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Pharm 840 Exam Number One > Superficial Fungal Infections (Perez) > Flashcards

Superficial Fungal Infections (Perez) Flashcards

1
Q

Vulvovaginal candidiasis (VVC) most common pathogen

A

-Candida albicans

80-90%

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2
Q

VVC Risk Factors

A
  • Sexual factors
  • Contraceptive agents
  • Host factors (Pregnancy or diabetes)
  • Medications (abx or SGL2 inhibitors)
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3
Q

If VVC is asymptomatic do you treat?

A

-No ya dingus!

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4
Q

Definition of Uncomplicated VVC

A
  • Mild/mod signs/symptoms
  • Infrequent (< 3 episodes /year)
  • Immunocompetent
  • NOT pregnant
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5
Q

Treatment of uncomplicated VVC

A

-Usually an Azole

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6
Q

Definition of Complicated VVC

A
  • Immunocrompromised
  • Pts with uncontrolled diabetes
  • Pregnant patients
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7
Q

How to treat complicated VVC

A

-Azole antifungals

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8
Q

Recurrent VVC definition and treatment

A
  • > /= 4 episodes with in 12 months

- Treatment: put a maintenance Azole antifungal on board

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9
Q

Which fungi in VVC is most likely to have antifungal resistance

A
  • Candida glabrata
    1) higher prevalence in pts with diabetes
    2) higher cure rates when boric acid vaginal suppositories are used
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10
Q

Fluconazole

A
  • Convenient
  • Long half life (30hrs)
  • Renally eliminated
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11
Q

Boric Acid Supp.

A
  • OTC products available
  • Administer vaginally only
  • Oral administration is TOXIC
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12
Q

Non-pharm recommendations for VVC

A 
Avoid: 
-Harsh soaps
-Constrictive clothing
-Don't use a douche 
Do this:
-Keep area clean and dry
-Cool baths to soothe skin
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13
Q

Treatment of Uncomplicated VVC

A
  • Clotrimazole (Gyne-Lotrimin)
  • Miconazole (Monistat)
  • Tioconazole (Vagistat)
  • Terconazole
  • Butoconazole (Gynazole)
  • Fluconazole (diflucan)
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14
Q

Treatment of Complicated VVC in pts with DM or immunocompromised

A
  • Oral fluconazole (Q72hrs for 2 to 3 doses)

- Topical azole antifungal (7-14 days)

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15
Q

Treatment of complicated VVC in pregnant pts

A
  • Topical clotrimazole
  • Topical Miconazole
  • Both have 7 day LOT
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16
Q

Treatment of recurrent VVC

A

1) Introduction
-Oral fluconazole
or
-Topical Azole antifungal
2) Maintenance
-Fluconazole 150mg weekly for 6mo

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17
Q

Treatment of Antifungal resistant VVC

A
  • Boric acid supp.
  • 1 supp. daily for 14 days
  • Followed by 1 supp twice weekly
18
Q

What is the most common pathogen in Oropharyngeal candidiasis (OPC)

A

-Candida albicans

19
Q

What are the most common opportunistic infections in HIV/AIDS

A
  • Oropharyngeal Candidiasis (OPC)

- Esophageal Candidiasis (EPC)

20
Q

Risk factors for OPC/EPC

A
  • Local
  • Systemic
  • Diabetes
  • Nutritional deficiencies
21
Q

Clinical Pearls for Clotrimazole troches

A
  • Doesn’t work well in people with dry mouth
  • Contains dextrose
  • Can cause tooth decay
22
Q

Clinical Pearls for Miconazole buccal tablets

A
  • Once daily admin (Dope)
  • Sugar free
  • Difficult to keep in place (bad)
  • Currently brand only (expensive?)
23
Q

Nystatin Suspension Clinical pearls

A
  • Unpleasant taste
  • High sucrose content
  • Tooth decay
  • Caution in pts with diabetes
24
Q

Itraconazole solution clinical pearls

A
  • Swish and swallow
  • Take on empty stomach
  • More expensive than fluconazole
25
Q

Posaconazole (Noxafil)

A
  • Shake before use (suspension)
  • Take with meal
  • No generic currently
  • More expensive than fluconazole
26
Q

Voriconazole tablets

A
  • Take on empty stomach
  • Visual disturbances/hallucinations
  • More expensive than fluconazole
27
Q

IV Echinocandins (Micafungin, caspofungin, anidulafungin)

A
  • Fever, headache
  • Infusion related reactions
  • Liver damage
28
Q

IV amphotericin B Deoxycholate

A
  • Fevers, chills
  • Nephrotoxicity
  • Electrolyte disturbances
  • Bone marrow suppression
29
Q

Duration of therapy for OPC

A

-7 to 14 days

30
Q

Initial treatment for mild OPC

A

1) Clotrimazole
2) Miconazole
3) Nystatin

31
Q

Initial treatment for moderate to sever OPC

A

1) Fluconazole
2) Itraconazole
3) Posaconazole
4) Voriconazole

32
Q

Duration of therapy for ECP

A

-14 to 21 days

33
Q

Initial treatment for ECP

A
  • Fluconazole
  • Micafungin
  • Capsofungin
  • Anidulafungin
34
Q

Treatment of recurrent ECP

A

-Fluconazole

35
Q

Most common pathogens in Dermatophyte infetions

A
  • Trichophyton
  • Microsporum
  • Epidermophyton
  • Malassezia (Tinea versicolor)
36
Q

Risk factors for Dermatophyte infections

A
  • prolonged exposure to sweat or water
  • maceration
  • intertiginous folds
  • sharing personal belongings
  • close living quarters
37
Q

Tinea Corporis (ringworm)

A
  • More common in children
  • Treat with topical antifungal
  • Nonpharm: don’t share towels, wash sheets and towels, change clothes ofter
38
Q

Tinea Cruris (Jock itch)

A
  • More common in males
  • Topical treatment is usually sufficient
  • Nonpharm: keep dry an avoid long exposure to moisture
39
Q

Tinea Versicolor

A
  • Topical treatment is usually adequate unless there is
    1) extensive involvement
    2) recurrent infections
    3) topical therapy has failed
40
Q

Tinea Pedis

A
  • Topical treatment should suffice

- Nonpharm: disinfect footwear, avoid walking bear foot in public places, wear absorbent socks

41
Q

Tinea Unguium (Onychomycosis-nails_

A
  • first line treatment = Terbinafine

- systemic drug works better than topical in this case

Pharm 840 Exam Number One (5 decks)

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