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22 Cards in this Set

  • Front
  • Back
List the fungus that caspofungin therapy converse?
and MOA
- Candida spp.
- Histoplasma spp.
- Asperigillus (sencond line)
Drug - Drug interactions of caspofunging:
Caspofungin needs the dose to be INCREASED if taken with rifampin, phenytoin, carba (they are metabolism inducers)
- elevated liver enzymes (ALT, AST, T.bili)
What is fluconazole used for?
- Vaginal Candidiasis
- Oropharyngeal and esophageal candidasis
- Crytococcal infectins
All A z o l e s INHIBIT CYP450 3A4 what drugs are increased dramatically?
- oral hypoglycemis
- warfarin
- statins
- phenytoin
- theophylline
- benzodiazepines
- calcineurin antagonist (cyclo, tacro)
COMMON a.e. of fluconazole:
- gi upset, headache
- very well tolerated.
1. Itraconazole:
2. Ketoconazole:
1. cola 8 oz. drink
2. 0.1 N HCl soluntion
for pt. with achlorhydric.
no antacids.
1. GI (reduced with food)
2. Inhibits adrenal sterol synthesis:
- gynecomastia
- decreased libido
- oligo and azoospermia.
2. impotence (decrease in testerone)
3. sticy skin syndrome.
Indications for MICONAZOLE:
- Candidiasis (vaginitis)
- dermatomycosis
- dermatophyte skin infections
- tinea infections.
Itraconazole and Voriconazole contraindicated in renal dysfunction patients if given I.V. because of a chemical called CYCLODEXTRIN
1. itraconazole: CrCl < 30 mL / min --> associated with pancreatic adenocarcinoma and renal cyts in rats
2. voraconazole: CrCl < 50 mL/ min --> vacoule formation in epithelium of proximal reanl tubules in rats.
Know the indications for voriconazole:
- Invasive asperigilosis
- Esophageal candidisis
- Scedosporium spp.
- Fusarium spp. infections.
Voriconazole inhibits 3A4, 2C9 2C19 and what drugs?
- rifampin
- carbamazepine
- ritonavir
- long acting barbiturates.
Indication for clotrimazole?
- Vaginal Candidasis
- Oropharyngeal Candidiasis
- Dermatomycosis
Ampotericin B:
Ampotericin B lipid complex:
Ampotericin B colloidal dispersion
Liposomal amphotericin B
Amphotericin B is excreted RENALLY - DRUG INTERACTIONS:
- Aminoglycosides
- Cisplatin
- Calcinerin antagonists (cyclosporin, tacrolimus)
- increase neuromuscular blocking agents.
- Binds to ergosterol thus azole antifungal maybe antagonistic since they deplet ergosterol.
A.E. OF amphotericin B
- hypokalemia and mag.
- infusion related: myalagia, arthalgias, muscle spasms, liposomal agents
- Impairment of renal function:
~ irreversible renal failure
Why use liposomal amphotericin B?
- renal insufficiency: SCr > 2.5 mg/dl or ClCr < 25 mL/min.
- failure with ampho B.
- infusion related ampho B.
- sign. increase in SCr (up to 2.5mg/dL)
Indications for flucytosine
Candida spp.
crytococccus spp.
Most common drug reactions due to flucytosine?
- bone marrow depression (irreversible ) usally occurs 2-4 weeks folowing the start of therapy
- hepatotoxicity.