Fungal Flashcards
Disease associations with cryptococcal disease
- HIV
- Lymphoproliferative disorders
- Sarcoidosis
- CCS therapy
- Organ Tx
- End stage renal disease
- Chronic liver disease
- Hyper IgM syndrome
- Hyper IgE syndrome
- Anti-TNF mal (eg infliximab)
- DM (?)
No underlying condition (20-25%)
Ketoconazole key points
cheap
oral
toxic
Itraconazole key points
oral/solution
blasto, histo, sporo, paracoccidioidomycosis
many drug interxns (cyt p450)
heart failure, liver disease
Fluconazole key points
oral/suspension, iv weaker safest good CSF candida, crypto, coccioidomycosis
Ampho B key points
iv only
infusion toxicity (F, rigors, chills, HoT, SOB)
renal toxicity (dec GFR, HoK, HoMg)
-use IVF to prevent
Voriconazole key points
PO/iv
visual toxicity (reversible)
drug interxns
aspergillus, CNS blasto
Key points for dosing of azoles (exc pos)
Need loading dose
Decrease dose in renal dysfunction
Echinocandins - for which 2 orgs?
Aspergillus
Candida
(poor CNS penetration - not CNS candidiasis)
Flucytosine (5-fluorocytosine) key points
use with ampho B (R if used alone)
adjust dose in renal insufficiency
penetrates CSF, peritoneal, synovial fluids
active against yeasts (candida, c neoformans), chromoblastomycosis
Pathogenic yeasts
Cryptococcus neoormans
Candida
Terbinafine key points
PO/ topical low SEs /drug interxns v protein bound - keratin, adipose decrease dose in renal/hepatic dysftn broad spectrum dermatophytes, dimorphic fungi (sporotrich)
Dimorphic fungi
Sporotrichosis Coccidioides, Paracoccidioides, Blastomyces Lacazia loboi and Histoplasma
Deep mycoses
Crypto neoformans
Histoplasmosis
Paracoccidiomycosis
Aspergillus
Subcutaneous mycoses
sporothrix schenckii
chromoblastomycosis orgs
lacazia loboi (lobomycosis)
eumycetes (mycetoma)
