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18 Cards in this Set

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  • Back
What is Amphotericin B?
the most common anti-fungal which comes in several dosage forms and is not as toxic as amphotericin, but is still very toxic
What is the mechanism of action of Amphotericin B?
binds to ergosterol in fungal cell membrane leading to loss of membrane integrity
What are the adverse side effects of Amphotericin B?
notoriously nephrotoxic and causes hypersensitivity reactions so much so that pts are prophylactically treated with prenisone and/or diphenhydramine just for S.E.
What is Echinocandins?
anti-mycosal drug family that is newer than Amphotericin and works by attacking fungal cell wall.
What are the Echinocandins that are used?
1. Capsofungin - heptatotoxic and very expensive
2. Micafungin - prophylaxis of Candida
3. Anidulafungin - tx of candidemia and is least hepatotoxic
What are Azoles?
systemic and topical family of anti-fungal drugs. they are hepatotoxic, inhibitors of CYP P450 3A4 causing toxicity.
What are the Azoles that are used?
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
What mycosal infections are treated with topical anti-fungals?
candidiasis
tinea corporis, cruris, pedis
What are some common antifungal drugs used to tx topical infections?
1. Griseofulvin - given orally for topical effect of trichophyton causing ringworm
2. Nystatin - oral swish and swallow for topical candida
What is the best antifungal?
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
What is the best way to apply antifungal topical ointments?
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
How is nail fungus (onychomycosis) tx?
1. terbinafine (more effective)
2. oral intraconazole

Penlac is NOT effective
What are the three common types of lice?
1. Phthirus pubic
2. Pediculus humanus capitis
3. Pediculus humanus corporis
How are lice tx?
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
What is the CDC recommendation for lice tx?
1. permethrin cream washed off after 10 minutes
How are scabies tx?
scabicides by rx only, Permethrin, Cromatiton, Lindane, Ivermectin
What is the CDC recommendation for scabies tx?
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
How are Helminth infections tx?
Mebendazole is used for pinworms and roundworms and it is the standard of care.