Antifungals Flashcards
Fluconazole dose for uncomplicated vs complicated vulvovaginal candidiasis
Uncomplicated = 150mg once
Complicated = 150mg every 3 days, 2 or 3 times
Fluconazole class?
Triazole
Fluconazole indications?
Candida infections, especially where topical therapy failed
Also for tinea infections where topical failed
MOA of fluconazole?
Inhibits ergosterol synthesis by inhibiting 14-alpha-demethylase - an enzyme in the synthesis pathway. Causes cell leakage and death
Monitoring and counselling point for fluconazole?
Has lots of drug interactions due to CYP involvement
Monitoring of hepatic function and electrolyte levels may be required for longer treatment courses
Common azole side effects?
Rash, nausea, headache
Fluconazole rare ADRs?
Fatigue, SJS, hypokalaemia
Amphotericin class?
Polyene
Amphotericin MOA?
Binds to ergosterol in the membrane and creates a pore, allowing ions to leak out, leading to cell death
Ions = potassium and magnesium
Indication for amphotericin?
Severe systemic Fungal infections
Oral candidiasis (lozenge)
Absorption in GIT is very poor so either used IV, or as a lozenge for local use in GIT
IV dose of amphotericin?
3-5 mg/kg once daily
Amphotericin lozenge dose?
The lozenge is 10mg. Taken 4 times a day for 1-2 weeks
ADRs of amphotericin?
Oral = diarrhoea, nausea, vomiting
IV = anaemia, tachycardia, nephrotoxicity
Which antifungal is commonly combined with hydrocortisone in Resolve Plus?
Miconazole
Formulation options + dosage for miconazole?
Oral gel = 2.5ml 4 times a day
(2%) Powder, liquid, cream = apply thin layer twice daily
