Antifungal Pharm Flashcards
What route is most antifungal meds?
Topical
Nystatin (mycostatin) class
Polyene class; treats superficial candida infections of mouth (thrush), oral mucosa, vagina, and skin
What route can nystatin NOT be used for?
IV—too toxic
Nystatin SE
Not many, mild skin irritation; N/V/D when taken orally, poor GI abs—not for systemic
Amphotericin B class
Polyene antifungal; used for most systemic fungal infections
Amphotericin B MOA
Binds to ergosterol in fungal cell membranes and causes them to be leaky; destroy cell wall of fungus
Why is Amphotericin B a high alert med? And NC
High risk for cardiac dysrthymias; must dilute and infuse, slow bc kidney probs; monitor BUN and creatinine, need tele and frequent vitals
Pre-tx for Amphotericin B
Diphenhydramine (Benadryl), Tylenol, aspirin bc get fever, nausea, headache from infusion
Flucytosine and Amphotericin B
Have a synergistic effect—can dec dose of Amphotericin B when also giving flucytosine
Flucytosine (ancoban)
Pyrimidine class; inhibits fungal DNA synth
“Azoles” MOA
Interrupts the integrity of the cell wall by interfering with the synthesis of ergosterol
“Azoles” Indication
Used for both superficial and less serious systemic fungal infections
“Azoles” SE
Topical—red, burn, itch; systemic—severe GI (N/V/D), LIVER TOXICITY—jaundice, ab pain
Azoles NC
Watch liver probs, take with food but not with antacids or drugs that Dec stomach acid bc need acidic enviro to work
Fluconazole/Diflucam advantages
Rapidly and totally absorbs when given orally—reaches bones, CNS, eyes, respiratory, urinary w/o using IV—less toxic than Amphotericin
