Antifungal, Antihelmintic, Ectoparasitic Flashcards
2 broad classifications for antifungal treatments
superficial infection and systemic infections
Where do superficial infections occur?
how are they treated?
scalp, nails, mucous membrane (oral vaginal)
-generally treated with topical drugs
which is more common- superficial or systemic fungal infections?
superficial
where do systemic fungal infections occur?
how do you treat systemic fungal infections?
internal organs: lung, brain, GI
-treat with IV or pill
which is more difficult to treat and requires more treatment time: systemic or superficial fungal infections?
systemic fungal infections
who is at risk for systemic fungal infections?
immunocompromised, transplants, HIV
3 systemic antifungal drugs to know
- Fluconazole (diflucan)
- Itraconazole (sporanox)
- Amphotericin B
How many categories of anitfungal drugs out there?
4
Amphotericin B- systemic or superficial antifungal
systemic antifungal
-broad spectrum
amphotericin B fxn
works by binding to ergosteroids in fungal cell membrane
- increase permeability
- cell leaks out cat ions like Potassium
amphotericin route
IV ONLY
Amphotericin Adverse effects
- nephrotoxicity
- electrolyte imbalance (K and Mg need replacing)
- anemia with long term use (monitor CBC)
total infusion time for 1 dose of amphotericin B
18 hours!
- 12 hours electrolyte
- 4 hours ampho
- 2 hours normal saline
Amphotericin Admin issues (3 general)
-phlebitis, fever, chills
Why use central line with amphotericin B?
avoid thrombophlebitis
how to decrease risk of nephrotoxicity with amphotericin B
give 500-1000 mL SALINE 1 hour before infusion of ampho
What do you premedicate with for Amphotericin B?
TYLENOL and BENADRYL to prevent infusion rxn of stimulating pro-inflammatory cytokines causing fever/chills/nause/headache
IV tubing and Amphotericin B
- IV tubing not compatible with normal saline!!
- –> change IV tubing to set up with D5
saline + aphotericin B=
precipitate
Amphotericin infusion rate
4 hours
Amphotericin B and Rigors- treat with….
merperidine (demerol) or dantrolene to stop shaking chills
2 post admin things to be done with Amphotericin B
- 500-1000 ml NORMAL SALINE over 1 hr
- Replace potassium and Magnesium
Amphotericin KCL replacement infusion rate
40 meq over 2 hours X 4 bags = 8 hours