Antifungal ~ systemic

Question 1

Aspergillosis tx

Answer 1

~ Voriconazole = best choice for aspergillosis
~ Liposomal amphotericin B = alternative 1st-line when voriconazole cannot be used.
~ Caspofungin, or itraconazole, used in refractory to, or intolerant of voriconazole & liposomal amphotericin B.
~ Itraconazole also used for tx of chronic pulmonary aspergillosis or as adjunct in` treatment of allergic bronchopulmonary aspergillosis [unlicensed].
~ Posaconazole licensed for invasive aspergillosis in refractory to, or intolerant of itraconazole or amphotericin B.

Question 2

Vagina candida

Answer 2

locally acting antifungals or with fluconazole given by mouth;
~ for resistant organisms in adults, itraconazole (by mouth)

Question 3

Itraconazole SEs, interactions

Answer 3

SE = HF + Hepatotoxic
Interactions: antacids, needs acidic pH for absorption

Question 4

Oral ketoconazole MHRA

Answer 4

~ risk of fatal hepatoxicity is greater than benefit of treating fungal infection

Question 5

Voriconazole SEs

Answer 5

Phototoxic & Hepatotoxic , carry alert card

Question 6

Amphotericin B SEs

Answer 6

Nephrotoxic
anaphylaxis with IV preps, do test dose & monitor for 30mins
specific brand; not interchangeable

Question 7

Oral thrush tx

Answer 7

1. Nystatin
2. Miconazole

Question 8

Vulval/Vaginal thrush

Answer 8

oral fluconazole
Topical imidazole (clotrimazole)

Question 9

Tinea capatis, corporis, cruris, pedis tx

Answer 9

Miconazole
Clortimazole
Terbinafine (athelets foot)

Question 10

Fungal nail infection

Answer 10

Amolorfine