Anti-Fungal Agents (week 10)

Question 1

What are opportunist drugs for systemic mycoses for?

Answer 1

Immunocompromised host

Question 2

What are nonopportunistic drugs for systemic mycoses for?

Answer 2

Infection that occurs in any host

Question 3

What are the three classes of Anti-fungal Drugs?

Answer 3

Polyene Antibiotics
Azoles
Echinocandins

Question 4

Name a Polyene Antibiotic

Answer 4

Amphotericin B

Question 5

What is Amphotericin B used for?

Answer 5

Progressive and Potentially fatal fungal infections

Question 6

How is Amphotericin B given?

Answer 6

IV, slowly over 2-4 hours

Question 7

How long does it take for Amphotericin B to be excreted?

Answer 7

Elimination can take up to 6 weeks.

Question 8

What is the MOA of Amphotericin B?

Answer 8

Binds within the fungal membrane, making it more permeable

Question 9

How is Amphotericin B adminstered?

Answer 9

IV

Intrathecal

Question 10

How do you order Amphotericin B?

Answer 10

Using proprietary doses

Question 11

What are common side effects of Amphotericin B?

Answer 11

Infusion reaction - assess for phlebitis

Question 12

What are some serious side effects for Amphotericin B?

Answer 12

Nephrotoxicity
Cardiac arrest

BLACK BOX WARNING - reserve use for progressive and potentially life threatening events

Question 13

What should you use for mild reactions related to Amphotericin B?

Answer 13

Diphenhydramine and Acetaminophen

Question 14

What drugs should you use to treat Rigors that are related to Amphotericin B?

Answer 14

Meperidine or Dantrolene

Hydrocortisone when all other treatments fail

Question 15

What drug should you avoid when you are taking Amphotericin B?

Answer 15

NSAIDS - hard on the kidneys

Question 16

What can you do to help prevent damage to the kidneys on treatment days when receiving Amphotericin B?

Answer 16

Infuse 1 L of saline to hydrate while getting treatment

Question 17

Broad-spectrum anti fungal drugs
Lower toxicity than Amphotericin B
Can be given orally

Answer 17

Azoles

Question 18

Name an Azole

Answer 18

Itraconazole (Sporanox)

Question 19

What is Itraconazole (Sproanox) used for?

Answer 19

Systemic and local mycoses

Question 20

What is the MOA of Itraconazole (Sporanox)

Answer 20

Inhibits fungal cytochrome P450 dependent enzymes

Question 21

What are some common side effects of Itraconazole (Sproanox)?

Answer 21

Edema

Elevated liver enzymes

Question 22

What are serious side effects of Itraconazole (Sporanox)?

Answer 22

BLACK BOX WARNING - do not administer for treatment of Onychomycosis (toe nail fungus) with heart failure

Question 23

What drugs are interact with Itraconazole?

Answer 23

Pimozide
Quinidine
Dofetilide
Cisapride

Question 24

How should you administer Itraconazole?

Answer 24

Once a day

Take with food or a COLA BEVERAGE

Question 25

What drugs should you not give within 1 hour with Itraconazole because they make the body too alkalotic?

Answer 25

PPI's and H2 Blockers

Question 26

What is Flucanazole used for?

Answer 26

Fungistatic infection

Question 27

How is Fluconazole administered?

Answer 27

IV and PO dosage the same

Question 28

Name an Echinocandin

Answer 28

Caspofungin (Cancidas)

Question 29

How is Echinocandin: Caspofungin (Cancidas) given?

Answer 29

IV

Question 30

What is the MOA of Echinocandin: Caspofungin (Cancidas)?

Answer 30

Inhibiting the biosynthesis of beta-1

Question 31

What is Echinocandin: Caspofungin (Cancidas) used for?

Answer 31

Systemic Candida infections such as peritonitis, pleural space infections, and intra-abdomninal absceses

Question 32

What are the adverse effects of Echinocandin: Caspofungin (Cancidas)?

Answer 32

Fever | Phlebitis