11 - Antifungals

Question 1

Which group is nystatin in? Can it be given IV?

Answer 1

• Amphotericin B group

- Can’t be given IV b/c too toxic

Question 2

Echinocandins are fungi___

Answer 2

Cidal

Question 3

What does S-DD mean? What should be done when you see this?

Answer 3

• Susceptible double dose

- If you see this for an azole, just use echinocandin instead

Question 4

Some people can be rapid metabolizers of which azole?

Answer 4

Voriconazole

Question 5

Which PK parameter is used for amphotericin B efficacy?

Answer 5

Cmax/MIC > 4

Question 6

Which PK parameter is used for azole efficacy?

Answer 6

AUC/MIC > 25

Question 7

Which PK parameter is used for echinocandins efficacy?

Answer 7

AUC/MIC > 10

Question 8

Amphotericin B is fungi____

Answer 8

Cidal

Question 9

Azoles are fungi___

Answer 9

Static

Question 10

What assumption should be made about absorption for fluconazole?

Answer 10

Instantaneous absorption from GI tract

Question 11

What is the most common Candida species causing infections?

Answer 11

Candida albicans

Question 12

Should liposomal amphotericin B be used?

Answer 12

• No, gives lower drug levels than deoxycholate ampho B given by continuous infusion
• Point of liposomal was to decrease toxicity when given as a 2-6 h bolus, but w/ continuous infusion no need for it