Chapter 42 Antifungals

Question 1

Mycotic infections

Answer 1

• Four general types incude cutaneous, subcutaneous, superficial, and systemic
• Candida Albicans may result from antibiotic therapy, antineoplastics, and immunosuppressants. Overgrowth can cause systemic infections

Question 2

Antifungal drug classes and examples

Answer 2

• Polyenes: amphotericin B (Fungizone), and nystatin
• Triazoles: fluconazole (Diflucan)
• Allylamine: terbinafine hydochloride (used for athletes foot and nail fungal infections)
• Systemic include amphotericin B, fluconazole, terbinafine hydrochloride, and ketoconazole
• Topical include nystatin, terbinafine, miconazole, and ketoconazole

Question 3

Amphotericin B

Answer 3

• Drug of choice for many severe systemic infections
• Adverse effects include fever, headache, malaise, hypotension, muscle and joint pain, lowered potassium and magnesium levels, nausea
• To reduce the severity of infusion related reactions, pretreatment with antipyretics, antihistamines, antimetics, or corticosteroids may be given.
• Use IV infusion pumps and the most distal veins possible

Question 4

Contraindications and interactions of antifungals

Answer 4

• Contraindications include liver and renal failure
• Many antifingals are metabolized by the cytochrome P450 enzyme system. Coadministration of two drugs that are metabolized by the same system may result in competition for these enzymes, and thus higher levels of one of the drugs

Question 5

Fluconazole adverse effects

Answer 5

Nausea, vomiting, diarrhea, stomach pain

Question 6

Nursing implications for Nystatin

Answer 6

• 5 mL oral suspension should be swished in the mouth for 2 minutes
• After meals and before bed
• DO not drink or eat 30 minutes after treatment