Fungal Infections

Question 1

AMPHOTERICIN B BOXED WARNING

Answer 1

MEDICATION ERRORS WITH LIPOSOMAL ALTERNATIVE
CARDIOPULMONARY ARREST
CONVENTIONAL AMPHO DOSE SHOULD NOT EXCEED 1.5 MG/KG/DAY

Question 2

AMPHOTERICIN B COVERAGE

Answer 2

BROAD SPECTRUM
MOST CANDIDAS AND CRYPTOCOCCAL NEROFORMANS
ASPERGILLUS
OTHER DIMORPHIC FUNGI

Question 3

AMPHOTERICIN B SIDE EFFECTS
(WHAT PREMEDICATION IS USED TO REDUCE REACTIONS?)

Answer 3

INFUSION RELATED: FEVERE, CHILLS, HA, MALAISE, RIGORS
OTHER: ↓K, ↓MG, NEPHROTOXICITY
(APAP OR NSAID, DIPHENHYDRAMINE OR HC)

Question 4

AMPHOTERICIN B PREPARATION NOTES

Answer 4

COMPATIBLE WITH D5 W ONLY
LIPID FORMULATIONS MUST BE FILTERED

Question 5

FLUCYTOSINE (5-FC) COVERAGE

Answer 5

DUE TO DEVELOPMENT OF RESISTANCE, CAN NOT BE USED ALONE
COMBO WITH AMPHO B FOR INVASIVE CRYPTOCOCCAL MENINGITIS AND CANDIDA INFECTIONS

Question 6

FLUCYTOSINE SIDE EFFECTS

Answer 6

MYELOSUPPRESSION

Question 7

FLUCONAZOLE VAGINAL CANDIDA DOSE

Answer 7

150 MG PO X1

Question 8

FLUCONAZOLE IV:PO RATIO

Answer 8

1:1

Question 9

ITRACONAZOLE BOXED WARNING

Answer 9

CAN WORSEN OR CAUSE HF, DO NOT USE IF HX OF HF
CAN ↑ RISK OF QT AND TDP

Question 10

WHICH AZOLE REQUIRES AN ACIDIC ENVIRONMENT FOR ABSORPTION?

Answer 10

FLUCONAZOLE

Question 11

KETOCONAZOLE BOXED WARNING

Answer 11

HEPATOTOXICITY LEADING TO TRANSPLANT OR DEATH
QT PROLONGATIONS
ORAL TABS ONLY IF OTHER OPTIONS UNAVAILALE OR INEFFECTIVE AND BENEFITS > RISK

Question 12

AZOLE CLASS EFFECTS

Answer 12

↑LFT
RISK OF QT PROLONGATION
MANY DRUG INTERACTIONS

Question 13

WHICH IS THE ONLY AZOLE THAT REQUIRES RENAL DOSE ADJUSTMENT?

Answer 13

FLUCONAZOLE

Question 14

WHICH IS THE ONLY AZOLE WITH RISK OF HEPATOTOXICITY THAT CAN LEAD TO TRANSPLANT OR DEATH

Answer 14

KETOCONAZOLE

Question 15

WHICH AZOLE CAN LEAD TO HF

Answer 15

ITRACONAZOLE

Question 16

WHICH AZOLE CAN CAUSE VISUAL CHANGES AND PHOTOTOXICITY

Answer 16

VORICONAZOLE

Question 17

WHICH AZOLE DOES NOT HAVE EQUIVALENT DOSE BETWEEN PO TABS AND PO SUSPENSIONS

Answer 17

POSACONAZOLE

Question 18

BIOAVAILABILITY OF AZOLES

Answer 18

ALL HAVE 1:1 IV:PO

Question 19

WHICH AZOLES CAN PENETRATE THE CNS TO ADEQUATELY TREAT FUNGAL MENINGITIS?

Answer 19

FLUCONAZOLE
VORICONAZOLE

Question 20

VORICONAZOLE: WHAT SHOULD BE DONE AT CRCL<50

Answer 20

THE SBECD IV VEHICLE BUILDS UP
ORAL SHOULD BE USED IF POSSIBLE

Question 21

SHOULD VORICONAZOLE BE TAKEN WITH OR WITHOUT FOOD?

Answer 21

EMPTY STOMACH

Question 22

POSACONAZOLE WITH OR WITHOUT FOOD

Answer 22

WITH FOOD

Question 23

WHICH AZOLE CAN ACTUALLY CAUSE QT SHORTENING

Answer 23

ISAVUCONAZONIUM SULFATE

Question 24

ECHINOCANDIN AGENTS

Answer 24

CASPOFUNGIN
MICAFUNGIN

Question 25

ECHINOCANDIN MOA

Answer 25

INHIBIT SYNTHESIS OF BETA-D-GLUCAN

Question 26

AZOLE COVERAGE

Answer 26

VARY BETWEEN AGENTS - FLUCONAZOLE = YEAST AND ONCHOMYCOSIS - ITRACONAZOLE = DIMORPHIC FUNGI AND ONCHOMYCOSIS - VORICONAZOLE = ASPERIGILLUS - KETOCONAZOLE = TOPICAL INFECTIONS

Question 27

ECHINOCANDIN COVERAGE

Answer 27

MOST CANDIDA SPECIES ALSO COVERS ASPERGILLUS, BUT OTHER CLASSES ARE TYPICALLY PREFERRED

Question 28

ECHINOCANDIN CLASS WARNING

Answer 28

HISTAMINE-MEDIATED SYMPTOMS CAN OCCUR RESULTING IN ANAPHYLAXIS

Question 29

ECHINOCANDIN DOSING

Answer 29

ALL ONCE DAILY AND DO NOT REQUIRE DOSE ADJUSTMENT IN RENAL IMPAIRMENT

Question 30

NYSTATIN COMMON USES

Answer 30

ORAL CANDIDIASIS INTESTINAL INFECTIONS

Question 31

GRISEOFULVIN COMMON USE

Answer 31

FUNGAL INFECTIONS OF SKIN, HAIR AND NAIL

Question 32

GRISEOFULVIN CONTRAINDICATION

Answer 32

PREGNANCY

Question 33

GRISEOFULVIN SIDE EFFECTS

Answer 33

PHOTOSENSITIVITY ↑LFT

Question 34

GRISEOFULVIN ADMINISTRATION

Answer 34

WITH FATTY MEAL TO ↑ ABSORPTION OR FOOD/MILK TO AVOID GI UPSET

Question 35

CLOTRIAZOLE COMMON USE

Answer 35

OROPHARYNGEAL CANDIDIASIS

Question 36

MICONAZOLE COMMON USE

Answer 36

OROPHARYNGEAL CANDIDIASIS

Question 37

EMPIRIC TREATMENT FOR OROPHAYNGEAL CANDIDA ALBICANS

Answer 37

MILD: TOPICAL SUCH AS CLOTRIMAZOLE OR MICONAZOLE MOD-SEV OR HIV+: FLUCONAZOLE

Question 38

EMPIRIC TREATMENT FOR CANDIDA ALBICANS ESOPHAGEAL

Answer 38

FLUCONAZOLE ALT: ECHINOCANDIN

Question 39

EMPIRIC TREATMENT FOR ALL CANDIDA BLOODSTREAM INFECTIONS

Answer 39

ECHINOCANDIN ALT: AMPHO B

Question 40

EMPIRIC TREATMENT FOR INVASIVE ASPERGILLUS

Answer 40

VORICONAZOLE ALT: AMPHO, ISAVUCONAZONIUM

Question 41

EMPIRIC TREATMENT FOR CRYPTOCOCCUS MENINGITIS

Answer 41

AMPHO + FLUCYTOSINE

Question 42

EMPIRIC TREATMENT FOR NAIL BED INFECTIONS

Answer 42

TERBINAFINE OR ITRACONAZOLE ALF: FLUCONAZOLE