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Pharm 1 > Anti-fungals > Flashcards

Anti-fungals Flashcards

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1
Q

how do azoles affect the metabolism of statins and CCBs?

A

they are substrates and dramatically increase serum levels of statins and CCBs (resulting in bradycardia and hypotension)

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2
Q

fungal infx in groin area including scrotum: tinea cruris or candida?

A

candida

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3
Q

groin fungal infx with satellite papules or pustules that extend beyond redness: tinea cruris or candida?

A

candida

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4
Q

what class: Ketoconazole (topical)
Miconazole
Clotrimazole

A

imidazoles

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5
Q

what class: Fluconazole (Diflucan®)
Itraconazole (Sporanox®)
Voriconazole (Vfend®)
Posaconazole (Noxafil®)

A

triazoles

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6
Q

which triazole has good CNS penetration?

A

Fluconazole (Diflucan®)

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7
Q

what class: Terbinafine (Lamisil®)

A

allyalamine

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8
Q

what class: Caspofungin (Cancidas), Micafungin (Mycamine), Anidulafungin (Eraxis)

A

echinocandins

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9
Q

imidazoles contraindications

A

no systemic azoles in pregnancy (esp 1st trimester). Liver disease

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10
Q

azoles adverses effects

A

GI upset, rash, photosensitivity, hepatoxicity

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11
Q

fluconazole is mainly for what?

A

candida

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12
Q

AE of long term triazole use

A

peripheral neuropathy

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13
Q

monitor what for all triazoles?

A

LFTs, serum drug concentration/theraputic drug monitoring

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14
Q

Itraconazole (Sporanox®)

contraindication

A

ventricular dysfunction, CHF

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15
Q

which azole treats endemic mycoses?

A

Itraconazole (Sporanox®)

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16
Q

Treatment of choice for Aspergillosis and Environmental molds(black mold).

A

Voriconazole (Vfend®)

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17
Q

SE: Rash, Hepatic enzymes, Visual disturbances (IV), Photosensitivity (oral) that is severe and can lead to skin cancers

A

Voriconazole (Vfend®)

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18
Q

what antifungal can lead to cardiomyopathy w/ long term use?

A

Itraconazole (Sporanox®)

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19
Q

least drug interactions and largest Therapeutic Index of all azoles

A

Fluconazole (Diflucan®)

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20
Q

Broadest spectrum Azole:

A

Posaconazole (Noxafil®)

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21
Q

OTC 1st line for athlete’s foot

A

Terbinafine (Lamisil®)

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22
Q

most effective Onychomycosis treatment

A

Terbinafine (Lamisil®)

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23
Q

contraindication for terbinafine

A

Avoid in hepatic and renal impairment

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24
Q

monitor what for terbinafine?

Study These Flashcards
A

LFTs before initiation and monthly

25
pt counseling for terbinafine topical
put on 1 inch of surrounding skin and continue for 1 wk after resolution.
26
how must amphotericin B be given?
central line IV
27
Mainstay of treatment of patients with severe endemic fungal infection.
amphotericin B
28
Broadest spectrum of all antifungals
amphotericin B
29
main SE of amphotericin B
Nephrotoxicity (preceded by hypokalemia and hypomagnesemia)
30
monitoring for amphotericin B
Monitor serum electrolytes and renal function carefully. amphoTERRIBLE for kidneys
31
nystatin treats
candida
32
Vaginal candidiasis OTC
clotrimazole, miconazole
33
Vaginal candidiasis Rx topical
butoconazole, terconazole
34
vaginal candidiasis Rx PO
fluconazole
35
first-line treatment for recurrent VVC
oral fluconazole 100-, 150-, or 200-mg weekly for 6 months
36
oral fluconazole stays in vaginal secretions for __ hrs
72
37
preferred treatment for pregnant vaginal candidiasis
clotrimazole
38
1st line for Oropharyngeal Candidiasis
topical clotrimazole, miconazole, nystatin
39
1st line for esophageal candidasis
PO fluconazole
40
causes of oraal candidasis
from broad-spectrum antibiotic use, tissue damage (due to chemotherapy, catheter tubing, trauma, or smoking), hyposalivation (anti-cholinergics), or immune deficiency
41
most common opportunitis infx in pts w/ HIV
oropharyngeal candidiasis
42
most common acquired immunodeficiency syndrome (AIDS)–defining disease
Esophageal candidiasis
43
counseling for Oropharyngeal & Esophageal Candidiasis
counseling: Medication should provide relief in 2-3 days and resolution at 7-10 days
44
1st line for tinea capitis
oral Griseofulvin for 6-8 weeks OR terbinafine
45
contras for Griseofulvin
hepatic failure or pregnancy
46
counseling for oral Griseofulvin
Take with a  fatty meal to decrease upset stomach and increase absorption
47
onychomycosis treatmetn
PO Itraconazole (BID for 1 week/month OR daily x 12 weeks) OR terbinafine (daily x 12 weeks)
48
treatment for Candida intertrigo
nystatin powder
49
treatment for Non-candida intertrigo
Topical azole antifungal cream (eg, ketoconazole, clotrimazole, miconazole, econazole)
50
treatment for Diaper rash secondary fungal infx
Topical Nystatin, Clotrimazole (Lotrimin), Miconazole. Greer's Goo (nystatin cream, Zinc oxide paste, hydrocortisone cream 1%)
51
treatment for endemic mycoses
"Mild: intraconazole | Severe: amphotericin B"
52
treatments for PJP
Bactrim, dapsone
53
most common opportunistic fungal pathogens encountered in hospitals
candida
54
does an asymptomatic urinary candidiasis req treatment
no
55
main treatment for candida
fluconazole
56
Aspergillosis treatment
voriconazole IV or PO; isavuconazole
57
what dz is fatal unless caught early?
Aspergillosis
58
"Cryptococcus neoformans treatment
6-12 months of PO/IV fluconazole if it does not resolve on its own If meningitis: Amphotericin B followed by 10 weeks of oral fluconazole "

Pharm 1 (17 decks)

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