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31 Cards in this Set
- Front
- Back
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infectious diseases caused by fungi
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mycoses
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are mycoses chronic or acute in nature
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chronic
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most difficult to treat and life-threatening fungal infections
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systemic mycoses
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fungal infections are susceptible or resistant to antibiotics
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resistant
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bacteria are susceptible or resistant to antifungals
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resistant
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4th most common septicemia
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candidemia
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drug of choice for life-threatening, systemic mycoses (effective against a wide range of fungi)
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amphotericin B (Amphotec)
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Amphotericin B increases risk for
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nephrotoxicity
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common route for fungal meningitis
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intrathecal
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therapeutic index of amphotericin B
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low therapeutic index (small test doses are usually adminstered to assess the degree of a pt's negative response; i.e. anaphylaxis or convulsions)
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first orally active -azole available for treatments of systemic mycoses
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ketoconazole (Nizoral)
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inhibits human gonadal and adrenal steroid synthesis, leading to decreased testosterone and cortisol production
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ketoconazole (Nizoral)
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What does ketoconazole require for dissolution?
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gastric acid
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What interferes with the dissolution of ketoconazole?
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drugs that raise gastric pH: antacids, histamine receptor blockers, and proton pump inhibitors
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Side effects of ketoconazole
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endocrine effects: gynecomastia, decreased libido, impotence, and menstrual irregularities due to decreased synthesis of androgen and adrenal steroid synthesis
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2 drugs that is clinically important because it does not cause the endocrine side effects of ketoconazole
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fluconazole (Diflucan) or itraconazole (Sporonox)
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drug that penetrates the CSF well
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fluconazole (Diflucan)
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administration of fluconazole (Diflucan)
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oral or IV (not dependent on gastric acidity)
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Newer broad spectrum antifungal
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itraconazole (Sporonox)
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Newer broad spectrum antifungal agent approved for invasive aspergillosis treatment
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voriconazole (VFend)
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Unique side effect of voriconazole (VFend)
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transient visual disturbance
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second line antifungal for those who have failed or cannot tolerate amphotericin B or itraconazole
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caspofungin
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side effect of caspofungin
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flushing (probably due to the release of histamine from mast cells)
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drug of choice for dermatophytoses, especially onychomycoses
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terbinafine (Lamisil)
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length of time of treatment with terbinafine (Lamisil)
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appx 3 months
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drug that has been largely replaced by terbinafine (Lamisil) for cutaneous mycotic infections
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griseofulvin (Grifulvin)
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length of time of treatment for cutaneous myctoic infections with griseofulvin (Grifulvin)
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6-12 months
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only used for topical treatment of candida due to systemic toxicity
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Nystatin (Mycostatin suspension)
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method of oral administration of Nystatin for the treatment of oral candidiasis
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"swish and swallow"
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3 topically active -azole drugs
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miconazole (Monostat)
clotrimazole (Gyne-Lotrimin) terconazole (Terazol) |
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True or False:
nystatin and any azole give similar outcomes in the treatment of vulvar candidiasis |
true
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