Veterinary Medicine - January 2008 - (Page 50)

Systemic antifungals PEER-REVIEWED CE You can earn two hours of Continuing Education credit from Kansas State University by answering the following questions on antifungals. Circle only the best answer for each question, and transfer your answers to the form on page 51. is considered the treatment of choice for CNS infections due to susceptible Cryptococcus neoformans? a. Fluconazole b. Itraconazole c. Ketoconazole d. Posaconazole e. Terbinaﬁne Article #2 1. The mechanism of action of the azoles is primarily due to: a. Inhibition of dihydrofolate reductase in fungal cells b. Inhibition of ergosterol formation, which disrupts cell wall function c. Inhibition of the 30s subunit of the fungal ribosomes d. Inhibition of the 50s subunit of the fungal ribosomes e. Inhibition of topisomerase IV 7. Which systemic antifungal is expected to have the least potential to inhibit the metabolism of concurrently administered drugs? a. Fluconazole b. Itraconazole c. Ketoconazole d. Voriconazole e. Terbinaﬁne 2. Which systemic antifungal is eliminated primarily by renal mechanisms? a. Fluconazole b. Itraconazole c. Ketoconazole d. Posaconazole e. Terbinaﬁne 8. Which systemic antifungal can result in hepatotoxicosis at clinically recommended dosages? a. Fluconazole b. Itraconazole c. Ketoconazole d. Voriconazole e. All of the above 3. Which of these antifungals should never be compounded from bulk substance? a. Fluconazole b. Itraconazole c. Ketoconazole d. Terbinaﬁne e. Voriconazole 9. Which systemic antifungal is expected to decrease endogenous cortisol production? a. Fluconazole b. Itraconazole c. Ketoconazole d. Posaconazole e. Terbinaﬁne 4. Which systemic antifungal can be administered without regard to feeding status in cats? a. Fluconazole b. Itraconazole c. Ketoconazole d. Posaconazole e. Terbinaﬁne 10. Which systemic antifungal has been reported to cause visual disturbances in people at clinically recommended dosages? a. Fluconazole b. Itraconazole c. Ketoconazole d. Terbinaﬁne e. Voriconazole 5. What fungal organism is typically resistant to ﬂuconazole? a. Aspergillus species b. Blastomyces species c. Candida species d. Coccidioides species e. Histoplasma species leishmaniasis. Expert Opin Investig Drugs 2005;14(11):1337-1346. 18. Kohler LM, Monteiro PC, Hahn RC, et al. In vitro susceptibilities of isolates of Sporothrix schenckii to itraconazole and terbina ne. J Clin Microbiol 2004;42(9):4319-4320. 19. Chapman SW, Pappas P, Kauffmann C, et al. Comparative evaluation of the ef cacy and safety of two doses of terbina ne (500 and 1000 mg day(-1)) in the treatment of cutaneous or lymphocutaneous sporotrichosis. Mycoses 2004;47(1-2):62-68. 20. Van Cauteren H, Heykants J, De Coster R, et al. Itraconazole: pharmacologic studies in animals and humans. Rev Infect Dis 1987;9(suppl 1):S43-S46. 21. Boothe DM, Herring I, Calvin J, et al. Itraconazole disposition after single oral and intravenous and multiple oral dosing in healthy cats. Am J Vet Res 1997;58(8):872-877. 22. Pinchbeck LR, Hillier A, Kowalski JJ, et al. Comparison of pulse administration versus once daily administration of itraconazole for the treatment of Malassezia pachydermatis dermatitis and otitis in dogs. J Am Vet Med Assoc 2002;220(12):1807-1812. 23. Legendre AM, Rohrbach BW, Toal RL, et al. Treatment of blastomycosis with itraconazole in 112 dogs. J Vet Intern Med 1996;10(6):365-371. 24. Queiroz-Telles F, Purim KS, Boguszewski CL, et al. Adrenal response to corticotrophin and testosterone during long-term therapy with itraconazole in patients with chromoblastomycosis. J Antimicrob Chemother 1997;40(6):899-902. 25. Lavrijsen K, van Houdt J, Thijs D, et al. Interaction of miconazole, ketoconazole and itraconazole with rat-liver microsomes. Xenobiotica 1987;17(1):45-57. 26. Odds FC, Cheesman SL, Abbott AB. Antifungal effects of uconazole (UK 49858), a new triazole antifungal, in vitro. J Antimicrob Chemother 1986;18(4):473-478. 27. Brito EH, Fontenelle RO, Brilhante RS, et al. Phenotypic characterization and in vitro antifungal sensitivity of Candida spp. and Malassezia pachydermatis strains from dogs. Vet J 2007;174(1):147-153. 28. Humphrey MJ, Jevons S, Tarbit MH. Pharmacokinetic evaluation of UK-49,858, a metabolically stable triazole antifungal drug, in animals and humans. Antimicrob Agents Chemother 1985;28(5):648-653. 29. Vaden SL, Heit MC, Hawkins EC, et al. Fluconazole in cats: pharmacokinetics following intravenous and oral administration and penetration into cerebrospinal uid, aqueous humour and pulmonary epithelial lining uid. J Vet Pharmacol Ther 1997;20(3):181-186. 30. Mastroiacovo P, Mazzone T, Botto LD, et al. Prospective assessment of pregnancy outcomes after rst-trimester exposure to uconazole. Am J Obstet Gynecol 1996;175(6):1645-1650. 31. Roffey SJ, Cole S, Comby P, et al. The disposition of voriconazole in mouse, rat, rabbit, guinea pig, dog, and human. Drug Metab Dispos 2003;31(6):731-741. 32. European Medicines Agency. Vfend. European Public Assessment Report (EPAR). Available at: http://www.emea.europa.eu/humandocs/Humans/EPAR/ vfend/vfend.htm. Accessed 08/01/2007. 33. Sabatelli F, Patel R, Mann PA, et al. In vitro activities of posaconazole, uconazole, itraconazole, voriconazole, and amphotericin B against a large collection of clinically important molds and yeasts. Antimicrob Agents Chemother 2006;50(6):2009-2015. 34. European Medicines Agency. Posaconazole SP. European Public Assessment Report (EPAR). Available at: http://www.emea.europa.eu/humandocs/ Humans/EPAR/posaconazoleSP/posaconazoleSP.htm. Accessed 08/01/2007. 35. Nomeir AA, Kumari P, Hilbert MJ, et al. Pharmacokinetics of SCH 56592, a new azole broad-spectrum antifungal agent, in mice, rats, rabbits, dogs, and cynomolgus monkeys. Antimicrob Agents Chemother 2000;44(3):727-731. 36. McLellan GJ, Aquino SM, Mason DR, et al. Use of posaconazole in the management of invasive orbital aspergillosis in a cat. J Am Anim Hosp Assoc 2006;42(4):302-307. 37. Kotnik T, Kozuh Erzen N, Kuzner J, et al. Terbina ne hydrochloride treatment of Microsporum canis experimentally-induced ringworm in cats. Vet Microbiol 2001;83(2):161-168 38. Kotnik T. Drug ef cacy of terbina ne hydrochloride (Lamisil) during oral treatment of cats, experimentally infected with Microsporum canis. J Vet Med B Infect Dis Vet Public Health 2002;49(3):120-122. 39. Shadomy S, Espinel-Ingroff A, Gebhart RJ. In-vitro studies with SF 86-327, a new orally active allylamine derivative. Sabouraudia 1985;23(2):125-132. 40. Petranyi G, Meingassner JG, Mieth H. Antifungal activity of the allylamine derivative terbina ne in vitro. Antimicrob Agents Chemother 1987;31(9):1365-1368. 41. Jensen JC. Clinical pharmacokinetics of terbina ne (Lamisil). Clin Exp Dermatol 1989;14(2):110-113. EXTRAS See for more about Microsporum canis infections. 6. Which systemic antifungal 50 January 2008 VETERINARY MEDICINE http://www.emea.europa.eu/humandocs/Humans/EPAR/vfend/vfend.htm http://www.emea.europa.eu/humandocs/Humans/EPAR/vfend/vfend.htm http://www.emea.europa.eu/humandocs/humans/EPAR/posaconazoleSP/posaconazoleSP.htm http://www.emea.europa.eu/humandocs/humans/EPAR/posaconazoleSP/posaconazoleSP.htm http://www.vetstreamfelis.com/ACI/January08/VMD1/bug00270.asp

Table of Contents Feed for the Digital Edition of Veterinary Medicine - January 2008

Veterinary Medicine - January 2008 Contents Digital Extra Letters Toxicology Brief Idea Exchange A Challenging Case: Phimosis in a Young Adult Dog The Indications and Technique for Continuous Ambulatory Electrocardiographic Recording in Dogs A Review of Selected Systemic Antifungal Drugs for Use in Dogs and Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - January 2008

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