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10 Cards in this Set
- Front
- Back
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Amphotericin B:
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Polyene antifungal
MOA: interact with ergosterol to form channels through the membrane, causing the cells to become leaky Indication: Broad spectrum Kinetics: IV only Adverse Reactions: Phlebitis at the infusion site; Chills; Renal toxicity (to reduce add saline) Reduced side effects in liposomal formulation |
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Nystatin:
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Polyene antifungal
MOA: interact with ergosterol to form channels through the membrane, causing the cells to become leaky Indication: Used to treat oral or GI fungal infections Kinetics: Given in units; Not absorbed in gut Adverse Reactions: Less toxic than amphotericin B |
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Azoles:
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MOA: Inhibit cytochrome P450 14-demethylase involved in the biosynthesis of ergosterol
Can be either imidazoles (2 nitrogens) or triazoles (3 nitrogens) Adverse Reactions: Life-threatening liver toxicity (less problematic with the triazoles); Nausea and vomiting |
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Azoles (Drug interactions):
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Azoles interact with other medications that are metabolized via similar pathways in the liver
Cyclosporine Phenytoin Sulfonylureas Loratadine Warfarin Chlordiazepoxide |
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Ketoconazole:
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Imidazole antifungal
MOA: Inhibit cytochrome P450 14-demethylase Indications: mucosal candidiasis and a variety of cutaneous mycoses Kinetics: Oral and topical Also used to treat Cushing’s syndrome and prostate cancer |
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Clotrimazole & Miconazole:
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Imidazole antifungal
MOA: Inhibit cytochrome P450 14-demethylase Indications: Vulvovaginal candidiasis Kinetics: Topical only |
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Fluconazole:
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Triazole antifungal
MOA: Inhibit cytochrome P450 14-demethylase Indications: Candidemia or cryptococcal meningitis Kinetics: IV or oral; Good CSF penetration |
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Itraconazole:
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Triazole antifungal
MOA: Inhibit cytochrome P450 14-demethylase Indications: Cryptococcosis, and certain aspergillosis Kinetics: Oral Dose-related inotropic effects; Avoid use with calcium channel blockers |
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Voriconazole (2nd gen):
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Triazole antifungal
MOA: Inhibit cytochrome P450 14-demethylase Indications: Extremely broad spectrum; Invasive aspergillosis and resistant candidiasis |
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Echinocandins:
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MOA: Inhibit b(1-3) glucan on fungal cell wall
Kinetics: IV only Adverse reactions: Minor GI irritation; Liver enzyme (potential drug interactions) Caspofungin: For disseminated and mucocutaneous candida infections & invasive aspergillosis Micafungin: Mucocutaneous candidiasis or prophylaxis for candidiasis (BM transplantation) Anidulafungin: For esophageal candidiasis & invasive candidiasis |
