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Flashcards in Antifungal Deck (20):
1

Available as a topical cream and oral tablet. Oral form may cause diarrhea and hepatitis. Used to treat skin and nail infections very effective for onchomycosis when given orally. Less active against candida and malassezia furfur (tinea versicolor)

Terbinafine

2

Binds ergosterol in the fungal membrane and forms pores in the membrane that lead to K+ leakage and death of the fungus

Nystatin

3

Topical (cream and shampoo) and oral formulations (requires gastric acidity). Blocks androgen synthesis and causes hepatitis. It is a P450 inhibitor that can cause drug interactions (avoid H2 blockers, PPIs, and antacids)

Ketoconazole

4

MOA: Nystatin

Binds ergosterol and forms pores in the membrane

5

MOA: Ketoconazole, clotrimazole, and miconazole

Blocks ergosterol synthesis

6

Uses: Ketoconazole

Tinea skin infections

7

Uses: Amphotericin B

Broad spectrum used for systemic fungal infections

8

Uses: Nystatin

Skin infections and mucosal candida (oral and vaginal but not esophageal)

9

Uses: Terbinafine

Skin and nail infections very effective for onchomycosis when given orally. Less active against candida and malassezia furfur (tinea versicolor)

10

Binds ergosterol in the fungal membrane, forming a transmembrane channel that leads to monovalent ion (K+, Na+, H+ and Cl?) leakage, which is the primary effect leading to fungal cell death

Amphotericin B

11

Topical cream, powder, and vaginal suppository. IV form can cause anaphylaxis. Used to treat tinea skin infections and candida vaginitis

Miconazole

12

MOA: Amphotericin B

Binds ergosterol and forms channels in the membrane

13

Uses: Miconazole

Tinea skin infections and candida vaginitis

14

Topical cream, lotion, solution, lozenge, and vaginal suppository with no significant toxicities. Used to treat tinea skin infections (creams and lotions), oral thrush (lozenge) and candida vaginitis (suppository)

Clotrimazole

15

Blocks ergosterol synthesis, a constituent of fungal cell membranes. It works principally by inhibiting the enzyme cytochrome P450 14-alpha-demethylase. This enzyme participates in the sterol biosynthesis pathway that leads from lanosterol to ergosterol

Ketoconazole, clotrimazole, and miconazole

16

Uses: Clotrimazole

Tinea skin infections (creams and lotions), oral thrush (lozenge) and candida vaginitis (suppository)

17

Topical and oral suspensions (no systemic absorption from GI tract, skin, or vagina) with no significant toxicities. Used for skin infections and mucosal candida (oral and vaginal but not esophageal)

Nystatin

18

Renal toxicity: decreased GFR, increased creatinine, distal renal tubular acidosis (decreased K &Mg). lipid formulations w/ decreased renal toxicity

Amphotericin B

19

Cream, powder, aerosol powder, and topical solution. It can cause skin irritation. Used mainly for tinea cruris (jock itch) and tinea pedis (athlete's foot). Not effective against candida

Tolnaftate

20

Uses: Tolnaftate

Used mainly for tinea cruris (jock itch) and tinea pedis (athlete's foot). Not effective against candida