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Pharm 840 Exam #1 > Dr. Perez > Flashcards

Dr. Perez Flashcards

1
Q

Vulvovaginal Candidiasis (VVC) most common pathogens

A
  • Candida albicans

- Candida glabrata (more likely to be resistant)

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2
Q

VVC risk factors

A
  • Pregnancy
  • Diabetes
  • Immunocompromised
  • Abx use
  • intravaginal contraception
  • High dose oral contraceptive agents
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3
Q

Signs and symptoms of VVC

A
  • Itching
  • Pain/soreness
  • Cheese like discharge
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4
Q

Definition of uncomplicated VVC

A
  • Mild to moderate s/sxs
  • Less than 3 episodes per year
  • Immunocompetent
  • Not pregnant
  • Female
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5
Q

Treatment of uncomplicated VVC

A

-Topical azole antifungal

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6
Q

Topical azole product counseling

A
  • Can decrease efficacy of latex condoms
  • Don’t use tampons concomitantly
  • Administer at night time
  • Wear a pad to help decrease messes
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7
Q

Definition of complicated VVC

A
  • Immunocompromised
  • Uncontrolled diabetes
  • Pregnant patients
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8
Q

Recurrent VVC

A

-4 or more events in 12 months

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9
Q

Treatment of complicated VVC

A

-Azole antifungal

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10
Q

Antifungal resistant VVC

A
  • Persistently positive yeast cultures and failure to respond to antifungal therapy despite adherence
  • Usually Candida glabrata
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11
Q

Treatment of Candida glabrata/ resistant VVC

A
  • Boric acid vaginal suppositories x 14days
  • Fluconazole 150mg x 1 dose
  • Most common in pts with diabetes
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12
Q

Non-pharm recommendations for VVC

A
  • Avoid harsh soaps
  • Keep ya junk clean and dry
  • Avoid tight clothing
  • Cool baths to sooth skin
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13
Q

Treatment of Uncomplicated VVC

A
  • Topical Azole for 3 to 7 days depending of formulation

- Fluconazole oral x 1 dose

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14
Q

Treatment of Complicated VVC

A

-Oral fluconazole 150mg Q72hrs for 2 to 3 doses
or
-Topical azole for 7 to 14 days
+/- low potency topical corticosteroid for 48hrs

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15
Q

Treatment of VVC in pregnancy

A

-Topical clotrimazole
or
-Topical miconazole
-for 7 days

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16
Q

Recurrent VVC treatment

A

-Induction with
1) Fluconazole 150mg q72hr x 3 doses
or
2) Topical azole for 7-14 days
-Maintenance
1) Fluconazole 150mg qweekly x 6 months

17
Q

Oropharyngeal (OPC) and Esophageal Candidasis (EPC)

A
  • Most common pathogen is Candida albicans

- Opportunistic infection in HIV/AIDS

18
Q

Risk factors for OPC/EPC

A
  • Steroid or abx use
  • Dentures
  • Dry mouth
  • Neonates/elderly
  • Immunocompromised
  • Diabetes
  • Nutritional deficiencies
19
Q

Treatment of mild to moderate OPC

A
  • 7 to 14 days of therapy
  • Clotrimazole 5x daily
  • Miconazole 1 tab daily
  • Nystatin swish and swallow 4x daily
20
Q

Treatment for moderate to severe OPC

A
  • 7 to 14 days of therapy

- Fluconazole 100 to 200mg daily

21
Q

Treatment of fluconazole refactory OPC

A
  • 14 to 28 days of therapy
  • Itraconazole
  • Posaconazole
  • Voriconazole
22
Q

Treatment of EPC

A
  • 14 to 21 days of therapy
  • Fluconazole (PO/IV)
  • Echinocandin (IV)
23
Q

Treatment of fluconazole Refractory EPC

A
  • 14 to 21 days of therapy
  • Itraconazole (PO)
  • Posaconazole (PO)
  • Voriconazole (PO)
  • IV echinocandin if needed
24
Q

Treatment of recurrent EPC, chronic suppressive therapy

A

-Fluconazole 100 to 200mg 3x/week chronically!

25
Q

Common pathogens in Dermatophyte infections

A
  • Trichophyton
  • Microsporum
  • Epidermophyton
  • Malassezia (tinea versicolor)
26
Q

Tinea Corporis (Ring worm)

A
  • Most common in children
  • Trunk, extremities, face
  • Treatment with topical antifunal
  • Don’t share towels or clothes
27
Q

Tinea Cruris (jock itch)

A
  • More common in males
  • Thighs and buttocks
  • Treatment with topical antifungal ( 1 to 2 weeks of therapy)
  • Keep area dry, check for tinea pedis too
28
Q

Tinea Vesicolor

A
  • Hyper/hypopigmentation
  • Scalp, face, trunk
  • Topical antifungal
  • Sunlight will help the skin return to its normal color
29
Q

Tinea Pedis (athletes foot)

A
  • Scaly feet/toes
  • Topical antifungal
  • Disinfect footware, control excessive sweating, wear nonocclusive shoes
30
Q

Tinea Unguium (Onychomycosis)

A
  • Yellowish/brownish nail discoloration
  • More common in adults (Diabetes or trauma)
  • Terbinafine is 1st line (systemic is better than topical in this case)
  • 4 to 6 months for finger nail to grow back
  • 12 to 18 months for big toe nail to grow back
31
Q

Clinical Pearls for Terbinafine

A
  • Don’t give in patients with hepatic disease
  • Monitor LFTs, prior to initiation and monthly there after
  • Moderate CYP2D6 inhibitor
32
Q

Treatment of Onychomycosis

A 
-Terbinafine 250mg/day for 6 weeks (fingernail)
12 weeks (toenail)

Pharm 840 Exam #1 (5 decks)

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