Topical anti-fungals Flashcards
Class/Indication: Terbinafine
Allylamine/benzylamine
Tinea capitis, Tinea pedis, Tinea corporis, dermatophytes
less activity against Candida
Terbinafine: Terb is in a fight with Tamaya and Darren, he’s fine with Cynthia but not great. The B in his name is for benzy
Class/Indication: Clotrimazole, ketoconazole, miconazole, econazole, sertaconazole, oxiconazole, sulconazole
Imidazole
Dermatophytes and yeasts
Azoles: Go to the Azores where you can tan your dermis and eat yeasty bread
Class/Indication: Nystatin
Polyene
Antifungal, candida, not effective against dermatophytes
Nystatin: Nastya dances on the Pole, she Avoided Fungus Candy but not the darn dermatophytes
Indication: Tolnaftate
Superficial fungal infections
Superman paid the Toll after he ate mushrooms
Class/Indication: Naftifine
Allylamine/benzylamine
Tinea capitis, Tinea pedis, Tinea corporis
Good for Candida
Naftifine: Naft took a raft to Ally’s house, they drank Chamomile Tea because she’s so boring .
Class/Indication: Butenafine
Allylamine/benzylamine
Tinea capitis, Tinea pedis, Tinea corporis
less active against Candida
Ally and Ben took a train to Butan, they found a Tin boat but couldnt paddle to Canada
Extra indication for Clotrimazole
is active against a wide variety of fungi, yeasts and dermatophytes
Clotrimazole: Chloe cooks with lots of mushrooms, and dont phy-get the yeast
Extra indication for Miconazole
inhibits the growth of common dermatophytes and the active organisms in tinea versicolor
Miconazole: My common dermatophytes vary in color
Extra indication for Ketoconazole
is broad-spectrum and has activity against dermatophytes and some yeast organisms
may cause allergic type reactions ranging from asthmatic episodes to anaphylactic symptoms
Ketoconazole: Keto diet helps shed those derms and yeasts, but it can make you sort of sick
Extra indication for Econazole and oxiconazole
is broad-spectrum and has activity against dermatophytes and some yeast organisms
For a good Economy you need a broad portfolio and a lot of phyte, and yeast need oxygen to rise
Extra indication for Sertaconazole
only indicated for interdigit tinea pedis treatment
Sir, that’s my finger
Indication for Ciclopirox olamine
Tinea
Good for Candida
Comes as nail lacquer to kill onychomycosis
Cyclone: Its a tinea twister, Dorothy painted her nails after she killed Ony and Can (John).
General info about topical antifungals: Poor absorption from
intact skin
General info about topical antifungals: Small amounts absorbed are metabolized in the liver and excreted in
bile
Ciclopirox topical nail lacquer should not be used in ___ with onychomycosis
immunocompromised or diabetic patients
Drug Interactions: Clotrimazole intravaginal
May inactivate spermicides
Drug Interactions: Corticosteroids + econazole
equal concentrations cause inhibition of antifungals
Azoles: miconazole and clotrimazole frequency
BID
Nystatin cream, ointment or powder frequency
2-3 times daily
Thrush- treatment should last
48 hrs post symptom resolution
Thrush treatment: Nystatin swish and swallow frequency
QID
Thrush treatment: Clotrimazole troches frequency
five times daily x 14 days
Cutaneous Candida infections: If nystatin, miconazole, and clotrimazole dont work, try
Other azoles
Oral fluconazole
T. Capitis- ringworm of the scalp. Treatment
Griseofulvin PO and twice weekly shampooing with sporicidal shampoo; selenium sulfide or ketoconazole
____ must be taken with a high fat meal to increase absorption
Griseofulvin
How do you take Griseofulvin
Griseofulvin must be taken with a high fat meal to increase absorption
T. Capitis- ringworm of the scalp is treated with Griseofulvin for how long
2 to 4 months
T. Capitis- ringworm of the scalp: If Griseofulvin does not work use PO t____, f____, i____
PO terbinafine, fluconazole and itraconazole
What is T. Corporis
superficial ringworm fungal infection of the skin
What is T. Cruris
jock itch;superficial fungal infection of the groin, upper thighs and intertriginous folds
Jocks on the crew team get it
T. Cruris- jock itch: treatment:
topical antifungal cream- miconazole, tolnaftate, or clotrimazole
If your balls itch, Maybe Tonight Clean down there
what is T. Pedis
athletes foot
pedis=foot
T. Pedis treatment
topical antifungal cream- miconazole, tolnaftate, or clotrimazole for 4 weeks
If your feet itch, Maybe Think about Cleaning them
what is T. Versicolor
superficial fungal infection of the skin caused by yeasts.
T. Versicolor treatment
Topical selenium sulfide shampoo or topical antifungal x 1 week
Topical azoles: miconazole, clotrimazole, and econazole x 2-4 weeks
what is T. Unguium aka Onychomycosis
fungal infection of the nail
T. Unguium aka Onychomycosis 1st line treatment
Itraconazole , terbinafine
IT doesn’t make sense
T. Unguium aka Onychomycosis 2nd line treatment
griseofulvin- monitor renal, liver, and CBC
Griselle went number 2, everyone threw up their kidney beans, liver pie, and blood pie
T. Unguium aka Onychomycosis alternative treatment if 2nd line doesn’t work
ciclopirox nail lacquer (Indicated in superficial white onychomycosis with less than 50% of the nail surface affected, when four or less nails are infected)
