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30 Cards in this Set

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Antifungal agents (5)
Imidazoles
Amphotericin
Griseofulvin
Flucytosine
Allylamines
Imidazoles: Drugs in this class all end in what?
-AZOLES

ALL are hepatotoxic
Fluconazole is the DOC for what?
most fungal infections;
thrush (candidiasis)
severe but non-disseminated coccidiodomycosis
cryptococcal (not meningeal)
What is the drug of choice for vaginal candidiasis?
miconazole
Alternative drug of choice for vaginal candidiasis in an HIV (+) patient?
topical nystatin

DOC: topical miconazole
What are phaeohyphomycoses ?
Rare infections caused by black molds
What is the DOC for blastomycosis, histoplasmosis, and sporotrichosis?
Itraconazole
Is Itraconazole more or less heaptotoxic than fluconazole?
MORE
List the adverse effects of Voriconazole? (3)
severe skin reactions, photosensitivity, and hepatotoxicity
What tests must be monitored continuously when using Voriconazole?
liver function tests and creatinine
DOC for aspergillosis and rare aggressive fungal species (scedosporium apiospermum)?
Voriconazole
Ketoconazole is the DOC for what?
tinea versicolor
MOA of imidazoles?
interact with the fungal P450; blocking demethylation of Ianosterol to ergosterol
Ergosterol is necessary for healthy fungal cell membranes
Does Amphotericin B cross the placenta?
YES
MOA of Amphotericin B
binds ergosterol in the fungal cell membrane; developing a pore which electrolytes will cross and results in severe electrolyte imbalances and fungal death
Which antifungal has the potential to cause renal failure, type I renal tubular acidosis, and hypokalemia?
Amphotericin B
What drug has similar action to amphotericin B but is used topically because of high systemic toxicity?
Nystatin
MOA of Griseofulvin
interacts with microtubules to disrupt mitotic spindles thereby inhibiting mitosis
Which antifungal accumulates in keratin, making skin and nails unsuitable for fungal growth?
Griseofulvin
Which antifungal acts as a nucleoside analog and inhibitts DNA synthesis?
5-flucytosine (5FC)
5-flucytosine in combo with amphotericin is another 1st line treatment of what?
cryptococcal meningitis

can cause bone marrow suppression
DOC for onychomycosis (fungal nail infections) and for tinea capitis (ringworm of the scalp)?
Terbinafine
Terbinafine inhibits what enzyme necessary for ergosterol synthesis?
squalene epoxidase
Terbinafine is contraindicated in which patients?
Those with liver disease because it can cause severe hepatitis
Drug similar to Terbinafine but used topically and therefore less toxic?
Butenafine
Butenafine is the drug of choice for all types of tinea except?
tinea capitis

DOC: terbinafine
True of False

ALL Imidazoles are hepatotoxic?
TRUE
Which antifungal is hepatotic and teratogenic; will cause a disulfiram-like reaction when alcohol is ingested and will cause a photosensitivity rash?
Griseofulvin
Which antifungal can severely damage kidneys, cause hypokalemia and anemia and may also result in hypotension and neurological effects?
Amphotericin
Are nystain and miconazole used orally or topically?
topically