Fungal pharmacology

Question 1

Topical Azole antifungals

Answer 1

Impair formation of fungal cell wall
Used topically, but have systemic absorption
DO not use with asthma or sulfa allergy

Question 2

Azole SE

Answer 2

Pruritis, burning, irritation

Question 3

Clotrimazole

Answer 3

Cutaneous candidas
Vulvovaginal candidiasis
Oropharyngran dancidiasis

Question 4

Clotrimazole

Answer 4

BID daily for up to 4 weeks

For oro: troche lozenge

Question 5

Mycostatin (Nystatin)

Answer 5

Cutaneous and mucocutaneous infections from candida.
Oral and intestinal candida infxns
can be oral suspension or topical

Question 6

Mycostatin SE

Answer 6

Contact dermatitis
Stevens johnson
N/V diarrhea

Question 7

Systemic Azole

Answer 7

Ketoconazole (Nizoral)
Itraconazole (sporanox)
Fluconazole (Diflucan)

Question 8

Systemic Azole SE

Answer 8

Inhibit CYP450

Question 9

Systemic Azole MOA

Answer 9

Inhibit synthesis of ergosterol (cell membrane)

Question 10

Ketoconazole (Nizoral)

Answer 10

Tx of systemic life-threatening fungal infxns when other safer agents cannot be use.

Question 11

Ketoconazole (Nizoral) SE

Answer 11

Hepatotoxicity
Decreased adrenal secretion
QT prolongation
CYP450 inhibition
MONITOR CLOSELY

Question 12

Itraconazole (Sporanox) indications

Answer 12

Aspergillosis
Blastomycosis
Oropharyngeal candidas
COccidiomycosis
Histoplasmosis
Anychomycosis

Question 13

Itraconazole (Sporanox) CI

Answer 13

CYP450 drugs
CHF
Pregnancy
Ventricular dysfxn

Question 14

Itraconazole (Sporanox) SE

Answer 14

N/V/D
Edema, heart failure
HA
Rash
Abnormal LFT's

Question 15

Fluconazole (Diflucan) indications

Answer 15

Blastomycosis
Candida
Coccidiomycosis
Cryptomycosis

Question 16

Fluconazole (Diflucan) MOA

Answer 16

Good distribution in CNS, body

30 hr half life

Question 17

Fluconazole (Diflucan) SE

Answer 17

Many drug interactions
HA/dizziness
N/V/D
elevated LFT's
QT prolongation

Question 18

What should be monitored for ALL systemic Azole antifungals

Answer 18

LFT’s
Current meds
Heart status

Question 19

Systemic Allylamine Antifungals

Answer 19

Terbinafine (Lamisil)

Question 20

Terbinafine Indications

Answer 20

Oncychomycosis of toenails, fingernails
Tinea capitis
Topical: Tineas

Question 21

Terbinafine CI / SE

Answer 21

CYP450 drugs

HA/ diarrhea, LFT’s

Question 22

Griseofulvin

Answer 22

Fungistatic
used for tinea infxns of skin, hair, nails
Most commonly for tinea capitis

Question 23

Griseofulvin CI

Answer 23

Liver failure
Porphyria
Pregnancy (category X)
breast feeding not recommended

Question 24

Griseofulvin SE

Answer 24

Many drug interactions
Photosensitivity, stevens johnson
Jaundice, N/V/D
drug-induced lupus-like syndrome

Question 25

Amphotericin B

Answer 25

IV only
Used in severe fungal infxns
adverse side effects