Anti-Fungal Agents (week 10) Flashcards
What are opportunist drugs for systemic mycoses for?
Immunocompromised host
What are nonopportunistic drugs for systemic mycoses for?
Infection that occurs in any host
What are the three classes of Anti-fungal Drugs?
Polyene Antibiotics
Azoles
Echinocandins
Name a Polyene Antibiotic
Amphotericin B
What is Amphotericin B used for?
Progressive and Potentially fatal fungal infections
How is Amphotericin B given?
IV, slowly over 2-4 hours
How long does it take for Amphotericin B to be excreted?
Elimination can take up to 6 weeks.
What is the MOA of Amphotericin B?
Binds within the fungal membrane, making it more permeable
How is Amphotericin B adminstered?
IV
Intrathecal
How do you order Amphotericin B?
Using proprietary doses
What are common side effects of Amphotericin B?
Infusion reaction - assess for phlebitis
What are some serious side effects for Amphotericin B?
Nephrotoxicity
Cardiac arrest
BLACK BOX WARNING - reserve use for progressive and potentially life threatening events
What should you use for mild reactions related to Amphotericin B?
Diphenhydramine and Acetaminophen
What drugs should you use to treat Rigors that are related to Amphotericin B?
Meperidine or Dantrolene
Hydrocortisone when all other treatments fail
What drug should you avoid when you are taking Amphotericin B?
NSAIDS - hard on the kidneys
What can you do to help prevent damage to the kidneys on treatment days when receiving Amphotericin B?
Infuse 1 L of saline to hydrate while getting treatment
Broad-spectrum anti fungal drugs
Lower toxicity than Amphotericin B
Can be given orally
Azoles
Name an Azole
Itraconazole (Sporanox)
What is Itraconazole (Sproanox) used for?
Systemic and local mycoses
What is the MOA of Itraconazole (Sporanox)
Inhibits fungal cytochrome P450 dependent enzymes
What are some common side effects of Itraconazole (Sproanox)?
Edema
Elevated liver enzymes
What are serious side effects of Itraconazole (Sporanox)?
BLACK BOX WARNING - do not administer for treatment of Onychomycosis (toe nail fungus) with heart failure
What drugs are interact with Itraconazole?
Pimozide
Quinidine
Dofetilide
Cisapride
How should you administer Itraconazole?
Once a day
Take with food or a COLA BEVERAGE
What drugs should you not give within 1 hour with Itraconazole because they make the body too alkalotic?
PPI’s and H2 Blockers
What is Flucanazole used for?
Fungistatic infection
How is Fluconazole administered?
IV and PO dosage the same
Name an Echinocandin
Caspofungin (Cancidas)
How is Echinocandin: Caspofungin (Cancidas) given?
IV
What is the MOA of Echinocandin: Caspofungin (Cancidas)?
Inhibiting the biosynthesis of beta-1
What is Echinocandin: Caspofungin (Cancidas) used for?
Systemic Candida infections such as peritonitis, pleural space infections, and intra-abdomninal absceses
What are the adverse effects of Echinocandin: Caspofungin (Cancidas)?
Fever
Phlebitis
