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34 Cards in this Set
- Front
- Back
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What is AMPHOTERICIN B(fungizon)?
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Broad spectrum antifungal agent and DRUG OF CHOICE for most SYSTEMIC MYCOSES.
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How does AMPHOTERICIN B (fungizone) work?
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INCREASES cell membrane permeability--acts as a fungicidal & Fungistatic
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What are the ADVERSE EFFECTS of AMPHOTERICIN B(fungizone)?
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Infusion Reactions(fever/ chills, N/V HA rigers)
Nephrotoxicity Hypokalemia Bonemarrow Depression |
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What should you PRE-treat pt. w/ to decrease Infusion Reactions when giveing AMPHOTERICIN B (fungizone)?
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Acetaminophen to reduce reaction
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When administering AMPHOTERICIN B(fungizone) IV how should you decrease Nephrotoxicity?
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Administer IV w/ 1L normal saline to reduce toxicity
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What drugs should you AVOID when taking AMPHTERICIN B (fungizone)?
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AVOID any drugs that are NEPHROTOXIC
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What does Flucytosine do when mixed w/ AMPHOTERICIN B(fungizone)? How should you adjust the dose of Amphotericin B?
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Flucytosine potentiates the anti-fungal actions of the drug, so LOWER the doasage of AMPHOTERICIN B to lower toxicity of the combination
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What is ITRACONAZOLE(sporanox)?
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Antifungal agent
BROAD spectrum against fungal Similar ations to Ketoconazole |
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How is ITRACONAZOLE (sporanox) administered?
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PO or IV
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How is ITRACONAZOLE (sporanox) absorbed? Distributed? Metabolized? Excreted?
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Absorbtion ENHANCED w/food
Distributed to lipophillic tissues(NOT CSF) Metabolized by LIVER Excreted RENAL |
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What are the Side efects of ITRACONAZOLE(sporanox)?
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Cardiosuppression(heartfail)
Liver Damage GI effects |
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What are the drug interactions of ITRACONAZOLE(sporanox)?
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Elevates Levels of Dig, Cyclosporin, warfarin etc.
Drugs that raise gastric pH REDUCE absorbtion |
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Why is KETOCONAZOLE(Nizoral) preferred over Amphotericin B?
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b/c it is given PO and much safer
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How does KETOCONAZOLE (Nizoral) work to kill bacteria in High & Low concentrations?
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LOW-FUNGISTATIC
HIGH-FUNGICIDAL |
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What environment does KETOCONAZOLE(Nizoral) require? Why?
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Requires an ACID environment b/c it is a weak base
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Where is KETOCONAZOLE(Nizoral) motabolized?
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Liver
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What are some drug interactions of KETOCONAZOLE? Treatments?
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OMEPRAZOLE give 2hrs. AFTER Ketaconazole.
DONT use PROTEIN pump inhibitors Cimetidine decreases acidity needed Rifampin reduces Keto levels so ^ Keto Inhibition of hepatic drug metabolizing enzymes so reduce dose of antihistamines |
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What are the ADVERSE effects of KETOCONAZOLE(Nizoral)?
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HEPATOTOXICITY-dont use if Hx of Liver damage DISCONTINUE @ 1st signs of liver injury
Gynecomastia, reduced libido, sterility, menstrual irregularities |
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Where is FLUCONAZOLE(diflucan) Absorbed? 1/2 life?
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Well absorbed in all tissues INCLUDING CSF, 1/2 life LONG-30hrs
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What drug cannot be taken with Fluconazole (Diflucan)
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Do not take with Sulfonylurea
*monitor for hypoglycemia* |
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What is Flucystosine used for? Is resistance common? What are common adverse effects?
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Used for serious infections of Candia & Cryptococcus neoformans, resistance is common, Bone marrow suppression & hepatotoxicity are common. *Monitor Renal Fx*
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What is Caspofungin (Cancidas)? How is it administered? What is it approved for?
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1st in new class of echinocandin antifungals- It inhibits the synthesis of an essential component of the fungal cell wall, Given IV, Approved for resistant invasive aspergillosis that is unresponsive to Amphotericin B
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What drugs are used for dermatophytic infections (ring worm)? What is the standard treatment length?
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Clotrimazole- topical
Griseofulvin- oral Continue drug Tx for 1 wk after s/s have cleared bc of deep fungal roots |
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How does the treatment of onychomycosis differ from the treatment of ringworm?
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It is difficult to treat and required prolonged treatment. Monitor liver enzymes.
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What is the standard treatment of Candida species of vulvovaginal area?
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Treat in 1-3 days in oral dose or topical treatment of nystatin or clotrimazole
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What is the drug of choice for dermathopytic infections & candiasis of the skin, mouth, & vagina? What are the adverse effects?
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Clomtrimazole (Lotrimin)
*Topical- causes stinging, redness, swelling, rash, & peeling of skin* Oral- GI distress* |
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What is Griseofulvin used for? What enhances its absorption?
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Only use for superficial mycoses (deposits in keratin cells of hair, skin, & nails) NOT used systemically, Fatty meal enhances absorption
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What are the adverse effects of Griseofulvin?
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Transient HA, rash, GI upset, insomnia, tiredness
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What is the drug of choice for dermatophylic infections & for cutaneous & vulvovaginal candidiasis? What are drug does it interact with?
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Miconazole (Monistat)
Intravaginal miconazole can intensify Warfarin (lower the dose warfarin dose) |
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What is Terbinafine (Lamisil) used for?
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Highly effective against dermatophytes and less effective against candidia. Topical for ringworm & oral for onchomycosis
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What is Butenafine (Lotrimin) use for?
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Topically for Tinea pedis, tinea coporis, tinea curis, and tinea vesicolor (white spots with tanning)
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What are Oxiconazole (Oxistat) & Sulcanazole (Exelderm) used for?
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Broad spectrum for tinea, not well absorbed
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What is Econazole (Spectazole) used for?
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Topical for ringworm & superficial candidiasis
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What is Sertraconazole (Ertaczo) used for?
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Topical tinea Pedis
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