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23 Cards in this Set
- Front
- Back
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discuss the duration of use of anti-fungals...why is it this way?
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usually require prolonged tx
b/c fungal organisms grow slowly and the infections often occur in poorly profused areas |
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fungal infections can be either superficial (skin, sub Q, mucous membrane) or systemic. Which is more serious?
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Systemic
Often life threatening |
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What is THE MOST IMPORTANT drug for SEVERE fungal infections?
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Amphotericin
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what are the orally effective mainstays of antifungal tx? (general, and 2 specific)
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-azoles
Itraconazole and Fluconazole note:Sometimes start with Amp B … after couple of weeks switch to azoles |
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Which formulation of Amp B will have lower nephrotox?
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Lipid fomulation
but this is expensive |
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what drug would you use for Cryptococcal meningitis
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Flucytosine + Amp B
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why is Flucytosine never used alone? what is it used with
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Resistance develops rapidly
used with Amp B for CNS involvement |
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DOC for tinea infection
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terbinafine
followed by azoles then griseofulvin |
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why is griseofulvin given orally
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have to accumulate in keratin cells
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DOC for dermatophytoses?
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Terbinafine
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DOC for onychomycosis?
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Terbinafine
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DOC for tinea infections?
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Terbinafine
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Can you use Azole's with Amp B?
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No
because Azoles get rid of ergosterol synthesis... and Amp B binds to ergosterol to alter the membrane fluidity and make pores |
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Persistent adrenal insufficiency
Gynecomastia Impotence Decreased libido Menstrual abnormalities adverse effects of? |
Ketoconazole
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you would give what for the initial treatment of fungal meningitis?
what would you follow up with prolonged tx? **** |
Amp B + Flucytosine (converts to 5-FU)
prolonged: Fluconazole |
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big use for Voriconazole?
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invasive aspergillosis
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for candidiasis of skin, mouth, vag, and mucocutaneous what will likely resolve the infection?
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topical azole
Clotrimazole Miconazole |
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3 drugs used for Tinea unguium?
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terbinafine (po) itraconazole (po) fluconazole (po)
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primary tx for tinea capitis (head ringworm)
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terbinafine
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tx for tine corporis, cruris, pedis
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Topical tx/ OTC products
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Superficial skin infection (3)
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Topical amphotericin B
Topical azoles or nystatin |
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Superficial mouth (thrush) infection (4)
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Nystatin (swish & swallow)
Clotrimazole lozenges Oral fluconazole Oral solution itraconazole |
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chronic mucocutaneous candidiasis tx (3)
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Fluconazole
Itraconazole Ketoconazole |
