Antifungals Flashcards
Amphotericin B
MOA
disturbs fungal cell membrane (binds ergosterol)
- IV only (limited use)
- works great
- resistance uncommon
Amphotericin B
AE
*infusion related rxn: fever , chills, nausea, HA
-pre medicate: NSAID, steroid, antihistamine
*nephrotoxicity- monitor renal fxn
Hypokalemia
Amphotericin B
Available products
Amphotericin B deoxycholate- traditional
* lipid forms: ambisone, amphotec, abelcet
* big molecules, too big to cross BBB
Limits side effects/toxicities
Far less toxic
Restricted for certain patients
Very expensive
linits how much exposure healthy tissues get, healthy blood vessels don’t let the drug out, leaky/infected cells release the drug at the site of infection only
Amphotericin B deoxycholate
Ambisone
Amphetec
Abelcet
Amphotericin B antifungals
Azole Antifungals
MOA
Inhibit synthesis of ergosterol (fungal cell membrane component)
Azole Antifungals
PO administration *sensitive to how they are administered -Ph -with or without food *most commonly used anti fungal drugs Better tolerated than ampho-B
Azole Antifungals
AE
Hepatic metabolism-impairs liver ability to break down other drugs * high drug inx risk
N/V/D
HA
Amphotericin B
Azole
Echinocandins
Flucytosine
Anti fungal agents
Itraconazole (sporanox)PO
Flucanazole (diflucan) PO IV
*variconazole (vfend)PO IV, visual disturbances
*ketoconazole (niroval) PO, gynecomastia, low libido, period changes
posacanazole (novafil$ PO
*isavucanazonium (cresemba) PO, IV, prodrug (isavuconazole)
Azole Antifungals
Echinocandins “fungins”
MOA
Disrupt fungi cell wall of some fungus
- all IV (limited use)
- narrow spectrum
Echinocandins
AE
Fever Phlebitis Rash N/V Histamine mediated rxn (itchin, dyspnea, low BP)
Caspofungin (cancidas)
Micafungin (mycamine)
Andiulafungin (eraxis)
Echinocandins antifungals
Flucytosine
Cytotoxic to fungi cells
Resistance develops rapidly (commonly used with ampho B)
Limited spectrum
Readily absorbed
AE: bone marrow suppression, nuetropenia, thrombocytopenia, * hepatotoxicty
