Antifungals Flashcards
Types of Fungal Infections
systemic, cutaneous, subcutaneous, superficial
Polyene Meds (list + MOA)
Amphotericin B (Fungizone), Nystatin (Mycostatin) MOA: binds to sterols in the fungal cell membrane, producing a change in membrane permeability that allows leakage of intracellular components from cell
Amphotericin B (Fungizone)
For mycoses (both systemic and local)
Indications: aspergillosis, cryptococcosis, histoplasmosis, other severe infections
Requires a test dose; often premedicated w antipyretics, antihistamines, antiemetics
Drug of choice for systemic infections
Slowing infusion can help A/E
A/E: numerous, confusion, chest pain, HYP, tachycardia, diarrhea, hyperbilirubinemia, incr liver enzymes, nephrotoxicity, chills, fever
NOT compatible with normal saline
Nystatin (Mycostatin)
Oral or Topical Only
Indications: skin and mucus membrane yeast (candidiasis)
Few A/E
Follow order for administration, suspension= swish, and spit or swish and swallow
Also available in topical creams and powders
DO NOT MIX w FOOD
AVOID mouthwash
Azoles Meds (list +MOA)
Fluconazole (Diflucan), Voriconazole (Vfend)
MOA: inhibit fungal cell cytochrome P-450 enzymes needed to produce ergosterol, causing leaky membranes
*Fewer toxic effects than polyene
Fluconazole (Diflucan)
Oral, topical, IV
Indications: cryptococcal meningitis, serious systemic infection, yeast infection, candidiasis
Preffered over ampho B
A/E: hepatotoxicity, skin d/o, h/a, dizzy
Should use alternate contraception while taking
Voriconazole (Vfend)
Indications: histoplasmosis, blastomycosis, aspergillosis, candidiasis
Monitor LFT
CATEGORY D
Give oral 1 hr before or 1 hr after meals
A/E: vision changes- caution while driving at night
Echinocandin Meds
Caspofungin (Cancidas)*, Micafungin (Mycamine)
MOA: prevents synthesis of glucans, essential components of fungal cell walls
Indications: aspergillosis, candidiasis
A/E: h/a, chills, incr creatinine, incr liver enzymes
