Fungal medications Flashcards
Itraconazole
Active against broad spectrum of fungi
Inhibits cytochrome P450
2 major adverse effects: liver damage and cardiosuppression
Inhibits CYP3A4, and raises leves of many drugs
Drugs that reduce gastric acidity (proton pumps, etc) can greatly reduce absorption of itraconazole
Take with food
Topical Clotrimazole-drug of choice for many superficial mycoses case by dermatophytes and candida species
superficial fungal infection
Onychomycosis
fungal infection of the fingernails difficult to treat Prolonged therapy Preferred Tx Terbinafine and Itraconazle monitor liver functions Toenail recurs in 80% of people
Tx of toenail fungus
Tx of fingernail fungus
Toenail= 6 months
200 mg itraconazole daily
Fingernail= 3 months
Griseofulvin
For tinea capitis -deposits in keratin precursor cells.
Increases levels of Warfarin
decreases levels of barbituates and cyclosporine
On head Tx for 8 weeks
body 2-4 weeks
nails 12 weeks
monitor liver function
Polyene atibiotics (Nystatin)
Used to tx Thrush
used 10-14 days.
placed in babies mouth on each side of cheek 3x daily
safe for Mom and baby
Azole like fluconazole (Diflucan)
Routine use should be avoided for the systemic drugs
Tinea pedi
athletes foot
tinea corporis
ringworm
tinea cruis
jock itch
tinea manu
one hand
tinea unguium
under the nails
With the exception of nails, tx the tineas with topical terbinafine (Lamisil) or clotimazole (lotrimin)
treatments
tinea versicolor -skin condition caused by superficial yeast in sub tropical areas.
Tx first line with selenium sulfide solution as lotion or shampoo applied 1x per day for 3-4 weeks Oral itraconazole may be 2nd line
CDC is gold standard for tx of vulvo vaginal cadidiasis guidelines
Sanford guide for anti-fungal agents in body areas
