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Antifungal Agents
Pharmacology Module 2
23
Medical
Graduate
06/16/2009

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Term
To which classification of mycoses do the following belong: dermatophytes (tinea, ringworm, onychomycoses) and candidiasis (vulvovaginal, oral, esophageal)?
Definition
superficial mycoses
Term
To which classification of mycoses do the following belong: candidiasis, aspergillosis, blastomycosis, histoplasmosis, coccidiomycosis?
Definition
systemic mycosis (mostly opportunistic)
Term
What are 3 classes of mycoses?
Definition
superficial, subcutaneous, systemic mycoses
Term
Which are usually more toxic: antifungal drugs or Abx?
Definition
difficult to design drugs selectively toxic to fungi but not human cells- antifungals more toxic.
Term
What are 5 antifungal classifications?
Definition
azoles, allylamines, polyenes, echinocandins, misc.
Term
To which antifungal class do the following belong: topical: clotrimazole, miconazole. systemic: ketoconazole, fluconazole, itraconazole, voraconazole?
Definition
azoles- most common
Term
To which antifungal class does the following belong: terbinafine (lamisil)?
Definition
allylamines
Term
To which antifungal class do the following belong: amphotericin B, nystatin?
Definition
polyenes
Term
To which antifungal class do the following belong: caspofungin, micafungin?
Definition
echinocandins
Term
To which antifungal class do the following belong: griseofulvin, flucytosine?
Definition
misc.
Term
What do the following medications tx: creams, lotions, powders, sprays. clotrimazole (lotrimin AF)- otc. miconazole (desenex)- otc. econazole (spectazole), oxiconazole (oxistat), sertaconazole (ertaczo)- rx?
Definition
tx: tinea infections (foot, groin)
Term
What do the following medications tx: specially formulated creams, tablets, and suppositories. otc- clotrimazole, miconazole. rx- econazole, terconazole?
Definition
tx: vulvovaginal candidiasis (candida albicans)
Term
What are the drug interactions of ketoconazole (nizoral)?
Definition
potent inhibitor of CYP 3A4 enzyme
Term
What is the most common rx azole for Candida infections? Is it rx for prevention or tx?
Definition
systemic azole: fluconazole (diflucan)- for prevention and tx
Term
What are the drug interactions of Fluconazole (diflucan)?
Definition
potent inhibitor of CYP 2C9
Term
What are the drug interactions of Itraconazole (Sproanox)?
Definition
potent inhibitor of CYP 3A4 enzyme
Term
What are the ADRs of voriconazole (vfend)?
Definition
adr: transient vision disturbances (30%)
Term
What are the drug interactions of Voriconazole?
Definition
metabolized by, and is an *inhibitor* of, cyp 2c19
Term
What are the drug interactions of phenytoin- a common convulsant?
Definition
metabolized by, and is an inducer of, cyp 2c19
Term
What is an older polyene antifungal used in OTC topical creams and ointments that can sometimes be given as oral suspension for oral thrush?
Definition
nystatin
Term
What is an older oral antifungal for dermatophyte infections? It involves poor tolerance due to allergic rxns, photosensitivity, gi distress and neurologic effects?
Definition
griseofulvin
Term
How must griseofulvin be taken for best absorption?
Definition
high fat meal for best absorption
Term
What is an antifungal agent given in IV form for severe systemic infections w/amphotericin B that is converted to 5-fluorouracil intracellularly: very toxic?
Definition
Flucytosine
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