Tinea and Oychomycosis

Question 1

oil in water emulsion

Answer 1

cream

Question 2

most effective topical delivery system

Answer 2

ointment–> provides a barrier

Question 3

solid until becomes agitated

Answer 3

gel

Question 4

dilute cream

Answer 4

lotion

Question 5

widespread tinea in order of liklihood of clinical success

Answer 5

ORAL THEREPY: terbinafine, itra, flucon, griseofulvin

Question 6

localized tinea infection

Answer 6

TOPICAL THERAPY: Azoles, Terbinafine, Naftifine, Cicloprox

Question 7

Oral therapy for onychomycosis (bad nail fungus)

Answer 7

TGIF–> terbin, gris, itra, fluc

Question 8

Topical onchomycosis

Answer 8

ciclopirox

amorolfine

Question 9

blocks fundal transmembrane transport depleting essential substrates and interfereing with RNA and DNA synthesis

Answer 9

Ciclopirox

Question 10

targets 14alpha demethylase preventing conversion of lanosterol to ergosterol

Answer 10

azoles

Question 11

inibits conversions of squalene to squalene epoxides

Answer 11

terbinafine

Question 12

bores holes in cell wall by targetting ergosterol

Answer 12

Ampho B

Nystatin

Question 13

INihibits DNA and RNA synthesis

Answer 13

Griseofulvin

Flucytosine

Question 14

systemic toxicty with topical azoles

Answer 14

essentially absent

Question 15

FDA warns against what three things for ketoconazole

Answer 15

1. hepatotoxicity
2. adrenal insufficiency
3. D-D interactions

Question 16

Side effects of Itraconcazole

Answer 16

Negative inotropic action
-heart failure
-Ventricular dysfunction
-Co-administration with drugs
Hepatotoxicity--> failure

Question 17

need to monitor LFT’s with this azole

Answer 17

intraconcazole

Question 18

contraindicated with prior hepatotoxicity or liver dysfunction

Answer 18

itraconazole–> all azoles really FVP included

Question 19

pregnancy cat C but deformations noted

Answer 19

itraconazole

Question 20

contraindicate postpartum

Answer 20

itraconazole

Question 21

all three cause prolonged Qt, hepatotoxicity and elevated LFT’s and interaction with CYP 3A4, and are contraindicated in pregnancy

Answer 21

Flu, Posa, Vori

Question 22

viroconazole causes

Answer 22

OPTIC neuritis
photosensitivity
SCC and melanoma

Question 23

acess to BBB

Answer 23

fluconazole

Question 24

elimniation with fluconazole

Answer 24

renally (dos adjustment)…all others hepatic

Question 25

only can be given orally

Answer 25

griseofulvin

Question 26

elimination of griseofulvin

Answer 26

renal/hepatic/ perspiration

Question 27

consequences of CYP 3A4 induction

Answer 27

dec anticoag. effect of coumadin
dec contraceptive effect
dec cyclosporin levels
inc ethanol effects (tachy, diaphoresis, flushing)

Question 28

contraindications of gris.

Answer 28

TERATOGEN

pregnancy, hepatotoxic, porphyria (interferes with porphyrin metabolism)

Question 29

product of penicillium can cross-react with any of these products

Answer 29

griseofulvin

Question 30

Lamisil

Answer 30

terbinafine

Question 31

side effects pof terbenafime

Answer 31

generally easily tolerated

Question 32

what to know about terbinafine

Answer 32

routine CBC’s

avoid in immunosupressed pt

Question 33

Nafitifine kills and inibits

Answer 33

bacertia (GP and GN)

PG’s, LKT, histamine–>VASOCONSTRICTION

Question 34

DONT COMBINE WITH TOPICAL AZOLES AND WHY

Answer 34

NAFTIFINE

INhibits sterol production at an upstream point and will reduce the effectiveness of the azole drugs

Question 35

mow for amolrifine

Answer 35

inhibits ergosterol synthesis

Question 36

draw back from ciclipirox

Answer 36

hypersensitivity to drug or coformulated materials