Antifungals Flashcards
Explain how fungus differs from bacteria.
It is composed of a rigid cell wall made up of chitin and various polysaccharides, and a cell membrane containing ergosterol.
What makes the fungus resistant to antibiotics?
Protective layers of the fungal cell make the organism resistant to antibiotics
What is the name of a fungal infection?
Mycosis
What patients are susceptible to fungal infections?
Immunocompromised patients
Give some examples of patients susceptible to fungal infections.
- Patients with AIDS and AIDS-related complex (ARC)
- Patients taking immunosuppressant drugs
- Patients who have undergone transplantation surgery or cancer treatment.
- Members of growing elderly population because their immune system is in decline.
What lifespan considerations are important to keep in mind when considering antifungal medication for children?
- Very sensitive to adverse effects and have more severe reactions occur
- Most systemic agents do not have proven safety and efficacy in children
- If needed, fluconazole, ketoconazole, terbinafine, and griseofulvin should be used due to pediatric dosing.
- Do not use topical agents over open or draining areas
- Do not use occlusive dressing or tight diapers over affected areas
Why should we not use topical antifungals over open or draining areas?
Because it increases systemic absorption which again increases the risk for toxicity.
Why should we not use topical antifungals under occlusive dressing or tight diapers over affected areas?
It increases the risk for systemic absorption.
If used in children, what are the names of the antifungal agents that we should prescribe? And why?
fluconazole, ketoconazole, terbinafine, and griseofulvin
These agents have pediatric dosing.
What lifespan considerations are important to keep in mind when considering antifungal medication for adults?
- Systemic agents can be very toxic
- Do not use unless causative organism has been identified
- OTC preps: follow instructions and call provider if situation does not improve
- Contraindicated in pregnancy and lactation
- Do not use topical agents over open or draining areas
What lifespan considerations are important to keep in mind when considering antifungal medication for older adults?
- More susceptible to adverse effects
- Hepatic dysfunction: may worsen hepatic problems or be toxic
- Systemic dose may need to be lowered
- Monitor patient more frequently (esp liver values)
- Some systemic agents are associated with renal toxicity
- Use cautiously in renal impairment and monitor closely
At what stage in our lifespan are we more susceptible to get a fungal infection?
As older adults.
When giving systemic antifungals, does the culture and sensitivity test need to be completed prior to administering, or can we administer medication and change if needed once results are back?
A culture and sensitivity should be completed prior to prescribing or administering systemic antifungal agents.
The only exception is if there is a quickly progressing life-threatening infection.
Considering patients who are prescribed antifungal agents are often already immunocompromised, what considerations should we take when administering these agents?
The need to wait for the culture and sensitivity test should be completed before administering these agents because these patients should not be placed at additional risks due to an incorrect agent and
their toxic effects.
What are the suffix(ex), names and potential outliers for the Systemic Azole Antifungals?
“-conazole”
- Fluconazole
- Itraconazole
- Ketoconazole
- Voriconazole
Why would we give Azole’s to patients?
fungal infections
How does Azole’s work in the body?
Bind to steroids causing cell death and inhibit glucan synthesis
TRUE/FALSE
Azoles are less toxic that some other antifungals, however this also makes them less effective.
TRUE
Are there any absolute & relative contraindications to prescribing Azole’s and if so, what are they?
Absolute : Allergy
Relative : hepatic and renal dysfunction
pregnancy and lactation