Exam 2 Antifungals Flashcards Preview

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Flashcards in Exam 2 Antifungals Deck (11):
1

5 reasons a patient may develop an upset in the oral flora balance resulting in a fungal infection

1. Immunosuppression
2. Systemic disease
3. Antibiotics
4. Hormones
5. Chemotheraphy

2

6 clinical appearance of oral fungal infections

1. "cottage-cheese" appearance
2. Pseudomembranous
3. Atrophic tongue
4. Hyperkeratotic
5. Geographic tongue
6. ANGULAR CHEILITIS

3

Systemic treatment for a fungal infection is used with caution due to its toxicities, drug interactions, hard on the liver, and it promotes resistance. When is it acceptable to use a systemic treatment?

Chronic, extensive/severe mucocutaneous candidiasis and the very immunocompromised.

4

2 types of systemic treatment for a fungal infection

1. AZOLE antifungals
2. amphotericin - IV for HIV patients

5

2 types of azole antifungals

1. itraconazole (Sporanox) - severe cardio/neuropathy effects
2. fluconazole (diflucan)

6

Why is topical treatment of antifungals preferred? What is a drawback of topical treatment?

Safer
Lower compliance - usually needed to apply 4-5x/day

7

What are the 2 go to topical topical medications?

1. NYSTATIN (MYCOSTATIN)
2. clotrimazole - when nystatin is not effective (hard on liver)

8

When treating angular cheilitis,, combination drugs are used, what are they?
2 combinations

Antifungal and topical steroid
1. iodoquinol and hydrocortisone cream
2. nystatin and triamcinolone acetonide ointment

9

What are the 4 forms of antifungal agents?

1. liquids
2. Troches - sweetened vaginal preps with cocoa butter
3. Pastilles - lozenge
4. Powders

10

How does nystatin work?

Similar to penicillin, it binds to sterols in cell membrane, changes permeability which causes lysis and cell death

11

What are the 3 usual steps when treating oral fungal infections?

1. Usual treatment period is 10-14 days
2.Treat for min of 48 hours after symptoms subside
3. Re-eval at 14 days after therapy