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31 Cards in this Set

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