Topical anti-fungals Flashcards by RICHARD TREAT

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

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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

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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

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Indication: Tolnaftate

Superficial fungal infections

Superman paid the Toll after he ate mushrooms

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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 .

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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

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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

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Extra indication for Miconazole

inhibits the growth of common dermatophytes and the active organisms in tinea versicolor

Miconazole: My common dermatophytes vary in color

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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

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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

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Extra indication for Sertaconazole

only indicated for interdigit tinea pedis treatment

Sir, that’s my finger

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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).

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General info about topical antifungals: Poor absorption from

intact skin

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General info about topical antifungals: Small amounts absorbed are metabolized in the liver and excreted in

bile

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Ciclopirox topical nail lacquer should not be used in ___ with onychomycosis

immunocompromised or diabetic patients

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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)