NR565 Week 6 Study Guide
Antifungal Pharmacotherapeutics
(Ans- Drug interactions: Multiple due to CYP 450 3A4 inhibition. -
Sensitivity-Azoles (broad spectrum): Candida, Cryptococcus species,
endemic mycoses, dermatophytes -itraconazole, posaconazole,
voriconazole: Aspergillus species -Itraconazole: histoplasmosis and
blastomycosis -posaconazole: prophy of BMT pts and for infection
refractory to other agents -Terbinafine: onychomycosis (fungus of nails)
--off-label for tinea pedis (ring work of feet athlete's foot), tinea capitis,
tinea corporis (ring of body), and tinea cruris (of groin/jock itch). -
Precautions/Contraindications -Hepatic impairment --May cause
hepatotoxicity -Ketoconazole --Prostate cancer -Vori: Preg D; other
azoles Preg C; Terbinafine: Preg B (but no adequate human studies) -
avoid antifungals while nursing
Antifungal Pharmacokinetics
(Ans- · Absorption of itraconazole is enhanced by food Absorption of
griseofulvin is enhanced by fat Fluconazole is an inhibitor of CYP 450
3A4 and 2C9 Itraconazole is an inhibitor of CYP 450 3A4 Ketoconazole is
an inhibitor of CYP 450 3A4
Antifungal Pharmacodynamics
(Ans- Polyene macrolides: amphotericin B and nystatin Azoles have
broad spectrum activity: butoconazole, clotrimazole, ketoconazole,
minonazole, terconazole, tioconazole, fluconazole, itraconazole
Allylamines active against yeast and dermatophytes: naftifine,
terbinafine Nuclear acid synthesis inhibitors: flucytosine Griseofulvin.