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Fungal Skin Infections
Exam 1
43
Pharmacology
Graduate
02/20/2012

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Cards

Term
How much of the US population do superficial fungal infections affect?
Definition
10-20% at one time
Term
Name the 6 most common superficial fungal infections.
Definition
Foot - tinea pedis
Body - tinea corporis
Groin - tinea cruris
Scalp - tinea capitis
Trunk - tinea versicolor
Nails - tinea unguium
Term
What are 4 common deramtophytes?
Definition
Candida, epidermophyton, tricophyton, microsporum
Term
What is the common name for tinea pedis?
Definition
Athlete's foot
Term
Which will you see more of as a pharmacist, acute or chronic tinea pedis?
Definition
Chronic. Patient won't come see you if it goes away on its own.
Term
Where can tinea corporis occur? What does it look like?
Definition
It can occur anywhere and it looks like a rash with a clearing in the middle, possibly some pustules on the edge.
Term
What is the common name for tinea cruris? Where does it occur? What does it look like?
Definition
"Jock itch"
On the groin, can spread to thighs and genitals.
Circular in appearance.
Term
What are the two types of tinea capitis?
Definition
Black dot and gray patch.
Term
Which form of tinea capitis is more common? What people exhibit it more? What is the other kind more like?
Definition
Black dot is more common, and it is more likely seen on children in the US.
Gray patch is more of a scaling.
Term
Where is the infection located in tinea unguium? What direction does the infection radiate?
Definition
Infection in nail bed.
Moves from end to cuticle.
Term
What is another name for tinea unguium?
Definition
Onchomyocosis
Term
Name the 4 main topical antifungals.
Definition
Azoles
Benzylamine
Allylamine
Hydroxypyridone
Term
Name 4 imidazoles with their matching generic/technical name.
Definition
Lotramin, clotrimazole
Spectazole, ecanazole
Nizoral, ketoconazole
Desenex, miconazole
Term
Name 1 triazole and its matching generic/technical name.
Definition
Diflucan, flucanazole
Term
What is the MOA of an azole antifungal?
Definition
Reduce ergosterol production by inhibiting fungal P450 enzymes. It has a broad spectrum including some gram positive bacteria.
Term
Azoles that are taken orally could result in elevated LFTs. What are LFTs?
Definition
Liver function tests.
Term
What azole is most likely to result in HA (hepatic abnormalities)?
Definition
Fluconazole
Term
What side effect does only ketoconazole produce?
Definition
Gynecomastia
Term
Which three azoles inhibit P450 enzyme 3A4 when used orally? Which one also inhibits 2C19?
Definition
Ketoconazole, Intraconazole, Fluconazole
Fluconazole also inhibits 2C19
Term
What are the 3 contraindications to oral ketoconazole?
Definition
pregnancy category c, lactation, achlorhydria or hypochlorhydria
Term
What are the 2 available benzylamine antifungal agents?
Definition
Lotramin Ultra Cream or Mentax, butenafine
Term
What is the MOA of Benzylamine antifungals?
Definition
Causes fungal cell death by inhibiting squalene epoxidase.
Term
What is the only "tinea" that azoles cannot treat?
Definition
Tinea versicolor / trunk
Term
What 4 things can benzylamine antifungals treat?
Definition
Tinea corpis, cruris, versicolor and interdigitale pedis
Term
What are the contraindications of benzylamine antifungals?
Definition
Not approved for use on children under 12 years old.
Term
What Allylamine antifungal agents are available?
Definition
Naftin, naftifine
Lamisil AT, Desenex Max, terbinafine
Term
What are the the allylamine antifungal MOAs?
Definition
Causes fungal cell death by inhibiting squalene epozidase.
Naftifine may have anti-inflammatory effects.
Term
What hydroxypyridone antifungal agents are available?
Definition
Loprox, Loprox TX, Penlac, ciclopirox
Term
What is the MOA of hydroxypyridone antifungals?
Definition
Causes cell death by blocking the intake of necessary substrates such as potassium ions.
Broad spectrum including yeast and some bacteria.
Term
What two "tineas" can hydroxypyridone NOT treat?
Definition
Tinea capitis and tinea unguium
Term
What are the possible side effects of hydroxypyridone?
Definition
Rash, erythermia, nail discoloration (nail lacquer only), pruritis, burning, worsening of sx
Term
What are the contraindications of hydroxypyridone?
Definition
Do not use on children less than 10 years of age.
Term
Name four other antifungal agents available?
Definition
Tinactin, Asorbine, Aftate, tolnaftate
Term
What are the side effects and drug contraindications of tolnaftate?
Definition
Burning and itching.
Do not use on children <2yrsold
Term
What is an available agent for adjunctive therapy for fungal infections? What is the MOA?
Definition
Aluminum salts
Astringents may decrease inflammation
Term
What are the contraindications of aluminum salts?
Definition
Do not use on deep fissures. External use only.
Term
Why are topical steroids not recommended to use on fungal infections?
Definition
They may mask the appearance of the infection without getting rid of it. Tinea incognito.
Term
When should you use a topical cream / solution?
Definition
On non-ionizing, moderately scaly lesions.
Term
When should you use a gel/ointment?
Definition
On hyperkeratotic lesions.
Term
When should you use a lotion?
Definition
On interdigitous or hairy areas. Also on oozing lesions.
Term
What 2 drugs are normally used for tinea unguium?
Definition
Itraconazole and terbinafine
Term
What is the dosing for terbinafine for toenail and fingernail?
Definition
250mg by mouth daily for 6 weeks (fingernail) or 12 weeks (toenail)
Term
What is the dosing for intraconazole?
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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