Term
| How much of the US population do superficial fungal infections affect? |
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Definition
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Term
| Name the 6 most common superficial fungal infections. |
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Definition
Foot - tinea pedis
Body - tinea corporis
Groin - tinea cruris
Scalp - tinea capitis
Trunk - tinea versicolor
Nails - tinea unguium |
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Term
| What are 4 common deramtophytes? |
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Definition
| Candida, epidermophyton, tricophyton, microsporum |
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Term
| What is the common name for tinea pedis? |
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Definition
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Term
| Which will you see more of as a pharmacist, acute or chronic tinea pedis? |
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Definition
| Chronic. Patient won't come see you if it goes away on its own. |
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Term
| Where can tinea corporis occur? What does it look like? |
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Definition
| It can occur anywhere and it looks like a rash with a clearing in the middle, possibly some pustules on the edge. |
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Term
| What is the common name for tinea cruris? Where does it occur? What does it look like? |
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Definition
"Jock itch"
On the groin, can spread to thighs and genitals.
Circular in appearance. |
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Term
| What are the two types of tinea capitis? |
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Definition
| Black dot and gray patch. |
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Term
| Which form of tinea capitis is more common? What people exhibit it more? What is the other kind more like? |
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Definition
Black dot is more common, and it is more likely seen on children in the US.
Gray patch is more of a scaling. |
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Term
| Where is the infection located in tinea unguium? What direction does the infection radiate? |
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Definition
Infection in nail bed.
Moves from end to cuticle. |
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Term
| What is another name for tinea unguium? |
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Definition
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Term
| Name the 4 main topical antifungals. |
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Definition
Azoles
Benzylamine
Allylamine
Hydroxypyridone |
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Term
| Name 4 imidazoles with their matching generic/technical name. |
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Definition
Lotramin, clotrimazole
Spectazole, ecanazole
Nizoral, ketoconazole
Desenex, miconazole |
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Term
| Name 1 triazole and its matching generic/technical name. |
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Definition
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Term
| What is the MOA of an azole antifungal? |
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Definition
| Reduce ergosterol production by inhibiting fungal P450 enzymes. It has a broad spectrum including some gram positive bacteria. |
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Term
| Azoles that are taken orally could result in elevated LFTs. What are LFTs? |
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Definition
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Term
| What azole is most likely to result in HA (hepatic abnormalities)? |
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Definition
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Term
| What side effect does only ketoconazole produce? |
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Definition
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Term
| Which three azoles inhibit P450 enzyme 3A4 when used orally? Which one also inhibits 2C19? |
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Definition
Ketoconazole, Intraconazole, Fluconazole
Fluconazole also inhibits 2C19 |
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Term
| What are the 3 contraindications to oral ketoconazole? |
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Definition
| pregnancy category c, lactation, achlorhydria or hypochlorhydria |
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Term
| What are the 2 available benzylamine antifungal agents? |
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Definition
| Lotramin Ultra Cream or Mentax, butenafine |
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Term
| What is the MOA of Benzylamine antifungals? |
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Definition
| Causes fungal cell death by inhibiting squalene epoxidase. |
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Term
| What is the only "tinea" that azoles cannot treat? |
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Definition
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Term
| What 4 things can benzylamine antifungals treat? |
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Definition
| Tinea corpis, cruris, versicolor and interdigitale pedis |
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Term
| What are the contraindications of benzylamine antifungals? |
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Definition
| Not approved for use on children under 12 years old. |
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Term
| What Allylamine antifungal agents are available? |
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Definition
Naftin, naftifine
Lamisil AT, Desenex Max, terbinafine |
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Term
| What are the the allylamine antifungal MOAs? |
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Definition
Causes fungal cell death by inhibiting squalene epozidase.
Naftifine may have anti-inflammatory effects. |
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Term
| What hydroxypyridone antifungal agents are available? |
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Definition
| Loprox, Loprox TX, Penlac, ciclopirox |
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Term
| What is the MOA of hydroxypyridone antifungals? |
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Definition
Causes cell death by blocking the intake of necessary substrates such as potassium ions.
Broad spectrum including yeast and some bacteria. |
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Term
| What two "tineas" can hydroxypyridone NOT treat? |
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Definition
| Tinea capitis and tinea unguium |
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Term
| What are the possible side effects of hydroxypyridone? |
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Definition
| Rash, erythermia, nail discoloration (nail lacquer only), pruritis, burning, worsening of sx |
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Term
| What are the contraindications of hydroxypyridone? |
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Definition
| Do not use on children less than 10 years of age. |
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Term
| Name four other antifungal agents available? |
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Definition
| Tinactin, Asorbine, Aftate, tolnaftate |
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Term
| What are the side effects and drug contraindications of tolnaftate? |
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Definition
Burning and itching.
Do not use on children <2yrsold |
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Term
| What is an available agent for adjunctive therapy for fungal infections? What is the MOA? |
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Definition
Aluminum salts
Astringents may decrease inflammation |
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Term
| What are the contraindications of aluminum salts? |
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Definition
| Do not use on deep fissures. External use only. |
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Term
| Why are topical steroids not recommended to use on fungal infections? |
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Definition
| They may mask the appearance of the infection without getting rid of it. Tinea incognito. |
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Term
| When should you use a topical cream / solution? |
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Definition
| On non-ionizing, moderately scaly lesions. |
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Term
| When should you use a gel/ointment? |
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Definition
| On hyperkeratotic lesions. |
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Term
| When should you use a lotion? |
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Definition
| On interdigitous or hairy areas. Also on oozing lesions. |
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Term
| What 2 drugs are normally used for tinea unguium? |
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Definition
| Itraconazole and terbinafine |
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Term
| What is the dosing for terbinafine for toenail and fingernail? |
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Definition
| 250mg by mouth daily for 6 weeks (fingernail) or 12 weeks (toenail) |
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Term
| What is the dosing for intraconazole? |
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Definition
200mg orally, daily for 12 weeks for toenail without or with nail
200mg orally twice a day for a week, 3 weeks off for pulse |
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