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23 Cards in this Set
- Front
- Back
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Topical Antifungals: Azoles (Clotrimazole), Polyenes (Amphotericin B), Other (Tolnaftate)
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No adverse effects
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Nystatin (mycostatin)
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oral candidiasis
few adverse effects |
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Clotrimazole (mycelex)
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oral candidiasis
rare adverse effects |
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Griesofulvin (grifulvin)
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dermatophytes
treat 12-18 months |
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Terbinafine (Lamisil)
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dermatophytes
loss of apetite, dyspepsia, nausea, vomiting, diarrhea, skin rxn, hepatotoxic |
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Amphotericin B
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1st line for everything EXCEPT PCP and dermatophytes
(sporothrix, cocci, histo, blasto, candida, crypto, aspergillus) "shake & bake" (prostaglandins, cytokines - NOT HISTAMINE!!), anemia, renal toxicity/acidosis, thrombophlebitis |
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Amphotericin B lipid complex (ABLC, Abelcet)
Liposomal Amphotericin B (AmBisome) |
Aspergillus (if Ampho intolerant); crypto meningitis
less nephrotoxicity than regular Amphotericin B |
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Ketoconazole (Imidazole) PO
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2nd line: Blastomyces
fungistatic; hepatic effects, lower testosterone/cortisol, nausea, rash |
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Fluconazole (triazole) PO/IV
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1st line: vaginal candidiasis
2nd line: crypto, cocci alopecia, nausea, rash |
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Voriconazole (triazole) PO/IV
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1st line: aspergillosis
2nd line: candida, histo altered mental status, visual alterations, nausea, rash, expensive |
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Itraconazole (triazole) PO/IV
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1st line: blasto, sporothrix
2nd line: aspergillosis, candida, cocci/paracocci, histo nausea, rare, need H+ for absorb |
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Posaconazole
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broad spectrum (especially mucorales, cocci)
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Ravuconazole
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less spectrum than posaconizole, long half life
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5-flourocytosine (5-FC, ancoban)
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5-FC + Amphotericin B for crypto meningitis
fewer relapsed with candida UTI adjust dose with renal insufficiency; nausea, vomit, rash, diarrhea, hepatic insufficiency, bloody diarrhea |
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Echinocandins (caspofungin, micafungin, anidulafungin)
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Candida (esp resistant ones), Aspergillus, dimorphic fungi, PCP cyst phase
fungicidal; rare adverse effects |
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Aspergillosis
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1st line: Amphotericin B (liposomal), Voriconazole, Caspofungin
2nd line: Itraconazole |
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Blastomycosis
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1st line: Itraconazole
2nd line: Ketoconazole Amphotericin B for life threatening |
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Candidiasis: Urinary
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1st line:Amphoteriicn B, Fluconazole
2nd line: 5-FC, Caspofungin |
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Candidiasis: systemic, organs
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Echnocandins, Amphotericin B
2nd line: voriconazole, itraconizole |
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Cryptococcosis
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Amphotericin B +/- 5-FC, fluconazole
2nd line: Fluconazole + 5-FC Echinocandins have NO activity |
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Coccidioidomycosis
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1st: Amphotericin B
2nd: Itraconazole, Fluconazole, Voriconazole, Posaconazole |
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Histoplasmosis
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1st: Amphotericin B
2nd: Itraconazole, Voriconazole |
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Sporotrichosis
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1st: Itraconazole
2nd: SSKI for cutaneous, terbinafine |
