Chapter 97- Antifungal Agents Flashcards
What are mycoses?
Fungal infections that can be systemic or superficial.
Includes opportunistic infections in immunocompromised hosts and non-opportunistic infections in any host.
What are the types of opportunistic infections?
- Candidiasis
- Aspergillosis
- Cryptococcosis
- Mucormycosis
What are the types of non-opportunistic infections?
- Sporotrichosis
- Blastomycosis
- Histoplasmosis
- Coccidioidomycosis
What is the first choice antifungal for most systemic mycoses?
Amphotericin B
What is the mechanism of action (MOA) of Amphotericin B?
Binds to fungal cell membrane increasing permeability.
How long is the typical treatment duration with Amphotericin B?
6-8 weeks to 3-4 months.
What is a major adverse effect of Amphotericin B?
Nephrotoxicity
What should be monitored every 3 to 4 days during Amphotericin B treatment?
Renal function
What adverse effects can occur during infusion of Amphotericin B?
- Fevers
- Chills
- Rigors
- Nausea
- Headache
What is the effect of lipid-based Amphotericin B compared to conventional forms?
Decreased renal damage.
What are some additional adverse events associated with Amphotericin B?
- Bone marrow suppression
- Delirium
- Hypotension
- Hypertension
- Rash
- Seizures
What drug interactions are notable with Amphotericin B?
- Nephrotoxic drugs (aminoglycosides, cyclosporine, NSAIDs)
- Flucytosine (potentiates antifungal actions)
What is the MOA of Itraconazole?
Inhibits synthesis of ergosterol.
What are common adverse effects of Itraconazole?
- Nausea
- Vomiting
- Diarrhea
- Rash
- Headache
- Abdominal pain
What should be avoided in patients with a history of heart failure when using Itraconazole?
Transient cardiac suppression.
Which drugs can cause fatal ventricular dysrhythmias when used with Itraconazole?
- Cisapride
- Pimozide
- Dofetilide
- Quinidine
What is the MOA of Echinocandins like Caspofungin?
Disrupt fungal cell wall.
What are common adverse effects of Caspofungin?
- Phlebitis
- Headache
- Rash
- Nausea
- Vomiting
What type of infections is Flucytosine used for?
Severe infections caused by Candida and Cryptococcosis.
What is the MOA of Griseofulvin?
Inhibits fungal mitosis.
What is the primary treatment for superficial mycoses?
Topical azoles.
What are examples of common dermatophytic infections?
- Ringworm
- Tinea pedis (athlete’s foot)
- Tinea corporis (ringworm)
- Tinea cruris (jock itch)
- Tinea capitis (ringworm of the scalp)
What is the treatment duration for toe nails with Griseofulvin?
Up to a year.
What antifungal is used for oral candidiasis in infants?
Nystatin.
What is the risk category of azole antifungals during pregnancy?
Risk category C or D.
What factors affect the absorption of antifungal agents in older adults?
Decreased gastric acid and drug interactions.
Fill in the blank: The drug _______ is used in combination with Amphotericin B to enhance antifungal activity.
Flucytosine
