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)

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2
Q

Fluconazole cautions/CIs

A
  • hard on liver - monitor hepatic function
  • QT prolongation - check EKG
  • avoid in pregnancy
  • CYP 3A4 and 2C9 inhibitor
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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)

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4
Q

Itraconazole cautions/CIs

A

BBW: avoid in patients with HF/myocardial dysfunction

  • hard on liver
  • QT prolongation
  • avoid in pregnancy
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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

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6
Q

Terbinafine cautions/CIs

A
  • arrhythmias (think QT)
  • hepatic impairment
  • avoid in pregnancy
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7
Q

Terbinafine ADRs

A

hepatotoxicity
hepatic failure
blood dyscrasias

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