Week 10: Systemic Azoles Flashcards
1
Q
Fluconazole MOA/indications
A
- interferes with fungal CYP 450 activity
- inhibits cell membrane formation
- broad spectrum
Indications: candidiasis (vaginal, oropharyngeal, esophageal)
2
Q
Fluconazole cautions/CIs
A
- hard on liver - monitor hepatic function
- QT prolongation - check EKG
- avoid in pregnancy
- CYP 3A4 and 2C9 inhibitor
3
Q
Itraconazole MOA/indications
A
- interferes with fungal CYPE 450 activity
- inhibits cell membrane formation
- broad spectrum systemic treatment
Indications: onychomycosis (fungal infection of nail bed)
4
Q
Itraconazole cautions/CIs
A
BBW: avoid in patients with HF/myocardial dysfunction
- hard on liver
- QT prolongation
- avoid in pregnancy
5
Q
Terbinafine/Ciclopirox (topical) MOA/indications
A
- inhibits squalene eposidase enzyme, a key enzyme in sterol biosynthesis in fungi
- results in fungal cell death
- metabolized by CYP450
Indication: onychomycosis (1st line)
- off label: extensive tinea fungal infection
6
Q
Terbinafine cautions/CIs
A
- arrhythmias (think QT)
- hepatic impairment
- avoid in pregnancy
7
Q
Terbinafine ADRs
A
hepatotoxicity
hepatic failure
blood dyscrasias