Antifungals Flashcards
What to know about Amphotericin B(injections, also known as AmBisone for the liposomal injection) side effects?
What does Ampho B need to be pre medicated with?
What does flucytosine get turned into and what are it’s side effects?
BBW: Doses should not exceed 1.5 mg/kg/day due to cardiopulmonary arrest. Infusion related side effects, low k and mag, nephrotoxicity. Lipid formulations have lower infusion reactions and low nephrotoxicity.
Acetaminophen or NSAID, Diphenhydramine and/or hydrocortisone.
Fluorouracil, used in combination of ampho b for crptococcal(meningitits) infection. Myelosuppresion.
When is fluconazole vs voriconazole used most often?
What are ketoconazole’s BBW?
What is fluconazole’s brand name, dose, and side effects for all the azoles to know of?
Fluconazole–> non pregnant vaginal candidiasis. Voriconzaole–> Drug of choice for aspergillus, watch for visual changes and phototoxicity.
Hepatoxicity, use oral tablets when other effective antifungal therapy is unavailable or not tolerated.
Diflucan, 150 mg PO x 1, Increased LFT’s, qt prolongation, fluconazole requires renal dose adjustment.
What is itraconazole’s BBW?
What special things to know about for Voriconazole(Vfend)?
What to know for Posaconazole(Noxafil) and which antifungal requires a filter?
CI’d in patients with HF, QT prolongation and ventricular tachyarrythmias including torsades de pointes.
Drug of choice for aspergillosis, CrCl < 50 mL/min: oral dosing is preferred, the IV vehicle(sbecd) can accumulate and worse renal function. Watch for liver damage, visual disturbance, phototoxicity, increased left’s, SCr, and CNS toxicity(hallucinations), don’t drive at night and avoid direct sunlight.
Take with food, watch for QT prolongation.Isavuconazonium requires a filter.
What are caspofungin and micafungin’s brand names and what to know about them?
What to know about Griseofulvin?
What to know about terbinafine?
Cancidas, Mycamine. Histamine-mediated symptoms. Give once daily and do not require dose adjustment in renal impairment.
binds to keratin precursor cells and is used for dermatomycosis and tinea infections of skin, hair, and nails. Take with a fatty meal(food or milk). CI’d in pregnancy and watch for photosensitivity and increase LFT’s.
Topical forms(rx, OTC), inhibits squalene epoxidase. Watch for hepatoxicity and HA, increased lft’s.
What to know about clotrimazole?
What to know about nystatin?
How do you treat candida albicans(thrush)?
troche/lozenge, mycelex name).
suspension and tablet, swish in the mouth and retain for as long as possible (several minutes) before swallowing.
Topical antifungals(clotrimazole and nystatin) if mild, If HIV+ or moderate-to-severe(fluconazole). Fluconazole or echinocandin if esophageal infection
How do you treat candida glabrata or krusei?
How do you treat aspergillus?
How do you treat cryptococcus neoformans?
Echinocandins
Voriconazole(preferred), liposomal ampho B, isavuconazonium.
Ampho B + (5-FC), consolidation: fluconazole(prolonged).
How do you dermatophytes?
What to know about Oseltamivir(Tamiflu)?
What to know about Zanamivir?
nail bed infections: itraconazole, terbinafine, or fluconazole.
Capsules, suspension, treatment is 75 mg BID x 5 days, 75 mg daily x 10 days is prophylaxis. Neuropsychiatric events.
inhalations, bronchospasm(do not use in asthma/COPD or any breathing problems).
What big things to know about Acyclovir or Valacyclovir or Penciclovir?
Caution with renal impairment, the elderly or those receiving nephrotoxic agents. Acyclovir dose is based on IBW;even in obese patients. Zovirax cream(for cold sores, herpes simplex), Valacyclovir(prodrug of acyclovir), Famciclovir is a prodrug of penciclovir=]
