Antifungal Drugs

Question 1

what are fungi?

Answer 1

they are large and divers group of micro-organism

Question 2

true or false: fungi affect immunocompromised individuals

Answer 2

true

Question 3

what are the different type of microorganisms?

Answer 3

Fungi, Yeast, Moulds, mycotic infections

Question 4

what is Candida albicans?

Answer 4

follow after an antibiotic therapy, antineoplastics, or immunesuppressants

Question 5

what is a growth of candida albicans in the mouth, and is common in newborn infants, and immunocompromised patients

Answer 5

thrush or oral candidiasis

Question 6

what is vaginal candidiasis?

Answer 6

yeast infections

Question 7

who is at risk for vaginal candidiasis?

Answer 7

pregnant women, women with diabetes, women taking oral contraceptives

Question 8

what are the anti fungal medications that are used to treat systemic infections?

Answer 8

terbinafine (lamisil) and voriconazole

Question 9

what are the four major groups of antifungals?

Answer 9

triazoles
echinocandins
imidazoles
polyenes

Question 10

what are the drugs in the triazole group?

Answer 10

fluconazole, voriconazole

Question 11

what are the drugs in the echinocandins group?

Answer 11

caspofungin

Question 12

what are the drugs in the imidazole group?

Answer 12

ketoconzaole

Question 13

what are the drugs in the polyenes group?

Answer 13

amphotericin B, nystatin

Question 14

MOA of griseofulvin

Answer 14

disrupts cell division
results: inhibited fungal mitosis
this is an older drug, we use newer ones

Question 15

MOA of amphotericin B and nystatin

Answer 15

binds to sterols in cell membrane lining
Results: fungal death

Question 16

what should make sure to do with amphotericin B (patient education)

Answer 16

swish and swallow water
refrain form sex, and still use it during your period

Question 17

MOA of ketoconazole, fluconazole

Answer 17

inhibit p450 enzymes

Question 18

Moa of caspofungin

Answer 18

prevent the synthesis of glucans (used for essential components of fungal cell walls)

Question 19

what do you use with severe systemic fungal infections

Answer 19

amphotericin B

Question 20

what drug passes into the cerebrospinal fluid and inhibits the growth of cryptococcal meningitis?

Answer 20

fluconazole

Question 21

what are contraindications for antifungal drugs?

Answer 21

allergy, liver, and kidney failure

Question 22

what is a special contraindication for griseofulvin?

Answer 22

porphyria

Question 23

what is a contraindication for itraconazole

Answer 23

for onchomycoses, and severe cardiac problems

Question 24

what is a contraindication for voriconazole?

Answer 24

fetal harm in pregnant women

Question 25

what are some adverse effects of Amphotericin B

Answer 25

cardiac dysrhythmias neurotoxicity, eye kidney toxicity pulmonary infiltrates fevers, chills, headache, nausea, occasional hypotension, GI, anemia

Question 26

what do we give with amphotericin b prior to treatment to help with the adverse effects?

Answer 26

antisemitics, antihistamines, antipyretics, corticosteroids

Question 27

why do we infuse amphotericin b over a long period of time?

Answer 27

(2-6 hours) because we want to prevent infusion related reactions

Question 28

adverse effects of fluconazole?

Answer 28

nausea, vomiting, diarrhea, stomach pain, increased liver enzymes caution with liver/kidney dysfunction

Question 29

what are some adverse effects of nystatin?

Answer 29

nausea, vomiting, anorexia, diarrhea, rash, urticaria

Question 30

anti fungal drug interactions?

Answer 30

P450 enzyme system drugs, because anti fungal drugs are metabolized this way as well

Question 31

what should you do before you administer these types of drugs?

Answer 31

CBC monitor vitals of patients who are receiving this therapy IV every 15-30 mins

Question 32

what vein should you use with amphotericin B IV therapy?

Answer 32

distal vein