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Infections > Antifungals > Flashcards

Antifungals Flashcards

1
Q

What antifungals are used to treat aspergillosis (first line)

A

Voriconazole, amphotericin

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2
Q

What antifungals are used to treat aspergillosis (intolerant to first-line)?

A

Caspofungin, itraconazole, posaconazole

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3
Q

First line and alternatives to treat vaginal candidiasis treatment?

A

Fluconazole (first line) or itraconazole or voriconazole (if resistant)

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4
Q

What is used to treat invasive or disseminated candidiasis?

A

Echinocandin

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5
Q

What is used to treat CNS candidiasis?

A

Amphotericin

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6
Q

What is the treatment for cryptococcosis mengingitis?

A

Amphotericin and flucytosine for 2 weeks then oral fluconazole for 8 weeks

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7
Q

What is the treatment for histoplasmosis (non-meningeal and severe)?

A

Itraconazole (non-meningeal) or amphotericin (severe) followed by itraconazole

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8
Q

Can oral terbinafine be used for pityriasis versicolor?

A

No

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9
Q

What is used to treat for tinea capitis and onychomycosis?

A

Griseofulvin, triazole antifungals, oral imidazole and terbinafine

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10
Q

What is used to treat prophylaxis in immunocompromised patients (fungal)?

A

Fluconazole (not against Aspergillus spp.), itraconazole (effective against Aspergillus)

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11
Q

What is caspofungin not effective against?

A

Fungal infections of the CNS

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12
Q

What can fluconazole be used to treat?

A

Fungal meningitis and candiduria (excreted largely unchanged in the urine)

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13
Q

When should itraconazole be avoided?

A

In patients with liver damage

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14
Q

What is posaconazole used to treat?

A

Invasive fungal infections unresponsive to conventional treatments

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15
Q

What is voriconazole used to treat?

A

Life-threatening fungal infections

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16
Q

What medications belong to the class of amidazole antifungals?

A

Clotrimazole, econazole, ketoconazole, ticonazole and miconazole

17
Q

What are amidazole antifungals used to treat?

A

Vaginal candidiasis and dermatophyte infections

18
Q

List polyene antifungals.

A

Amphotericin and nystatin

19
Q

What cautions should be taken with amphotericin’s formulation?

A

There are lipid formulations of amphotericin as well as a conventional formulation. Lipid formulations are less toxic. The conventional formulation is associated with nephrotoxicity. These formulations are NOT interchangeable.

20
Q

List echinocandin antifungals.

A

Caspfungin and micafungin

21
Q

What are echinocandin antifungals used against?

A

Asperigillus spp. and Candida spp. They are not effective against fungal infections of the CNS.

22
Q

Caspofungins are recommended to be used with what type of drugs?

A

Enzyme inducers such as carbamazepine, dexamethasone, phenytoin and rifampicin

23
Q

What dose adjustments are recommended with caspofungin?

A

Half the dose in moderate (renal) impairment

24
Q

What are the indications of amphotericin?

A

Aspergillosis, severe invasive candidiasis, cryptococcal meningitis and disseminated cryptoccocis in HIV patients

25
Q

What are the monitoring requirements for amphotericin?

A

Hepatic and renal function tests, blood counts, and plasma electrolyte (including plasma-potassium and magnesium concentration)

26
Q

When should amphotericin be discontinued?

A

Abnormal hepatic function

27
Q

What is the licensing for fluconazole capsules OTC?

A

Age: 16-60
Indication: Vaginal candidiasis and candidal balanitis
Dose/container: 150mg, max dose of 150mg.

28
Q

What are the indications of fluconazole?

A

Vaginal candidiasis, candidal balanitis, mucosal candidiasis, dermal candidiasis
Invasive candidal infections
Cryptococcocal infections (including meningitis)
Tinea pedis, corporis, cruris

29
Q

What are the indications of isavuconazole?

A

Invasive aspergillosis

30
Q

What are the indications of itraconazole?

A 
Aspergillosis
Histoplasmosis
Cryptococcosis (inc. meningitis)
Onychomycosis
Pityriasis versicolor
Systemic candidiasis 
Oral or oesophageal candidiasis in HIV+
Tinea pedis and manuum (30 days/7 days)
Tinea corporis and cruris (15 days/7 days)
31
Q

What should patients be advised when taking itraconazole?

A

Seek prompt medication attention if symptoms such as anorexia, nausea, vomiting, fatigue, abdominal pain or dark urine develop (indicative of liver disorder)

Infections (6 decks)

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