PHARM ANTIFUNGALS

Question 1

MOA amorolfine

Answer 1

topical ergosterol synth. inhibitor

Question 2

MOA ciclopirox

Answer 2

Blocks fungal transmembrane transport, depleting essential substrates and interfering w/ RNA &DNA synthesis. Topical
only

Question 3

MOA azoles

Answer 3

ergosterol synthesis inhibitor

Question 4

MOA naftifine

Answer 4

squalene 2,3-epoxidase inhibitor topical

Question 5

MOA terbinafine

Answer 5

inhibits squalene 2,3-epoxidase

Question 6

what are the main adverse effects of itraconazole?

Answer 6

negative inotropic action

• heart failure
• ventricular dysfunction
• coadministration w/ drugs

also hepatotoxicity, Cat. C., distributed in breastmilk (contraindicated post partum)

Question 7

which azole has significant interpatient variability for serum levels due to gene polymorphisms?

Answer 7

voriconazole

Question 8

All 3 of these azoles cause QT prolongation and also cause hepatotoxicity?

Answer 8

Fluconazole
Posaconazole
Voriconazole

Question 9

which azole has visual disturbances?

Answer 9

voriconazole

Question 10

which azole must be administered with a full meal or acidic carbonated drink for adequate bioavailability?

Answer 10

posaconazole

Question 11

which azole is the excpetion to the rule in that it has renal elimination (instead of hepatic elimination like the others)

Answer 11

fluconazole

Question 12

which 2 azoles are good for penetration into the CSF?

Answer 12

fluconazole>voriconazole

Question 13

which 2 azoles are pregnancy cat. D?

Answer 13

fluconazole and voriconazole (same 2 that enter the CSF)

Question 14

what is a notable adverse effect of terbinafine?

Answer 14

bloody dyscrasias w/ oral drug (check CBCs)

Question 15

how is terbinafine administered?

Answer 15

topical + oral

Question 16

why don’t you combine naftifine with topical azoles?

Answer 16

they both block ergosterol synthesis