42. Antifungal drugs Flashcards
Most commonly used drugs in this class
topical antifungals
The single antifungal drug for ophthalmic use
natamycin
Amphotericin B and nystatin are classified as __
polyenes
Ketoconazole is classified as an __
imidazole
Fluconazole, itraconazole, voriconazole, posconazole, and isavuconazonim are classified as __
triazoles
Imidazoles and traizoles are often referred to by the more general term __
azole antifungals
Caspofungin, micafungin, and andiulafungin are classified as __
echinocandins (-fungin)
-fungin is the suffix for which classification of antifungals?
echinocandins (-fungin)
Two antifungals that are not specifically classed
flucytosine and griseofulvin
Cause cell death by binding to sterols in fungi cell membrane
polyenes
Inhibit fungal cell cytochrome P-450 enzymes, which inhibits ergosterol production
imidazoles and triazoles (-azole)
Prevent synthesis of glucans for fungal cell walls
echinocandins (-fungin)
A polyene used to treat oropharyngeal candidiasis (aka thrush)
nystatin
A polyene effective against a wide range of fungi, synergistic with flucytosine
amphotericin B
Most common contraindication
drug allergy
A triazole that can cause fetal harm in pregnant women
voriconazole
A triazole that should never be used to treat onychomycoses in pts with cardiac problems
itraconazole
Drug of choice for severe systemic mycoses; many AEs; caution in bone marrow suppression or renal impairment; polyene
amphotericin B
For treatment of severe Aspergillus infection; must be reduced in pts w impaired liver function; echinocandin
caspofungin
Preferred to amphotericin B; triazole
fluconazole
Treatment for oral and vaginal candidiasis; topical for candidal diaper rash and taken orally as prophylaxis against candidal infections in immunosuppressed pts; polyene
nystatin
Topical, gel, and spray for superficial dermatologic infections (tenia pedis, tinea cruris, and tinea corporis); Tablet for systemic use to treat onychomycoses; Only drug classified as an allylamine antifungal
Terbinafine
Severe Aspergillus infections and variety of other severe fungal infections; Contraindicated in pts taking other P-450 drugs; Only antifungal contraindicated in pregnancy; Must be adjusted for renal dysfunction; Triazole
Voriconazole
__ lozenges not used in children younger under 5; polyene
Nystatin
Patient teaching for nystatin lozenges
Do not chew or swallow whole
Patient teaching for nystatin oral suspension
Swish medication thoroughly for as long as possible before swallowing
Monitor vital signs every 15 mins after IV amphotericin B; if severe reaction occurs then __
discontinue the infection while closely monitoring patient
Almost all pts given the polyene __ by IV experience fever, chills, hypotension, tachycardia, malaise, muscle/joint pain, anorexia, N, V, headache
amphotericin B
Pretreatment w antipyretics, antihistamines, antiemetics, and corticosteroids is common to decrease severity of infusion-related reaction in this polyene
amphotericin B
