Anti-fungal

Question 1

Dermatophyte (tinea) Infections - areas effected

Answer 1

Skin, hair, and nails

Question 2

Dermatophyte (tinea) Infections - type

Answer 2

Filamentous fungi in the generaTrichophyton,Microsporum,andEpidermophyton

Question 3

Dermatophyte (tinea) Infections - subtypes

Answer 3

Tinea corporis– Infection of body surfaces other than the feet, groin, face, scalp hair, or beard hair
Tinea pedis– Infection of the foot
Tinea cruris– Infection of the groin
Tinea capitis– Infection of scalp hair
Tinea unguium (dermatophyte onychomycosis)– Infection of the nail

Question 4

Treatment is either

Answer 4

Topical or systemic

Question 5

most can be treated with

Answer 5

Most can be treated with topical therapy with agents such as azoles, allylamines,butenafine,ciclopirox, andtolnaftate

Question 6

Nystatin - effective

Answer 6

Nystatin – effective for Candida infections but not dermatophytes

Question 7

Oral agents used for

Answer 7

Oral agents used for extensive for refractory cutaneous infections

Question 8

Tinea Pedis - What is common

Answer 8

Athlete foot – common

Question 9

Tinea Pedis - common causes

Answer 9

Common causes areTrichophyton rubrum,Trichophyton interdigitale(formerlyTrichophyton mentagrophytes), andEpidermophyton floccosum

Question 10

Tinea Pedis topical drugs

Answer 10

Topical drugs - azoles, allylamines,butenafine,ciclopirox,tolnaftate, and amorolfine

Question 11

Tinea Pedis Topical is applied

Answer 11

Topical – applied once or twice daily, continue for 4 weeks

Question 12

Tinea Pedis oral therpaies

Answer 12

Oral therapy –
Terbinafine: 250 mg per day for two weeks
Itraconazole: 200 mg twice daily for one week
Fluconazole: 150 mg once weekly for two to six weeks

Question 13

Tina Corporis - Occurs in the sites other than the

Answer 13

Occurs in sites other than the feet, groin, face, or hand

Question 14

Tina Corporis common cause

Answer 14

T. rubrumis the most common cause of tinea corporis. Other notable can includeTrichophyton tonsurans,Microsporum canis,T. interdigitale(formerlyT. mentagrophytes),Microsporum gypseum,Trichophyton violaceum, andMicrosporum audouinii.

Question 15

Tina Corporis topical

Answer 15

Topical - azoles, allylamines,butenafine,ciclopirox, andtolnaftate

Question 16

Tina Corporis - Topicl once or twice

Answer 16

Systemic – extensive skin involvement and patients with fail topical
Terbinafine and itraconazole are common

Question 17

Tina Corporis - systemic

Answer 17

Systemic – extensive skin involvement and patients with fail topical
Terbinafine and itraconazole are common

Question 18

Tinea Cruris - example

Answer 18

Jock itch

Question 19

Tinea Cruris - common cause

Answer 19

Common cause – T. rubrum. Other – E. floccosumandT. interdigitale(formerlyT. mentagrophytes)

Question 20

Tinea Cruris topical

Answer 20

Topical drugs - azoles, allylamines,butenafine,ciclopirox,and tolnaftate

Question 21

Tina Capitis - common

Answer 21

Scalp hair – often small children

Question 22

Tina Capitis - oral

Answer 22

Oral anti-fungal therapy

Question 23

Tina Capitis - cause

Answer 23

TrichophytonandMicrosporumspecies of dermatophyte fungi

Question 24

Tina Capitis systemic

Answer 24

Systemic therapy - griseofulvin,terbinafine,fluconazole, anditraconazole

Question 25

Candida Infections - example

Answer 25

Oropharyngeal infections (thrush)

Question 26

Candida Infections - infants

Answer 26

Infants, older adults, ICS use

Question 27

Candida Infections HIV NEG

Answer 27

HIV negative –
Clotrimazole troches
Nystatin swish and swallow

Question 28

Candida Infections - HIV POS

Answer 28

HIV positive
Topical agents – mild
Oral fluconazole – moderate to severe

Question 29

Candida Vulvovaginitis

Answer 29

Inflammation in the setting of Candida Species

Question 30

Antifungals: Precautions - Topical

Answer 30

Few contraindications because of minimal absorption

Most are pregnancy category B

Question 31

Antifungals: Precautions - Systemic

Answer 31

All should be used cautiously in patients with liver problems.
Griseofulvin has possible cross-sensitivity with penicillin

Question 32

Topical Antifungals - ADR

Answer 32

Skin irritation, itching, burning, rash

Gentian violet: may cause staining of skin and clothing

Question 33

Topical Antifungals - Interactions

Answer 33

Few interactions with topical antifungals
Theoretical interaction with azoles and amphotericin B
Clotrimazole intravaginal preparations: should not be administered concurrently with nonoxynol-9 and octoxynol
Systemic antifungals: have a number of interactions