Fungal Infections

Question 0

Fluconazole (Diflucan)

Answer 0

Therapeutic class – antifungal

Pharmacologic class – inhibitor of fungal cell membrane synthesis, triazole (azole)

Pregnancy category C

Contraindications –
Hypersensitivity to the drug or another azole

Adverse effects –
Nausea
Vomiting
Diarrhea

Patient family teaching –
Immediately report signs of liver toxicity
If diabetic, maintain proper blood sugar controldisclose all current medications
Immediately report signs of drug allergy
Immediately report known or suspected pregnancy

Question 1

Amphotericin B Deoxycholate (Fungizone)

Answer 1

Therapeutic class – antifungal (systemic type)

Pharmacologic class – polyene

Pregnancy category B

Contraindications –
Blood urea nitrogen and (BUN) exceeds 40 mg/dL
Serum creatinine above 3 mg/dL her

Adverse effects-
Acute fever
Chills
Vomiting
Anorexia
Headache
Phlebitis
Potassium deficiency
Electrolyte imbalance

Patient family teaching –

• Notify if no improvement in 1 to 2 weeks
• Immediately report worsening symptoms
• Do not breast-feed
• Wash any towels or clothing that comes in contact with the affected areaimmediately report change in the amount of color of urine, unusual bleeding or bruising, yellowing of eyes or skin, palpitations, or chest pain
• Report any loss of hearing, dizziness, or ringing in the ears

Question 2

Nystatin (Mycostatin, Nystop, others)

Drugs for superficial mycoses

Answer 2

Therapeutic class – antifungal, superficial type

Pharmacologic class – polyene

Pregnancy category B

Contraindications – hypersensitivity to the drug

Adverse effects –
Minor skin irritation and burning (topical)
Contact dermatitis (topical)
Diarrhea, nausea, and vomiting (PO)

Patient family teaching –

• Stop drug, report symptoms of dermatitis
• Treat oral candidiasis (thrush) after meals, at that time
• Does off troches in mouth for 30 minutes
• no food or drink while dissolving the troche
• remove dentures before rinsing with oral suspension, dissolving the troche, in the mouth, and at night
• dust feet, shoes, and stockings with nystatin dusting powder
• use cream instead of appointments in body folds or areas of skin to skin contact; use powder on moist lesions
• Treatment of candida takes at least two weeks; therapy stops after two negative tests
• Vulvovaginal candidiasis treatment last two weeks; continue during menstruation
• use vaginal tablets up to six weeks before the end of pregnancy
• do not breast-feed