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Antifungal Flashcards

(64 cards)

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1
Q

Three forms of fungal infections

A

Superficial, subcutaneous, systemic

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2
Q

Griseofulvin- source

A

Penicillin

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3
Q

Griseofulvin method-

A

Fungistatic

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4
Q

Griseofulvin- effective against

A

Dermatophytosis- Microsporum, epidermophyton, trichophyton- no effect on others!

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5
Q

Most common fungal disease in cats

A

Dermatophytosis

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6
Q

Griseofulvin- mechanism

A

Active on growing cells, binds to intracellular microtubules to inhibit mitosis, nucleic acid and protein synthesis, chitin synthesis

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7
Q

Griseofulvin- how does it reach skin

A

In sweat, incorporated in keratin loosely- undetectable in skin 2-3 days

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8
Q

Griseofulvin- time to reach skin after admin’n

A

4-8 hours

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9
Q

Griseofulvin- absorption dependent on

A

Formulation (microsize or ultramicrosize particles in polyethylene glycol) and food (increase absorption with fatty meal)

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10
Q

Griseofulvin- metabolism

A

Oxidation by hepatic enzyme; 6 times faster than in people

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11
Q

Griseofulvin- duration of tx

A

min 4 weeks, sometimes over 3 months

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12
Q

Griseofulvin- interactions

A

phenobarb decreases absorption

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13
Q

Griseofulvin- adverse

A

Bad taste- nausea, V, D; bone marrow suppression in cats with FIV or persians/himalayans/siamese/abyss - CBC q 2 weeks

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14
Q

Griseofulvin- Contraindications

A

HIGHLY teratogenic- DO NOT GIVE TO PREGNANT ANIMALS - brain and skeletal malformations, eye issues, absence of nostrils, soft palate

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15
Q

Amphotericin B- method

A

static or cidal depending on dose; Punches holes in cell membrane by binding to sterols (fungal and mammalian = not specific)- leakage until death

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16
Q

Amphotericin B- uses

A

Cryptococcosis, blasto, histoplasmosis, coccidiomycosis - only in serious cases due to possible toxicity due to lack of sterol specificity (Think ampho blasto histo, cocco)

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17
Q

Amphotericin B- route

A

IV only- no oral absorption

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18
Q

Amphotericin B- cautions

A

Dehydration increases toxicity so administer in 5% dextrose after saline diuresis; max cumulative dose before danger

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19
Q

Amphotericin B- metabolism

A

KIDNEY- high protein binding, 24 hour half life

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20
Q

Amphotericin B- limit

A

4-8 mg/kg (higher if done subcutaneous)

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21
Q

Amphotericin B-best formulations

A

liposomal- better brain penetration and longer half life leads to less dose needed

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22
Q

Amphotericin B- side effects

A

Thrombophlebitis, nephrotixicity (vasoconstriction and renal tubule toxicity), hypokalemia, resistance over time

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23
Q

Ketoconazole- method

A

static/cidal

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24
Q

Ketoconazole- mechanism

A

Inhibit lanosterol 12-demethylase; suppresses p450!!!!!

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25
All azoles do what?
Interfere with p450- ex. cyclosporin dose lowered when on azole
26
Ketoconazole- cautions-
inhibits p450; affinity but not 100% specificity for fungal vs mammalian
27
Ketoconazole- uses
Broad - systemic, dematophytosis, malassezia,
28
Ketoconazole- administration
Oral with acidic environment (with food!)
29
Ketoconazole- metabolize
LIVER, halflife 2 hours, peak level in 2 hours, lipophilic
30
Ketoconazole- speed of action
5-10 days
31
Itraconazole- specificity
more affinity for fungal enzyme
32
Itraconazole- effective against
Broad spectrum
33
Itraconazole- metabolism
LIVER, high skin and fat concentration (lipo and ketratophilic), poor CSF and eye penetration
34
Itraconazole- half life
8-12 hours dogs, 40-120 hours in cats; stays in nails for 6 months
35
Itraconazole- administration
Oral with food
36
Itraconazole- side effects
Better in cats than ketocon
37
Fluconazole- effective against
Broad spectrum
38
Safest most specific azole
Fluconazole
39
Fluconazole- metabolism
No liver, long half life, good absorption, excellent brain penetration
40
Fluconazole- administration
oral, lasts 10 days after administration
41
Fluconazole- side effects
ok for cats, safe for liver
42
What drug is best for patients with immune compromise
Vfend- voriconazole
43
What drug is best for aspergillus
Vfend- voriconazole
44
Vfend- voriconazole- metabolism
LIVER - p450 suppression
45
Which azoles are safe in cats
itraconazole and fluconazole (think FIC)
46
Which antifungals are metabolized by the liver
most azoles- (Itraconazole, ketoconazole, vfend- not fluconazole) and griseofulvin
47
Which antifungal is metabolized by the kidney
amphotericin b
48
Which azole does not get metabolized by the liver
Fluconazole
49
Terbinafine (lamisil) - mechanism
Inhibition of ergosterol synthesis via squalene epoixdase- HIGHLY fungal specific
50
Terbinafine (lamisil) - uses
Dermatophytosis, malassezia
51
Iodides- uses
Sporotrichosis in horses
52
Iodides- Side effects
GI (give with food), twitching, hypothermia, alopecia/scaling
53
Caspofungin- uses
Aspergillus, candida, **oomyces (think O-fungin)
54
Caspofungin- administration
IV
55
Ketoconazole shampoo- uses
dermatophytes, malassezia
56
Chlorhexadine- uses
Limited antifungal topical, can be irritating
57
Miconazole- uses
Topical for Malassezia dermatitis, yeast otitis
58
Chlortrimazole- uses
topical for yeasts and dermatophytes
59
Enizconazle- uses
Dermatophytes, malassezia, aspergillus
60
Selenium disulfide (selsun)- uses
Malassezia
61
Selenium disulfide (selsun)- contraindications
cats, can be drying
62
Lyme sulfur- uses
VERY effective against dermatophytosis
63
Thiabendazole (tresaderm) - type
Antihelmintic imidazole
64
Thiabendazole (tresaderm) - uses
Malassezia otitis, ear mites

Pharm 3 (8 decks)

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