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NURS 252 (Pharmacology 2) > Antifungal Drugs > Flashcards

Antifungal Drugs Flashcards

1
Q

What are fungal infections also known as?

A

Mycoses

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2
Q

What are the four general types of mycotic infections?

A

Systemic, cutaneous, Subcutaneous and superficial

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3
Q

What part of the body do the cutaneous, subcutaneous and superficial fungal infections affect?

A

Integumentary system (Skin, hair, nails)

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4
Q

Fungi that cause integumentary infections are known as ____________

A

Dermatophytes

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5
Q

What are infections of the integumentary system called?

A

Dermatomycoses

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6
Q

How do yeasts reproduce?

A

Budding

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7
Q

Yeasts are ____________ and Moulds are _______

A

Single-celled; multicellular

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8
Q

What can the use of antibiotics, antineoplastics and immunosuppressants cause?

A

Colonization by candida albicans

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9
Q

What is an infection of candida albicans in mouth called?

A

Oral candidiasis or thrush

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10
Q

Who is more at risk for vaginal candidiasis?

A

Pregnant women, women with diabetes and women taking oral contraceptives

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11
Q

What are two types of systemic antifungal drugs?

A

Terbinafine and Voriconazole

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12
Q

What are the 4 major groups of antifungal frugs and give examples?

A

Triazoles: Fluconazole, Ketoconazole, Voriconazole
Echinocandins: Caspofungin
Imidazole: Ketoconazole
Polyenes: Amphotericin B, Nystatin

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13
Q

What is the MOA of Amphotericin B and nystatin?

A

They bind to sterols in the cell membrane lining and result in fungal cell death
They do not bind to human cell membranes.

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14
Q

What are considerations when administering nystatin orally (mouthwash)?

A

Swish and swallow.
No food for 30 minutes afterwards

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15
Q

T/F: Do not stop nystatin cream therapy during menstruation

A

True

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16
Q

Why do polyenes not bind to human cell membranes?

A

Human cell membranes have cholesterol instead of ergosterol.
Polyenes have a strong affinity for ergosterol

17
Q

What is the MOA of Imidazoles and triazoles?

A

They inhibit fungal cell cytochrome P450 enzymes, resulting in cell membrane leaking

18
Q

What is the MOA echinocandins?

A

They prevent the synthesis of glucans which are essential components of fungal cell walls resulting in fungal cell death.

19
Q

What is the drug of choice for severe systemic fungal infections and what are other parameters when choosing a drug?

A

Amphotericin B
Type and location of infection

20
Q

What is an indication of fluconazole?

A

Cryptococcal meningitis because it passes into the CSF and inhibits the growth of cryptococcal fungi

21
Q

What medication is used to treat onychomycosis?

A

Terbinafine
It is used for finger and toe nail fungal infections

22
Q

What are the contraindications of antifungal drugs?

A

Drug allergy
Liver failure
Kidney failure
Porphyria (Abnormal metabolization of Hb)

23
Q

What is a contraindication of voriconazole?

A

Can cause fetal harm in pregnant women

24
Q

What are the adverse effects of amphotericin B ?

A

Cardiac dysrhythmias
Neurotoxicity, tinnitus, visual disturbances, paresthesia, convulsions
Kidney toxicity, K loss, Hypomagnesemia
Pulmonary infiltrates
Fever, chills, headache, nausea, hypotension, GI upset, anemia

25
Q

What meds are used to prevent the adverse effects of amphotericin B and what can decrease the likelihood of infusion-related reactions?

A

Antiemetics, antihistamines, antipyretics, corticosteroids
Using longer than average drug infusion times (2 to 6 hours) and initiating a pre-infusion admin of 500-1000mL bolus of NS

26
Q

What are the adverse effects of fluconazole? What is one contraindication?

A

Nausea, vomiting, diarrhea, stomach pain, increased liver enzymes
Use with caution in patients with kidney or liver dysfunction

27
Q

What are the adverse effects of nystatin?

A

Nausea, vomiting, anorexia, diarrhea, rash, urticaria

28
Q

What are possible interactions with antifungal drugs?

A

Many antifungal drugs are metabolized by the P450 enzyme
Co-admin of two drugs metabolized by P450 can cause competition for this enzymes resulting in higher levels of one of the drugs

29
Q

How often should you monitor VS of patients receiving IV infusions?

A

15 to 30 minutes

30
Q

What are some considerations for administering amphotericin B?

A

Use IV infusion pumps and the most distal veins possible

31
Q

What tissue does an aspergilli’s infection affect?

A

Lungs

32
Q
A

NURS 252 (Pharmacology 2) (23 decks)

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