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34 Cards in this Set
- Front
- Back
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What type of antifungal is Fluconazole (Diflucan)
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Azole antifungal that targets cell membrane synthesis of ergosterol
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What type of drug is Itraconazole (Sporanox)
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Azole antifungal that targets cell membrane synthesis of ergosterol
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What type of drug is Ketoconazole (Nizoral)
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Azole antifungal that targets cell membrane synthesis of ergosterol
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What type of drug is Voriconazole (Vfend)
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Azole antifungal that targets cell membrane synthesis of ergosterol
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What type of drug is Posaconazole (Noxafil)
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Azole antifungal that targets cell membrane synthesis of ergosterol
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What type of drug is Terbinafine (Lamisil)
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Allylamine antifungal that targets cell membrane synthesis of ergosterol
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What are the therapeutic uses for ketoconazole
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used in shampoos rarely PO used for mucosal infections only.
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What are the s/e of ketoconazole
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N/V, hepatotoxicity, gynecomastia, oligospermatism, decreased libido (inhibits CYP 450 responsible for testosterone synthesis)
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How can you increase absorption of ketoconazole
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give it with cola or fruit juice since its absorption is dependent on pH
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What caution do you have to use when prescribing ketoconazole
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it has severe drug interactions with drugs such as cyclosporine, warfarin, corticosteroid and theophylline
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What are the most common Candida spp. That infect humans
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C. Albicans, Tropicalis, Parapsilosis, Glabrata, Krusei
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What drug has historically been first line tx for Candida infections (but due to increasing resistance has been loosing that status)
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Fluconazole also covers Cryptococcus neoformans and coccidiomycosis
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What are the major s/e of using Fluconazole
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N/V and rash and a lot of drug interactions but not as severe as some of the other azoles
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How are fungi becoming resistant to fluconazole
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genetic mutation, altered target site and up regulation of efflux pumps
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Which azole has greater coverage itraconazole or fluconazole
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itraconazole
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What is one of the biggest limitations in using itraconazole (where doesn't it get)
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doesn’t cross the BBB
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What are the major s/e of using Itraconazole
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taste disturbances, N/V, osmotic diarrhea, rash, hepatic toxicity, avoid using in pts with ventricular dysfunction
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What is itraconazoles place in therapy
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preferred azole to tx many varied infections 2nd line for Blastomyces, histoplasmosis, and 3rd line for Aspergillus
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What place in therapy does Voriconazole have
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used to tx invasive aspergillosis (1st line) and resistant Candida infections esp. Glabrata and Krusei.
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What is the best antifungal to tx Mucor and Rhizopus fungus
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Posaconazole
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What are the major s/e of using Voriconazole
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Visual disturbances (30%)
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What type of drug is amphotericin B
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Polyene antifungal that targets ergosterol
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What type of drug is Nystatin
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Polyene antifungal that targets ergosterol and is only used topically
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Why is Amphotericin B considered the big gun of antifungal tx
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is targets major fungi such as aspergillosis, blasto, Candida, coccidio, crypto, histo and Mucor just not Fusarium, lusitaniae and other rare fungi
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What are the major s/e of using Amphotericin B in antifungal tx
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delayed toxicity, wasting of potassium and magnesium, (Na+ loading can combat this side effect), fevers, chills, hypotension (pretreat with Benadryl, APAP or hydrocortisone)
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What drug interactions does amphotericin B have
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enhances nephrotoxicity (cyclosporins, aminoglycosides, foscarnet, pentamidine) Antineoplastic drugs (cisplatin and nitrogen mustard toxicities are enhanced)
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What type of drug is Caspofungin
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Echinocandin (Glucan synthesis inhibitor)
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What type of drug is micafungin
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Echinocandin (Glucan synthesis inhibitor)
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What type of drug is Anidulafungin
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Echinocandin (Glucan synthesis inhibitor)
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What are the advantages of Echinocandins in tx of fungal infections and what are the limitations
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tx most common fungal infections (Candida and Apergillus) limited adverse effects, no drug interactions, but IV only and limited activity against fungi outside Candida and Aspergillus
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What are the major s/e of using Echinocandins for tx fungi
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infusion related affects (IV site irritation, fever, HA, flushing, erythema and rash), histamine release
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What type of drug is flucytosine
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DNA/RNA synthesis inhibitor
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What are the major s/e of using flucytosine
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Bone marrow toxicity, monitor blood levels when using with ampho B
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If you need an extremely effective antifungal what is your gold standard choice
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Amphotericin B
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