Antifungals and Antivirals

Question 1

what are some common dermatophyte topical agents?

Answer 1

lime-sulfur
azoles (clotrimazole, miconazole, ketonazole, itraconazole)

Question 2

what are some common dermatophyte systemic agents?

Answer 2

azoles
terbinafine
griseofulvin

Question 3

itraconazole is the first-line recommended treatment for ________ it has product approved for this purpose

Answer 3

cats

Question 4

what is griseofulvin effective on?

Answer 4

dermatophytes

Question 5

what are some important adverse effects of griseofulvin?

Answer 5

hematologic: bone marrow suppression, cats more prone to this
teratogen
not for use in food animals: possible carcinogen

Question 6

what does amphotericin B do?

Answer 6

interrupts sterol (ergosterol) synthesis in cell membrane of fungus resulting in leaky membranes

Question 7

what is the major side effect of amphotericin B?

Answer 7

nephrotoxicity

Question 8

why would you use liposomal amphotericin B?

Answer 8

liposomal encapsulation prevents damage to the kidney

Question 9

what are some common azoles?

Answer 9

ketoconazole
itraconazole
fluconazole

Question 10

what do azoles impair?

Answer 10

synthesis of ergosterol

Question 11

what are the primary adverse effects of ketoconazole?

Answer 11

gastrointestinal
rare hepatotoxicity

Question 12

what is important to think about with ketoconazole and other drugs?

Answer 12

P450 enzyme inhibitor: drug interactions

Question 13

what is the antifungal of choice for CNS and eye?

Answer 13

fluconazole

Question 14

what is terbinafine used for?

Answer 14

dermatophytes and systemic mycoses

Question 15

what is one use of systemic iodides?

Answer 15

Actinobacillus lignieressii: woody tongue in cattle

Question 16

voriconazole is more active against _______________

Answer 16

Aspergillus

Question 17

what is amantadine banned from?

Answer 17

ELDU in chickens, turkeys, ducks (avian influenza resistance concerns)
no approved use
banned from use in animals in Europe

Question 17

what are some systemic agents for treating dermatophyte infections?

Answer 17

azoles
terbinafine

Question 18

what is the first-line recommended treatment for cats with dermatophyte infections?

Answer 18

itraconazole

Question 19

who are more prone to bone marrow suppression with griseofulvin and what may increase the likelihood of it happening?

Answer 19

cats
FeLV or FIV infection

Question 20

what is used topically for the treatment of nasal aspergillosis and is active against dermatophytes and yeast?

Answer 20

clotrimazole
yeast: Malassezia, Candida

Question 21

what are the categories of common antifungal agents used to treat systemic mycoses?

Answer 21

polyenes
azoles
iodides

Question 22

what is one polyene?

Answer 22

amphotericin B

Question 23

what are some azoles used to treat systemic mycoses?

Answer 23

ketoconazole
itraconazole
fluconazole

Question 24

what is one iodide used to treat systemic mycoses?

Answer 24

sodium and potassium iodine

Question 25

what is amphotericin B useful for?

Answer 25

systemic candidal infections and most systemic mycoses

Question 26

what is often resistant to amphotericin B?

Answer 26

aspergillus

Question 27

what are azoles useful for?

Answer 27

systemic candidal infections and most systemic mycoses

Question 28

what is a common potential adverse effect with azoles?

Answer 28

potentially hepatotoxicity

Question 29

what is the tissue penetration of itraconazole like?

Answer 29

better, but still often subtherapeutic in CNS

Question 30

how hepatotoxic is itraconazole?

Answer 30

more than ketoconazole also more expensive

Question 31

is itraconazole effective against aspergillus?

Answer 31

yes

Question 32

which antifungal enters the urine at therapeutic concentrations?

Answer 32

fluconazole

Question 33

how hepatotoxic is fluconazole?

Answer 33

less hepatotoxic also less expensive

Question 34

what systemic mycoses are terbinafine used for?

Answer 34

Aspergillus Blastomyces/Histoplasma Sporothrix Cryptococcus Candida

Question 35

what is terbinafine often used with?

Answer 35

azole therapy

Question 36

what is responsive to iodide therapy?

Answer 36

only sporotrichosis

Question 37

what is an adverse effect of iodides?

Answer 37

signs of iodinism if overdose: lacrimation, coughing, dermatitis