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Flashcards in Antifungals Deck (38):
1

Systemic mycoses

Histoplasmosis, aspergillosis, coccidiomysosis, blastomycosis, cryptococcosis, and sporotrichosis

2

Topical antifungals include:

Local antifungals EXCEPT griseofulvin

3

Systemic antifungals include:

Systemic antifungals PLUS Griseofulvin

4

List the Broad-Spectrum topical antifungals:

Azoles
Polyenes
Haloprogin
Cuprimyxin
Ciclopirox olamine

5

List the Narrow spectrum topical antifungals:

Tolfanate
Terbinafine

6

Other topical antifungals that do not fall under a 'spectrum;

Iodides (tissue damage at high conc)
Lime sulfer
Thymol
Hexachlorphene (stains skin)

7

Which 'azole' was originally an antihelmenthic?

Thiabendazole

8

Which 'azole' is often made into an antifungal medicated shampoo?

Miconazole

9

List the systemically administered antifungal drugs.

Griseofulvin
Amphotericin B
Flucytosine
Azoles
Allylamines
Lufenuron

10

Fungi cell membrane is made out of what

Ergesterol

11

What is the synthesis pathway of ergosterol?

Squalene (+Squalene epoxidase)
--> Squalene epoxide
--> Lanosterol (+14alphaDimethylase)
--> Ergosterol

12

What drug blocks Squalene epoxidase?

Terbinafine (allylamines)

**Fungicidal

13

What drug blocks 14 alpha dimethylase?

'Azoles'

**fungistatic

14

What is the mechanism of action for Amphotericin B/Polyenes?

binding irreversibly to ergosterol

**fungicidal

15

What is flucytosine mechanism of action?

inhibiting thymidylate synthase (like anticancer?)

**fungicidal

16

What is the mechanism of action of Griseofulvin?

Inhibiting mitosis
**fungistatic

17

What is the mechanism of action of Lufenuron?

inhibiting chitin

18

What is Griseofulvin used for?

Oral treatment of dermatophytes (deposits in keratin)

19

Contraindications/Adverse effect of Griseofulvin?

Enzyme inducer (drug-drug), GI irritation, idisyncratic liver dysfunction AND bone marrow suppresion in cats

20

What is the most dangerous side effect of Amphotericin B?

NEPHROTOXIC

21

What is Amphotericin used for?

Most effective drug for systemic mycosis in immuno-compromised animals (combined with azoles)

*Also can be used topically for candida

22

How can you make Amphotericin B less nephrotoxic

use the liposomal encapsulate preparation as it is less toxic

23

What is flucytosine used for?

Used to be used for cryptococcal meningitis with Amphotericin B (penetrates CNS while AmpB doesnt)

24

Why do you need to give food before administering ketoconazole?

requires an acidic pH

25

Contraindications effects of ketoconazole?

- Inhibits 14 alpha Dimethylase in the fungi as well as the liver and adrenal cortex (not good)

26

What does ketoconazole work on?

broad spectrum!
Local: dermatophytes, candida, and malassezia
Systemic: Blastomycosis, Histoplasmosis (in immunocompetant)

27

Adverse effects of ketoconazole?

inappetance, pruritis/alopecia, inhibited cortisol and testosterone synthesis, and teratogenic (DONT GIVE TO PREGNANT ANIMALS)

*cats are more sensitive

28

What is Itraconazole the dug of choice for? (three things)

Systemic mycoses (Blastomycosis/Histoplasmosis), ASPERGILLOSIS, and SPOROTRICHOSIS

29

Why is itraconazole better than ketoconazole?

Does not inhibit cortisol or testosterone synthesis at therapeutic doses

30

Can you give ketoconazole or itraconazole to pregnant animals?

Hell nah

31

What is the drug of choice for treating cryptococcal meningitis?

Fluconazole

32

What is Terbinafine used for?

topical against dermatophytosis

33

What enzyme can Terbinafine elevate in cats?

ALT

34

What is Lufenuron used for?

Oral tx of dermatophytosis

*can also treat ectoparasites as they also have chitin

35

Drug of choice for Aspergillus Keratitis in a horse?

Clotrimazole

36

Drug of choice for Canine nasal aspergillosis?

Clotrimazole or Enilconazole

37

Drug of choice for systemic aspergillosis?

Itraconazole

38

Local fungal infections

Dermatophytes - ringworm (trichohyton/microsporum) and Candida