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48 Cards in this Set

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  • Back
Candidemia/Disseminated candidiasis treatment of choice for susceptible strains
Fluconazole x14days
Candidemia/Disseminated candidiasis drug of choice for infections due to fluconazole resistant isolates and/or severe infections
Amp B x14days
Candidemia/Disseminated candidiasis 2nd line therapy for patients not responding to conventional therapy or with renal insufficiency
a.Liposomal amp B x14days
b.Amp B lipid complex x14days
Candidemia/Disseminated candidiasis agents reserved for resistant organisms or intolerance to other antifungals
Caspofungin, Micafungin, Anidulafungin, Voriconazole
Agents used for empiric therapy of Candidemia/Disseminated candidiasis
AmpB, Caspofungin, Micafungin, Anidulafungin
This agent is an excellent choice for completion of therapy for fluconazole resitant isolates (oral)
Hepatosplenic candidiasis treatment for stable patients
Hepatosplenic candidiasis treatment for severely ill patients
Amp B
Urinary candidiasis important points
1. Foley cathetar must be changed
2. DON'T treat colonization
3. Evaluate the urinalysis
Treatment for urinary candidiasis
This agent should not be used for urinary candidiasis unless a resistant organism is present secondary to toxicity
Amp B
These agents may be considered for urinary candidiasis for resistant isolates
Voriconazole, Caspofungin
Invasive aspergillosis gold standard for therapy
Amp B 1-1.5mg/kg IV Q24H
Invasive aspergillosis treatment that many clinicians consider the therapy of choice
Voriconazole 6mg/kg IV BID x 2 doses then 4mg/kg IV BID


200mg PO BID
These agent is reserved for patients intolerant to voriconazole or amphortericin products for invasive aspergillosis
Caspofungin 70mg IV x 1 then 50mg IV Q24H

Severe liver disease: 70mg IV x 1 then 35mg IV Q24H
Histoplasmosis treatment for severe disease/initial CNS disease
AmpB 0.7mg/kg IV Q24H
Histoplasmosis agents for treatment of mild to moderate disease
-Fluconazole (preferred for CNS disease)
Acute Pulmonary Histoplasmosis treatment for mild/moderate symptoms's <4weeks=No therapy's >4weeks=Itraconazole x6-12weeks
Chronic Pulmonary Histoplasmosis treatment for mild/moderate symptoms
Itraconazole x12-24months
Disseminated Histoplasmosis in non-AIDS for mild/moderate symptoms
Itraconazole x6-18months
Disseminated Histoplasmosis in AIDS for mild/moderate symptoms
Itraconazole lifelong
Meningitis Histoplasmosis for mild/moderate symptoms
AmpB x3months then fluconazole x12 months

*same for severe disease
Blastomycosis "Chicago's Disease" agents for severe disease/initial CNS disease
Amp B 1mg/kg IV Q24H
Blastomycosis agents for mild/moderate disease
-Itraconazole 200-400mg IV/PO Q24H
-Fluconazole 400-800mg IV/PO Q24H (preferred for CNS disease)
-Lipid Amp B 3mg/kg IV Q24H
Blastomycosis treatment for immunocompromised patients
AmpB-after completed suppressive therapy w/ itraconazole should be started
Blastomycosis treatment for pregnancy and pediatrics

Alternative for peds=Itraconazole
Coccidioidmycosis primary respiratory infection uncomplicated
i.Asx=no treatment
ii.treat all sx patients and high-risk patients (HIV, organ transplant, pregnancy, severe infections)

Severe infections=
a. >10%wt. loss
b. bilateral pneumonia or 1/2 of lung involved
c. night swts >3weeks
d. symptoms for >2months
Coccidioidmycosis primary respiratory infection uncomplicated agents
1. AmpB x3-6months (until response, then complete course with azoles)
2. Azole antifungals x3-6months
3. Immunocompromised may require lifelong therapy
Coccidiodmycosis primary respiratory infection diffuse pneumonia agents
1. AmptB x1year (until response then complete course w/ azole)
2. Azole antifungals x1year
3. Immunocompromised may require lifelong therapy
Coccidiodmycosis pulmonary nodule treatment
Asx=solitary lesions don't require tx unless pt. immunocompromised
Coccidiodomycosis Pulmonary cavity asymptomatic treatment
i. most benign requiring no tx
ii. RESECTION considered if cavity progresses, has been present about 2 years, or if it's immediately adjacent to pleura
Coccidiodomycosis Pulmonary cavity symptomatic treatment
i. Azole therapy shows improvemtn, but sxs may return after discontinuation
ii. resection alternative
Coccidiodomycosis Pulmonary cavity ruptured treatment
i. lobectomy is tx of choice in young healthy patients along with antifungal therapy until the procedure
ii. patients for whom surgery not option antifungal therapy indicated
Coccidiodomycosis Disseminated infection non-meningeal treatment
i. azole antifungals
ii. AmpB for more severe infections
Coccidiodomycosis Disseminated infection meningitis treatment
i. Fluconazole 400-800mg PO/IV Q24H treatment of choice
ii. Itraconazole and intrathecal AmpB alternatives
Cryptococcal disease in non-HIV infected (pulmonary) mild/moderate disease
i. Fluconazole 200-400mg Q24Hx 6-12months
ii. Itraconazole
iii. AmpB
Cryptococcal disease in non-HIV infected (CNS) INDUCTION
1. AmpB 0.7-1mg/kg Q24H
flucytosine 25mg/kg IV Q6H x2 weeks
Cryptococcal disease in non-HIV infected (CNS) CONSOLIDATION
1. Fluconazole 400mg at least for 10weeks
2. AmpB PLUS flucytosine
3. AmpB
4. Lipid AmpB
Cryptococcal disease in HIV infected (pulmonary) mild/moderate disease
1.Fluconazole lifelong
2.Itraconazole lifelong
3.Fluconazole PLUS flucytosine x10weeks
Cryptococcal disease in HIV infected (CNS) INDUCTION
1.AmpB PLUS flucytosine x2weeks
Crytpococal disease in HIV infected (CNS) CONSOLIDATION
1.Fluconazole for atleast 10weeks
2. AmpB PLUS flucytosine
3. AmpB
4.Fluconazole x10-12weeks
5.Itraconazole x10-12weeks
6.Fluconazole PLUS flucytosine x6weeks
7. Lipid AmpB x6-10weeks
Cryptococcal disease in HIV infected (CNS) MAINTENANCE
1.Fluconazole lifelong
2.Itraconazole lifelong
3. AmpB 1-3 times per week lifelong
Amphotericin products toxicities
1. infusion related side effects
-fever, hypotension, HA, flushing

Azoles drug interactions
All potent inhibitors of CYP3A4
Azoles toxicities
1. GI-N/V
2. Hepatotoxicity
3. Rash

-transient changes in vision
Echinochandins-Caspofungin drug interactions
i.increased caspofungin

ii.decreased caspofungin
-carbamazepine, efavirenz, nevirapine, phenytoin, rifampin

iii.Decreased effect of other drug
Echinochandins-Micafungin drug interactions
i. Increased effect of other drugs
-sirolimus, nifedipine
Echinochandins Toxicities
iii.Infusion reactions
iv.elevated AST,ALT, ALK phosphatase