Antifungals

Question 1

Superficial Mycoses

— topical, po

Answer 1

• Griseofulvin
• Nystatin
• Terbinafine (fungicidal)
• Azoles
• Miscellaneous Agens

Question 2

– Fungistatic
– MOA: Unknown
– PK: ⬆️ absorption w/ fatty foods
– PO
– Use: tx of dermatophyte infxn/ tinea

Answer 2

Griseofulvin

Question 3

– Chem: Polyene
– MOA: Binds to ergosterol
– DOC: yeast infection
– Topical

Answer 3

Nystatin

Question 4

– Fungicidal

– MOA: Inhibition of Squalene Epoxidase

Answer 4

Terbinafine

Question 5

– MOA: inhibition of fungal CYP450

– Imidazoles: less selective in inhibiting human CYP450

Answer 5

Azoles

Question 6

Imidazoles

Answer 6

• Keroconazole
— Topical Azoles
        - Clotrimazole 
        - Miconazole
        - Ticonazole

Question 7

Triazoles

— more selective un (-) fungal CYP450

Answer 7

• Fluconazole
• Itraconazole
• Voriconazole
• Posaconazole

Question 8

Miscellaneous Agents

Answer 8

• Ap- Ap Solution
• Whitfield’s Ointment
• Selsun Blue
• KI solution

Question 9

Ap ap Solution

Answer 9

Salicylic Acid

Question 10

Whitfield’s Ointment

Answer 10

SA + Benzoic Acid

Question 11

Selsun Blue

Answer 11

Selenium sulfide “antidandruff”

Question 12

KI solution

Answer 12

Sporotrichosis DOC

Question 13

Less Serious Mycoses

Answer 13

• Itraconazole
• Ketoconazole
• Fluconazole

Question 14

– mild to moderate systemic fungal infxn

– 2nd line: Systemic/ Endemic Mycoses

Answer 14

Itraconazole

Question 15

– Tx of cutaneous candidiasis

– Withdrawn

Answer 15

Ketoconazole

Question 16

– DOC: cryptococcal meningitis
– PK: ⬆️ H2O solubility
– excellent BBB penetration
– highest sensitivity in (-) fungal CYP450

Answer 16

Fluconazole

Question 17

Serious Mycoses

Answer 17

• Amphotericin B
• Flucytosine
• Voriconazole
• Echinocandins
• Posoconazole

Question 18

– Grandfather of all antifungals
– MOA: binds to ergosterol — cytoplasmic leakage
– Reduce fungal burden 
– Combined with Flucytosine
– AE: Nephrotoxic
– DOC: Systemic/ Endemic Mycoses

Answer 18

Amphotericin B

Question 19

– Pyrmidine analog
– MOA: Converted to FUTP & FdUMP
– Combined with Amphotericin B
– NEVER given alone

Answer 19

Flucytosine

Question 20

DOC for Aspergillosis

Answer 20

Voriconazole

Question 21

– MOA: (-) Synthesis of B [1,3] D glucan

• Micafungin
• Caspofungin
• Anidulafungin

Answer 21

Echinocandins

Question 22

DOC for Mucormycosis

Answer 22

Posaconazole