Flashcards in 09 Fungus Drug Table Questions Deck (34):
What are the only anti-fungals to cover Zygomycoses (Rhizopus, Mucor)?
What are the only anti-fungals to cover Fusarium?
AMB. Voriconazole. Pozaconazole
What are the only anti-fungals to cover Cryptococcus neoformans?
What are the only anti-fungals to cover Histoplasma blastomyces?
What are the only anti-fungals to cover Histoplasma capsulatum?
What are the only anti-fungals to cover Coccidioides immitus?
AMB. Oral Azoles (all of them except Pozaconazole)
What are the only anti-fungals to cover Blastomyces dermatidis?
What are the only anti-fungals to cover Scedosporium?
What are the only anti-fungals to NOT cover Candida parapsilosis?
What are the only anti-fungals to NOT cover Candida lusitaniae?
AMB. Fluconazole. Itraconazole
What are the only anti-fungals to NOT cover Candida krusei?
What are the only anti-fungals that have NO Aspergillus spp. coverage?
What are the only anti-fungals to NOT cover Aspergillus terreus?
AMB. Ketoconazole. Fluconazole
What form is AMB administered?
Where does AMB have POOR distribution?
CSF, brain, bone, eye
What are the goal levels of Azoles?
Maintain AUC:MIC > 50, or 1-2x MIC for entire dosing interval
What is the CYP450 inhibition heirarchy for Azoles?
Vori, Itra > Posa > Flu
What form is Ketoconazole administered?
What is a rare side effect of Ketoconazole?
Gynecomastia, Oligospermia, Decreased libedo, Adrenal insufficiency
What form is Fluconazole administered?
IV and PO
What is the main route in which Fluconazole is cleared?
What form is Itraconazole administered?
Capsules. Oral solution
What is important to remember about Voriconazoles PK?
Non-Linear. large change in AUC w/ small change in dose. Differs among all patients
What form is Voriconazole administered?
IV and PO
What is dose adjustment like for Voriconazole?
Hepatic: Normal LD, decrease MD by 50% for Child-Pugh A, B. Renal: avoid in CrCl < 40 (d/t cyclodextran carrier accumulation)
What is dose adjustment like for Fluconazole?
Requires renal dose adjustment
What drugs are CI with Voriconazole?
Rifampin. Carbemazepine. Long-Acting Barbiturates. Sirolimus
What form is Pozaconazole administered?
What form are Echinocandins administered?
IV only d/t very low BA
What is the elimination of Anidulafungin like?
What is often used clinically for an Aspergillus infection?
DOC: Voriconazole (best for pulmonary aspergillosis). Other agents: L-AMB, echinocandins
What is often used for Coccidiomycosis treatment (Pulmonary cavitation)?
Oral azoles (onlyl if symptomatic). Ruptured lesions need lobectomy + antifungals
What is often used for Coccidiomycosis treatment (Chronic Progressive Fibrocavitary Pneumonia)?
Immediate therapy with oral Azole for 1 year