University:
University of North Carolina at Chapel Hill
Course:
NURS 312 | Pharmacology
Academic year:

2020
Views:

483

Pages:

1
Author:

folclord7m

5.3 – “There’ “There’ss no place like Canada Canada”: ”: Griseofulvi Griseofulvin, n, terbinafine, echi echinocandins nocandins • Dermatophyte infections include tinea corporis, tinea pedis, & tinea cruris (rust spots on the tin man) • Griseofulvin (grease can) o Fungistatic. Binds fungal cell microtubules, halting mitosis in M-phase (vines binding tin man look like M-phase) o Administered orally to treat dermatophytosis (grease in mouth). Has been largely replaced by newer agents. o Accumulates in keratin containing tissues. Most effective in treating scalp & skin. Can be used for onychomycosis, although recurrence is common (farmhand has some gnarly nails). o First line therapy for tinea capitis in children, along with terbinafine (kid in tin-funnel hat standing between the tin man and the pigpen). o Adverse effects ▪ GI distress ▪ Headache ▪ Rash ▪ Hepatotoxicity ▪ Granulocytopenia ▪ Activation of CYP450 (chrome bumper & CYP450 license plate on a functioning car; thumbs up for upregulation) • Terbinafine (turban) o Fungicidal. Interferes with ergosterol synthesis by inhibiting squalene epoxidase → accumulation of squalene (squealing pigs) o Dermatophytosis (little tin man in crystal ball) o First line therapy for tinea capitis in children, along with griseofulvin (kid in tin-funnel hat standing between the tin man and the pigpen). o Administered orally for onychomycosis (wiz is biting his nails) o Adverse effects ▪ GI upset (mud in pigpen) ▪ Hepatotoxicity. Rare, but calls for monitoring (liver shaped mud spots) • Echinocandins (Echino-Canadians fur cap) o Caspofungin, micafungin, anidulafungin o Inhibit synthesis of β-1,3-glucan, a major polysaccharide component of fungal cell wall (note the cell wall, not the cell membrane which is composed of ergosterol) (walled hay truck) o Excellent activity against candida (Canada flag and yeasty snow). Given IV for systemic candida infections (ivy on flagpole) ▪ Also given for mucocutaneous candidiasis, candidemia, and prophylaxis of candidiasis in transplant patients. ▪ Candida esophagitis (exhaust pipes on truck) o Invasive aspergillosis, particularly with poor response to amphotericin (scarecrow with straw coming out of his lower lung fields) o Adverse effects: extremely well tolerated, with GI & flushing reported rarely.