Ch.33: Anti-fungal Agents (Marcela) Flashcards by Sara Prent

thiabendazole (tresaderm)

antihelmintic imidazole combination product

- treats malassezia otitis, ear mites

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lime sulfur treats:

dermatophytosis

-strong antipruritic

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lime sulfur side effects

drying, yellow stain, sulfur smell

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amphotericin B MOA

binds to sterols; disrupts integrity of the membrane

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amphotericin B spectrum

cryptococcosis
blastomycosis
histoplasmosis
cocidiomycosis

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formulations of amphotericin B

liposomal (best*)
colloidal
lipid complex

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amphotericin B adverse effects***

nephrotoxicity***
thrombophlebitis
hypokalemia
resistance develops over time

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Malassezia more common in dogs/cats?

dogs

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Candida more common in dogs/cats?

cats

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Nystatin MOA

binds to ergosterol

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Nystatin spectrum

candida

malassezia

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ketoconazole MOA***

inhibits synthesis of ergosterol via inhibition of lanosterol 14-demethylase (a cytochrome P450 enzyme)

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ketoconazole spectrum

broad spec: systemic infections, dermatophytosis, malassezia

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what should you check before treating with ketoconazole?***

patien’ts liver function

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Ketoconazole drug interactions

drugs using cytochrome P450

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which species should not use Ketoconazole

cats. Also older dogs

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adverse effects of Ketoconazole

GI
hepatoxicity
teratogenic
alopecia
pruritis

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itraconazole features of note

more active than ketoconazole
more expensive
increased affinity for fungal enzyme
fewer adverse effects
WELL tolerated in cats
broad spec
lipophilic
keratinophilic

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itraconazole adverse effects**

vasculitis at high doses**
- side effect of itraconazole but not ketoconazole
drug interactions
GI
liver toxicity

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how is itraconazole metabolized?

liver

is fluconazole metabolized by liver?**

NO (different from other azoles)

fluconazole in cats?

Voriconazole metabolized by liver?

Y (via P450 suppression)

voriconazole features of note

used for serious infections in immune compromised patients
excellent oral absorption
liver metabolism

rank azoles that do liver metabolism in order of decreasing suppressive effect on P450***

ketoconazole > itraconazole > fluconazole > voriconazole

Terbinafine features of note

- lipophilic - keratinophilic - NO P450 interference

Terbinafine spectrum

dermatophytosis | malassezia

iodides used for

sporotrichosis (esp. in horses)

only anti-fungal drug that targets oomyces**

caspofungin

caspofungin MOA

glucan synthesis inhibitor

T/F: chlorhexidine has limited anti-fungal efficacy

miconazole used for:

malassezia dermatitis, yeast otitis

Clortrimazole spectrum

yeasts, dermatophytes

enilconazole spectrum

dermatophytes malassezia aspergillus

selenium disulfide spectrum

malassezia

disadvantages of selenium spectrum

no effect on dermatophytes toxic for cats drying

griseofulvin is fungistatic/cidal?

static

griseofulvin produced by:

penicillium griseofulvum

griseofulvin spectrum*****

dermatophytosis. NO effect on other fungi/bacteria**

most common fungal disease in cats

dermatophytosis

griseofulvin MOA

- active on growing cells - binds to intracellular microtubules which inhibits mitosis, synthesis of nucleic acids and proteins, and chitin synthesis - temporarily incorporated into keratin**

metabolism of griseofulvin

- hepatic | - excreted in urine

does griseofulvin have long residual effect?*

absorption of griseofulvin dependent on:

- microsize form (smaller the particle, more absorption there will be) - food (increases absorption)

what drug decreases absorption of griseofulvin?

phenobarbital

adverse effects of griseofulvin

GI | bone marrow suppression

teratogenicity of griseofulvin

can induce malformation of the brain, skeleton, eye, etc. Never prescribe to pregnant animals!! **

misc. properties of griseofulvin

anti-inflammatory | suppresses allergic and irritant reactions