent.

Question 11

What are some preventative measures to prevent fungal infections?

Answer 11

Keep skin clean and dry do not share towels, clean showers with bleach, wash, socks, towels, and bath mats and very hot water. Avoid long periods of exclusive footwear and avoid bare feet in public pools and gym dressing rooms.

Question 12

Which three classes of antifungal drugs, alter cell membrane permeability

Answer 12

Polyene macrolides, azole derivatives, and Allyamines

Question 13

Which class of antifungals inhibit, DNA and protein synthesis?

Answer 13

Pyrimidine analog flucytosine

Question 14

Which antifungal class of drugs acts by disrupting cell wall integrity

Answer 14

Echinocandins (IV only)

Question 15

Which class of antifungal drugs is most useful for opportunistic infections?

Answer 15

Echinocandins

Question 16

Which antifungal drug is used for amino compromised conditions of systemic candidiasis

Answer 16

Amphotericin B

Question 17

Which class of antifungals acts by inhibiting ergosterol synthesis?

Answer 17

Azoles

Question 18

What are the exceptions for fungal treatments that are systemic?

Answer 18

Nail mycoses, tinea capitis, infections that are resistant to topicals, and invasive fungal infections in immunocompromised patients.

Question 19

What does the efficacy of topical antifungal depend upon?

Answer 19

Type of lesion mechanism of drug action, viscosity, hydrophobicity, and acidity of the formulation

Question 20

What are the preferred formulas for topical antifungal?

Answer 20

Creams solutions and powders

Question 21

How does antifungals that are systemic impact metabolism and excretion?

Answer 21

They impact G.I. function they impact polymorphisms of CYP2C19 genes and they impact drug interactions and some antifungals inhibit clearance of other drugs

Question 22

What is the antifungal Polyene macrolide that potentially binds to fungal ergosterol which alters cellular permeability?

Answer 22

Amphotericin B

Question 23

What are the adverse effects of systemic antifungals?

Answer 23

Hepatotoxicity, G.I. upset, hepatitis, cholestasis, and hepatic failure.

Question 24

What drugs do ketoconazole interact with?

Answer 24

CYP 450 inhibitor interacts with benzodiazepines bupropion carbamazepine corticosteroids Protease inhibitors sulfonylureas and warfarin.

Question 25

What does fluconazole increase the action of?

Answer 25

Benzodiazepines buspirone corticosteroids losartan sulfonylureas warfarin, statins and clarithromycin

Question 27

What drugs does griseofulvin decrease the action of?

Answer 27

Anticoagulant, oral contraceptives, hormone replacement, drugs, cyclosporine, and alcohol.

Question 28

Which antifungal can APN not prescribe?

Answer 28

Capsofungin

Question 29

What is the first line treatment for finger and toenail onychomycosis?

Answer 29

Turbinafine

Question 30

What is the first line of treatment for candidia that is esophageal oral or vaginitis

Answer 30

Fluconazole

Question 31

What is the first line of treatment in tinea capitis for pediatric patients and tinea pedis

Answer 31

Griseofulvin

Question 34

What happens when a fungal infection is treated with a topical steroid

Answer 34

Tinea incognito occurs and it makes it much more difficult for the provider to identify the I Etiology of the lesion

Question 35

What is the first line of treatment aspergillosis and candidemia

Answer 35

caspofungin

Question 35

What drug class and root of administration would you consider for the treatment of toenail fungal infection

Answer 35

A systemic allylamine should be considered first line

Question 36

All oral and systemic antifungal drugs have what common adverse effect

Answer 36

Hepatotoxicity

Question 37

Which class of antifungals when given systemically shows the lowest rate of drug interactions

Answer 37

The Echinocandins

Question 39

What is the difference untreated tinea and incognito tinea

Answer 39

Incognito has a less raised margin, is less scaly, and more pustular, more extensive, and more irritated

Question 40

What are the three important things to consider when prescribing antifungals

Answer 40

Spectrum of activity, metabolism, and excretion.

Question 41

What drug would you give for thrush?

Answer 41

Nystatin

Question 42

What drug would you give for tinea capitis, pedis, and corporis

Answer 42

Terbinafine

Question 43

What drug do you give for most candida infections?

Answer 43

Fluconazole

Question 44

When do you give fluconazole for tinea?

Answer 44

When it’s pedis

Question 46

What is the first line of treatment for thrush?

Answer 46

Nystatin