Exam 2 Antifungals Flashcards
5 reasons a patient may develop an upset in the oral flora balance resulting in a fungal infection
- Immunosuppression
- Systemic disease
- Antibiotics
- Hormones
- Chemotheraphy
6 clinical appearance of oral fungal infections
- “cottage-cheese” appearance
- Pseudomembranous
- Atrophic tongue
- Hyperkeratotic
- Geographic tongue
- ANGULAR CHEILITIS
Systemic treatment for a fungal infection is used with caution due to its toxicities, drug interactions, hard on the liver, and it promotes resistance. When is it acceptable to use a systemic treatment?
Chronic, extensive/severe mucocutaneous candidiasis and the very immunocompromised.
2 types of systemic treatment for a fungal infection
- AZOLE antifungals
2. amphotericin - IV for HIV patients
2 types of azole antifungals
- itraconazole (Sporanox) - severe cardio/neuropathy effects
- fluconazole (diflucan)
Why is topical treatment of antifungals preferred? What is a drawback of topical treatment?
Safer
Lower compliance - usually needed to apply 4-5x/day
What are the 2 go to topical topical medications?
- NYSTATIN (MYCOSTATIN)
2. clotrimazole - when nystatin is not effective (hard on liver)
When treating angular cheilitis,, combination drugs are used, what are they?
2 combinations
Antifungal and topical steroid
- iodoquinol and hydrocortisone cream
- nystatin and triamcinolone acetonide ointment
What are the 4 forms of antifungal agents?
- liquids
- Troches - sweetened vaginal preps with cocoa butter
- Pastilles - lozenge
- Powders
How does nystatin work?
Similar to penicillin, it binds to sterols in cell membrane, changes permeability which causes lysis and cell death
What are the 3 usual steps when treating oral fungal infections?
- Usual treatment period is 10-14 days
- Treat for min of 48 hours after symptoms subside
- Re-eval at 14 days after therapy
