Antifungal Drugs Flashcards
General Types of Mycotic Infections
Cutaneous
Subcutaneous
Superficial
Systemic (can be life-threatening, usually occur in immunocompromised host)
Systemic Mycoses
Infections often resist treatment
Treatment may require prolonged therapy with drugs that frequently prove toxic
Candida Albicans
May follow antibiotic therapy, antineoplastics, or immunosuppressants (corticosteroids)
May result in overgrowth and systemic infections
Common in newborn infants and immunocompromised patients
Vaginal Candidiasis
Yeast infection
Common in pregnancy, women with diabetes mellitus, women taking oral contraceptives
Amphotericin B
Broad-spectrum antifungal agent
Highly toxic (infusion reaction and renal damage occur in many patients)
Must be given IV
Drug of choice for most systemic mycoses
Adverse Effects of Amphotericin B
Cardiac dysrhythmias, paresthesia, neurotoxicity, renal toxicity, pulmonary infiltrates, fever, chills, headache, nausea, hypotension
Toxic to veins, need to use big veins to avoid extravasation
Interactions of Amphotericin B
Aminoglycosides, cyclosporin, NSAIDs (increase nephrotoxicity)
Cause digoxin toxicity
Fluconazole (Diflucan)
Fungistatic
Same mechanism of action as itraconazole
Good PO absorption as well as IV
Used for infections caused by Candida and dermatophytic infections
Nystatin (Mycostatin)
Used only for candidiasis
Drug of choice for intestinal candidiasis but also used for candidal infection of the skin, mouth, esophagus, and vagina
Can be given PO or topically
Nursing Implications
Give pretreatment with antipyretics, antihistamines, antiemetics, and corticosteroids when giving Amphotericin B
Use IV infusion pumps and the most distal veins possible for Amphotericin B
Nystatin given as an oral lozenge should be slowly and completely dissolved in the mouth, not swallowed
