Antifungals

Question 0

Nystatin/ Mycostatin

Answer 0

Binds to ergosterol in cell membrane- forms pores & causes K leakage= cell death
Fungicidal
Oral candidiasis, superficial mycoses(tinea’s), vaginal/esophageal candida, prophylaxis for pts at risk for mycoses(immunocomprimised)
N/V possible

Question 1

Clotrimazole/ Lotrimin

Answer 1

Interrupts cell membrane- causes leakage during division
Topical
Superficial mycoses- tinea’s yeast vaginitis
Inc resistance is occuring

Question 2

Terbinafine/ lamisil

Answer 2

Effective against dermatophytes
Topical
Superficial mycoses
Onychomycosis
Abd. Discomfort, diarrhea, HA, nausea. 
May cause elevated liver enzymes- monitor liver fxn before and with use

Question 3

Fluconazole/ Diflucan

Answer 3

Inhibits membrane synthesis
Superficial mycoses- yeast vaginitis
Systemic mycoses- cryptococcosis, histoplasmosis
N/V with oral & IV dosing
Can inhibit cyt enzymes for metabolism of many drugs

Question 4

Amphotericin B/ Amphocil

Answer 4

Binds to ergosterol in cell membrane- forms pores & causes K leakage= cell death
Systemic mycoses
Very toxic- “ampho-terrible”- fevers, shakes, chills, hypotension, renal impairment, severe anemia
Pre tx with Benadryl, NSAIDS, prednisone to mitigate fever/chills