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18 Cards in this Set
- Front
- Back
What is Amphotericin B?
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the most common anti-fungal which comes in several dosage forms and is not as toxic as amphotericin, but is still very toxic
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What is the mechanism of action of Amphotericin B?
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binds to ergosterol in fungal cell membrane leading to loss of membrane integrity
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What are the adverse side effects of Amphotericin B?
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notoriously nephrotoxic and causes hypersensitivity reactions so much so that pts are prophylactically treated with prenisone and/or diphenhydramine just for S.E.
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What is Echinocandins?
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anti-mycosal drug family that is newer than Amphotericin and works by attacking fungal cell wall.
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What are the Echinocandins that are used?
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1. Capsofungin - heptatotoxic and very expensive
2. Micafungin - prophylaxis of Candida 3. Anidulafungin - tx of candidemia and is least hepatotoxic |
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What are Azoles?
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systemic and topical family of anti-fungal drugs. they are hepatotoxic, inhibitors of CYP P450 3A4 causing toxicity.
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What are the Azoles that are used?
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1. Voriconazole - topical tx for aspergillosis. vision and hallucination S.E.
2. Ketoconazole - oral and topical tx 3. Flucanazole - Candida tx, NOT effective against Aspergillas. Used for vaginal candidiasis 4. Itraconazole - oral tx for nail fungus onychomycosis 5. Posaconazole - oral prophylaxis of aspirgillosis and candida |
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What mycosal infections are treated with topical anti-fungals?
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candidiasis
tinea corporis, cruris, pedis |
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What are some common antifungal drugs used to tx topical infections?
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1. Griseofulvin - given orally for topical effect of trichophyton causing ringworm
2. Nystatin - oral swish and swallow for topical candida |
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What is the best antifungal?
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1. Terbinafine - Allylamine family (cell wall target) topical tinea tx, oral onychomycosis tx, can cause hepatotoxicity
2. butenafine - azole family topical Candida and Tinea tx |
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What is the best way to apply antifungal topical ointments?
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use creams and ointments over sprays or powders, apply 1-2 inches outside of demarcated border, use for 1 to 2 weeks after healing looks like it's done
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How is nail fungus (onychomycosis) tx?
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1. terbinafine (more effective)
2. oral intraconazole Penlac is NOT effective |
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What are the three common types of lice?
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1. Phthirus pubic
2. Pediculus humanus capitis 3. Pediculus humanus corporis |
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How are lice tx?
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1. Pyrethrins - flower extract, OTC, rare allergy rx, commonly ineffective
2. Permethrin - sythetic, more effective/less allergenic 3. Malathion - insecticide, very effective, very toxic, contraindicated in infants, flammable! 4. Lindane - very toxic, not affective anymore 5. Ivermectin - vet product, NOT first line therapy, hardcore cases only 6. Benzyl Alcohol Lotion - suffocates lice |
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What is the CDC recommendation for lice tx?
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1. permethrin cream washed off after 10 minutes
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How are scabies tx?
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scabicides by rx only, Permethrin, Cromatiton, Lindane, Ivermectin
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What is the CDC recommendation for scabies tx?
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Permethrin cream (high concentration than w/ lice) to be put on entire body from neck down and be left on for 8 to 14 hours
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How are Helminth infections tx?
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Mebendazole is used for pinworms and roundworms and it is the standard of care.
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