Pharm-Antifungals Flashcards
Therapy for widespread tinea
Oral only
Terbinafine > itraconazole > fluconazole > griseofulvin
Therapy for localized tinea
Topical azoles, terbinafine, naftifine, ciclopirox
Onchomycosis oral therapy?
Terbinafine, griseofulvin, itraconazole, fluconazole
Onchomycosis topical therapy?
Ciclopirox, amorolfine
Ciclopirox MOA
Blocks fungal tmem tport, depleting substrates and int w nucleotide synthesis
Ketoconazole AEs
Notoriously hepatotoxic
Adrenal insufficiency
CYP interactions
Itraconazole AEs
Negative inotropic action: HF, vent dysfunction, co-administrations
Hepatotoxicity: monitor LFTs
CYP
C/I post-partum and pregnancy
Flu Pos Vori AEs
CYP
QT
Hepatotoxic
Vori unique AEs
visual disturbances
photosensitivity
Posaconazole ADME
must be given with full meal or carbonated drink
Which azoles can be used in pregnant patients?
NONE
Fluconazole ADME
Renal elim - dose adj necessary
Which azoles penetrate the CSF?
Fluconazole > voriconazole
Griseofulvin ADME
Cannot penetrate skin - never topical
Griseofulvin AEs
CYP inducer: Anticoags, contraceptives, cyclosporine, EtOH
Photosensitivity
C/I: preg, hepato, porphyria
Which azole has potential cross-reactivity with penicillins?
Griseofulvin (with penicillin, cephs, and carbapenems)
Terbinafine AEs
Few, get CBCs
C/I immunosuppression
Naftifine MOA
Squalene 2,3 epoxidase inhibitor somehow blocks ergosterol synthesis
Interacts with azoles
Ciclopirox ADME AE
Topical only
Hypersensitivity
Amorolfine MOA
inhibits ergosterol synthesis
Amorolfine ADME AEs
Topical only, hypersensitivity possible
