Fungal

Question 1

What is aspergillosis

Answer 1

Fungal infection

Most commonly affects respiratory system

Question 2

If a patient is immunocomprimised where can an aspergillosis infection spread too

Answer 2

brain
skin
heart

Question 3

what is the best treatment options for an aspergillosis fungal infection

Answer 3

Voriconazole

Or

Amphotericin B if cannot be used

Question 4

What may be a final treatment options for an aspergillosis fungal infection

Answer 4

itraconazole and posaconazole

Question 5

What is candidiasis

Answer 5

it is another form of fungal infection

Question 6

how are superficial candidial infections treated

Answer 6

they are treated locally with something like an antibiotic cream e.g. miconazole or fluconazole

Question 7

how would a widespread invasive candidial infection be treated

Answer 7

caspofungin

or

Fluconazole if a patient hasn’t received an azole treatment recently

Question 8

what would be an alternative to caspofungin and fluconazole for an invasive candidial infection

Answer 8

Amphotericin B

Question 9

how would a vaginal candida infection be treated

Answer 9

thrush cream e.g. clotrimazole or fluconazole

oral fluconazole

Question 10

With amphotericin B what should we consider doing before initiating for treatment

Answer 10

test dose is advisable before the first infusion as anaphylaxis can occur

Question 11

how long do we observe the patient for anaphylaxis after a testing dose of amphotericin B

Answer 11

we carefully observe them for 30 minutes

Question 12

In a patient who have previously had an infusion related reaction what could we give to them

Answer 12

prophylactic antipyretics

OR

hydrocortisone

Question 13

give some examples of antipyretics

Answer 13

ibuprofen
aspirin
paracetamol

Question 14

When prescribing amphotericin B what should we pay GREAT attention to so that we can prevent overdose.

Answer 14

Formulation (conventional or liposomal)

Brand Name

Question 15

In regards to infusion speed what rate should be given to limit the risk of arrythmias

Answer 15

slow as rapid infusion can lead to the increased risk of arrythmias

Question 16

What does itraconazole have a good action against

Answer 16

dermatophytes

Question 17

What environment do itraconazole capsules require to have for optimal absorption

Answer 17

acidic

Question 18

what type of organ damage is itraconzazole associated with

Answer 18

liver

Question 19

what type of disease should itraconazole be used with cautiously

Answer 19

liver disease

Question 20

what non liver condition is itraconazole used with caution in

Answer 20

heart failure

Question 21

what symptoms should a patient go to a doctor about while taking itraconazole

Answer 21

anorexia
nausea
vomiting
fatigue
abdominal pain

Question 22

What spectrum of coverage does voriconazole have

Answer 22

broad spectrum

Question 23

what is voriconazole indicated for

Answer 23

life threatening infections

Question 24

what are the side effects of voriconazole (2 types) to be aware of

Answer 24

Hepatitis
cholestsis
hepatic failure

phototoxicity

Question 25

What monitoring does voriconazole require

Answer 25

renal function hepatic function

Question 26

how frequently should we measure the patients renal and hepatic function while on voriconazole

Answer 26

weekly for a month every month after

Question 27

What fungal medication is no longer provided for fungal infections

Answer 27

oral and iv ketoconazole

Question 28

what can ketoconazole actually be used for

Answer 28

cushing syndrome

Question 29

What monitoring does ketoconazole require

Answer 29

ecg adrenal function hepatic function