Topical Antifungal Agents

Question 1

Candida efficacy (based on MIC) in vitro

Answer 1

Ciclopirox = azoles > butenafine > naftifine > terbinafine

Question 2

Most of azoles have demonstrated ability to inhibit chemo tactic ability of PMN
therefore anti inflammatory effects

Answer 2

True

Question 3

In vitro anti dermatophyte potency

Answer 3

Butenafine>terbinafine>ciclopirox = naftidine > Azores

Question 4

Nystatin is effective clinically and mycologically in treatment of cutaneous and mucocutaneous mycotic infections caused by Candida albicans

Answer 4

True

Question 5

Azoles block biosynthesis of ergosterol by interfering with cytochrome P450 dependent enzyme , squalene epoxidase

Answer 5

False

14a demethylase but rest is true

Question 6

Absorption of azole compounds is increased up to 4% on inflamed or damaged skin

Answer 6

True

Question 7

Miconazole can be detected in stratum Corneum up to four days after single application

Answer 7

T

Question 8

> 1% of miconazole is absorbed systemically

Answer 8

F

Question 9

Miconazole has some activity against gram positive bacteria

Answer 9

True

Can be used to treAt erythrasma

Question 10

Miconazole is a twice daily application except in tinea versicolor when it is once daily

Answer 10

True

Question 11

Clotrimazole is used in oropharyngeal but not vaginal candidiasis

Answer 11

False

Used in both

Question 12

Ketoconazole is water soluble with broad spectrum coverage of dermatophytes and yeast

Answer 12

True

Question 13

Nystatin MoA

Answer 13

irreversible binding to cell membrane sterols causing cell leakage and permeability changes

Question 14

Nystatin is a polyene antibiotic

Answer 14

True

Question 15

Nystatin has some antibacterial activity

Answer 15

False

None

Question 16

Nystatin is soluble in water so can be used on intact skin, GI tract or vagina

Answer 16

No
Water insoluble
Not used in these sites as not absorbed

Question 17

14a demethylase catalyses conversion of ergosterol to labosterol

Answer 17

False

Labosterol to ergosterol

Question 18

Miconazole is slightly water soluble

Answer 18

T

Question 19

Miconazole has some activity against gram positive bacteria

Answer 19

T

Has been modestly effective in erythrasma (corynebacterium = gram positive rod) impetigo and ecthyma

Question 20

Clotrimazole has some activity against gram positive bacteria

Answer 20

True

Question 21

Ketoconazole 2% cream is effective in treating cutaneous candidiasis and tinea versicolor

Answer 21

T

Question 22

Fungicidal concentrations of itraconazole are found in epidermis within 5 hours of application

Answer 22

T

Question 23

Econazole is a desamino derivative of miconazole

Answer 23

False

Deschloro derivative

Question 24

Econazole 1% cream is not as effective as clotrimazole 1% cream for treatment of tinea infections and cutaneous candidiasis

Answer 24

False
Equally effective
And more realistic onset of activity in pt treated with econazole

Question 25

Econazole has some gram positive and gram negative activity

Answer 25

True

Question 26

Ciclopirox olamine affects sterol biosynthesis as its MoA

Answer 26

False Acts by interfering with active membrane transport of essential macromolecular precursors , disrupting cell memb integrity and inh enzymes essential for respiration

Question 27

Topical antifungals which do not contain propylene glycol

Answer 27

``` Miconazole Clotrimazole Econazole Sertaconazole Ciclopirox olamine Selenium sulfide ```

Question 28

Clotrimazole coverage

Answer 28

Trichophyton Epidermophyton Microsporum Candida (less than nystatin)

Question 29

Nystatin is effective in dermatophyte infection

Answer 29

F | Only candida

Question 30

Terbinafine is concentrated in sebum and hair follicles

Answer 30

T | Highly Lipophilic