Antifungals Flashcards
Types of anti fungal
TIPO
Triazole
Imidazole
Polyene
Other
Examples of triazole
For systemic infections
Fluconazole
Itraconazole
Poscanozole
Voriconazole
Examples of imidazol
Clotrimazole
Miconazole
Ketoconazole
Econazole
Treat skin and vagunal
Polyene anti fungal examples
Nystatin (oral and skin infection)
Amphoterecin (IV) systemic infections
Other antifungal examples
Terbinafene (skin and nails)
Griseofulvin
Why is amphotericin brand specific
Different IV preps - liposomal, liposomal pegylated, lipid complex
What monitoring with amphotericin
Renal - nephrotoxic
Hepatic
FBC
What is fluconaze used for
Thrush - 150mg dose one off
What is oral ketoconazole used for
Cushing syndrome - prevents release of cortisol so lowers cortisol but can cause hepatoxiciry
Vorticonazole side effects
Skin cancer - lesions - avoid sunlight
Photosensitivity
Need to measure liver before weekly for a month then monthly
Which patients must carry alert card
Those on voriconazole and they must report if they get skin burns asap to doctor
Vorticonazole monitoring
Hepatic function before then weekly for a month then monthly
Fluconazole side effects
QT prolongation
Skin reaction
Liver disease
GI probs
N&V
Itraconazole side effects
Heart failure
Jaundice
Itrazonazole interaction
With antacids
- the drug needs a acidic pH to work but antacids don’t do the opposite
Which antibiotics to avoid with parental route
Neomycin and amphoterican
Why to avoid fast infusion with amphiterican
Causes arrythmia
Guidance on prescribing amphotwriocn
Administer dose and monitor for 30 mins as risk of anaphylaxis
Can give prophylactic antipyretics or steroids if patient previously had adverse reaction
What to monitor with ketoconazole
ECG
Electrolytes (hyponatraemia, hypoglycaemia)
Hypotension
Anorexia
Vomiting
Hepatic disorders
Adrenal function
Types of fungal infections
Tinea corpis - skin
Tinea pedis - athlete foot
Tinea unguim - fungal nail
Tinea capitis - scalp
Treatment of tinea capitis
oral griseofulvin or terbinafine
Can add on topical ketoconazole (twice weekly for 2-4 weeks)
Imidizole cream under 5 daily for 1 week
If culture trichophyton tonsuran then continue terbinafine
If culture microsporum then use griseofulvin
Review after 4-8 weeks
Treatment for athletes foot - tinea pedis
Topical miconazole, clotrinazole 1% or terbinafene
Can add hydrocortisone 1% daily for 7 days if inflammation
If doesn’t work then oral terbinafine or griseofulvin
Duration of terbinafene 1%
12+
Apply 1-2 times a day for 7 days
Duration of clotrimazole 1%
3/4 times daily for 4 weeks
Duration of miconazole 2%
Twice daily for 2-6 weeks and cont for 10 days after lesion heal
Duration of econazole 1%
BD until lesions heal
