Antifungals

Question 1

amphotericin B: MOA

Answer 1

polyene macrolide antibiotic with anti fungal activity. Fungistatic or fungicidal based on concentration. binds to ergosterol–> increases permeability of cell membranes and leakage–> cell death.

Question 2

amphotericin B: uses

Answer 2

Histoplasma, Blastomyces, Cryptococcus, Coccidioides, Candida, Rhodotorula, Mucor

Question 3

amphotericin B: adverse effects

Answer 3

Nephrotoxicity, hypokalemia, anorexia, chills, nausea, vomiting, seizures, hypotension, fever, thrombophlebitis, hepatic dysfunction, anemia, arrhythmias, cardiac arrest, anaphylactoid reactions, weight loss.

Question 4

amphotericin B: contraindications

Answer 4

renal disease

Question 5

itraconazole: class/MOA

Answer 5

oral triazole. blocks conversion of Ianosterol to ergosterol. Specific for fungal Cytochrome P-450. Fungistatic/fungicidal based on concentration.

Question 6

itraconazole: uses

Answer 6

PULSE THERAPY! treatment of superficial, deep, and systemic mycoses in humans and animals. Treatment of choice for sporotrichosis in small animals. Compared to ketoconazole: better absorption, longer duration of action, less toxic, more potent

Question 7

itraconazole: adverse effects

Answer 7

well tolerated. nausea, anorexia, vomiting. idiosyncratic hepatotoxicity (reversible). potential vasculitis at high doses

Question 8

itraconazole: contraindications

Answer 8

don’t use with terfenadine or astemizole due to arrhythmias.

Question 9

fluconazole: class/MOA

Answer 9

oral triazole. blocks conversion of Ianosterol to ergosterol. Chytochrome P450-minimal liver metabolism, SAFEST among azoles!

Question 10

fluconazole: uses

Answer 10

systemic mycoses and superficial infections. well tolerated in cats! safe for patients with liver problems.

Question 11

fluconazole: adverse effects

Answer 11

vomiting, nausea. less toxic than ketoconazole

Question 12

fluconazole: contraindications

Answer 12

don’t use in patients with renal problems

Question 13

ketoconazole: class/MOA

Answer 13

oral and topical imidazole. blocks conversion of Ianosterol to ergosterol. fungal and mammalian cytochrome P450 inhibitor

Question 14

ketoconazole: uses

Answer 14

broad spectrum, not for feline sporothricosis. fungistatic and fungisidal depending on dose

Question 15

ketoconazole: adverse effects/toxicity

Answer 15

nausea, vomiting, diarrhea, anorexia. Don’t give to pregnant animals (abortigenous). hepatopathy, alopecia, pruritus, lengthening of coat

Question 16

Griseofulvin: MOA

Answer 16

binds to microtubules inhibiting mitosis. inhibit synthesis of nucleic acids and proteins. breakdown membranes of intracellular organelles

Question 17

Giseofulvin: uses

Answer 17

fungistatic of dermatophytes

Question 18

Giseofulvin: adverse effects/toxicity

Answer 18

cats are more susceptible than dogs. vomiting and diarrhea, teratogenic, hepatotoxic, bone marrow suppression.

Question 19

Giseofulvin: contraindications

Answer 19

pregnancy, hepatic disease, IMMUNOSUPPRESSED CATS (FIV, FeLV)

Question 20

Terbinafine: MOA

Answer 20

inhibits squalene epoxidase (causes membrane disruption and death). affinity for fungal squalene epoxides >mammalian

Question 21

Terbinafine: uses

Answer 21

fungicidal of yeast and dermatophytes (superficial mycoses). Better than griseofulvin and ketoconazole for dermatophytes.

Question 22

Iodides: MOA

Answer 22

unknown

Question 23

Iodides: uses

Answer 23

mostly in large animals. sporotrichosis. used as saturated or super-saturated solutions (NaI, KI, SSKI)

Question 24

Iodides: adverse effects/toxicity

Answer 24

nausea, vomiting, diarrhea, twitching, hypothermia, scaling, alopecia