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22 Cards in this Set
- Front
- Back
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List the fungus that caspofungin therapy converse?
and MOA |
- Candida spp.
- Histoplasma spp. - Asperigillus (sencond line) |
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Drug - Drug interactions of caspofunging:
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Caspofungin needs the dose to be INCREASED if taken with rifampin, phenytoin, carba (they are metabolism inducers)
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COMMON a.e. of CASPOFUNGIN:
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- elevated liver enzymes (ALT, AST, T.bili)
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What is fluconazole used for?
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- Vaginal Candidiasis
- Oropharyngeal and esophageal candidasis - Crytococcal infectins |
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All A z o l e s INHIBIT CYP450 3A4 what drugs are increased dramatically?
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- oral hypoglycemis
- warfarin - statins - phenytoin - theophylline - benzodiazepines - calcineurin antagonist (cyclo, tacro) - CCB |
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COMMON a.e. of fluconazole:
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- gi upset, headache
- very well tolerated. |
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1. Itraconazole:
2. Ketoconazole: |
1. cola 8 oz. drink
2. 0.1 N HCl soluntion for pt. with achlorhydric. no antacids. |
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A.E. of KETOCONAZOLE
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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. |
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Indications for MICONAZOLE:
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- Candidiasis (vaginitis)
- dermatomycosis - dermatophyte skin infections - tinea infections. |
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Itraconazole and Voriconazole contraindicated in renal dysfunction patients if given I.V. because of a chemical called CYCLODEXTRIN
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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. |
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Know the indications for voriconazole:
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- Invasive asperigilosis
- Esophageal candidisis - Scedosporium spp. - Fusarium spp. infections. |
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Voriconazole inhibits 3A4, 2C9 2C19 and what drugs?
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- rifampin
- carbamazepine - ritonavir - long acting barbiturates. |
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Indication for clotrimazole?
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- Vaginal Candidasis
- Oropharyngeal Candidiasis - Dermatomycosis |
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Ampotericin B:
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Fungizone
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Ampotericin B lipid complex:
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Abelcet
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Ampotericin B colloidal dispersion
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Amphotec
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Liposomal amphotericin B
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AmBisome
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Amphotericin B is excreted RENALLY - DRUG INTERACTIONS:
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- Aminoglycosides
- NSAIDs - Cisplatin - Calcinerin antagonists (cyclosporin, tacrolimus) - increase neuromuscular blocking agents. - Binds to ergosterol thus azole antifungal maybe antagonistic since they deplet ergosterol. |
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A.E. OF amphotericin B
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- hypokalemia and mag.
- infusion related: myalagia, arthalgias, muscle spasms, liposomal agents - Impairment of renal function: ~ irreversible renal failure |
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Why use liposomal amphotericin B?
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- 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) |
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Indications for flucytosine
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Candida spp.
crytococccus spp. |
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Most common drug reactions due to flucytosine?
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- bone marrow depression (irreversible ) usally occurs 2-4 weeks folowing the start of therapy
- hepatotoxicity. |
