Fungal Infections - Chapter 33 Flashcards
Fungi
- Primitive plant-like cells that reproduce by budding, releasing spores, or fusing hyphae
- many are beneficial and do not cause disease, some can cause severe illness
Mycoses
Fungal infections
Fungal Infections of the Skin
Most fungal infections are caused my dermatophytes
Dermatophytes
- Thrive on dead skin and keratin found on skin, hair, and nails
- Not found in mouth or vaginal mucosa, but groin often affected
Tinea Fungal
Infections
Mycoses caused by the dermatophyte tinea are named for the site of the infection
Tinea manus
Hands
Tinea corporis
body
Tinea capitis
head
Tinea unguium
nails
Tinea pedis
feet
Athlete’s Foot (tinea pedis)
- Common infection that affects athletes and non-athletes
- easily acquired by walking across infected surface
- flaking, itching, burning and peeling of skin between toes
Ringworm
- Caused by tinea fungi
- May occur on body, scalp, feet, fingernails, or toenails
- Is contagious and can be spread between humans and animals
Onychomycosis
-Fungal infections of the nails
Candidiasis
Vulvovaginal Candidiasis is known as a “yeast infection”
Signs and symptoms include:
- itching
- cottage cheese-like discharge
- pain during intercourse
Risk factors for vulvovaginal Candidiasis
- Decreased immune status
- Diabetes
- Drug therapy
- Pregnancy or menses
- Sexual activity
- Douching
- Tight, synthetic clothing; bath products
Oral Candidiasis (thrush)
- Candida infection in the oral cavity
- Common in infants
Antifungal Agents MOA
- Destroying the fungus’s cell membrane
- Interference with the synthesis of nucleic acids needed for replication
- Inhibit fungal cell wall synthesis
Antifungals Classification
- Imidazoles and triazoles
- Allylamines
- Polyenes
- Thiocarbamates
- Echinocandins
- Misc.
Imidazoles and Triazoles
-Common ending: “azoles”
- Interfere with ergosteral, an essential component needed for the synthesis of the fungal cell membrane
- Some are OTC, some are RX and some are both, depending on formulation
Generic: clotrimazole
Canesten, Clotrimaderm
- OTC
- For vaginal or skin candida infections
Generic: miconazole
Monistat, Micatin
- OTC
- For vaginal or skin candida infections
Generic: ketoconazole
Nizoral
Shampoo
-OTC
Generic: fluconazole
Diflucan
- Only 150 mg oral are OTC
- 50 mg, 100 mg, and oral suspension are RX
Fluconazole ADR’s
- Headache
- Nausea
- Stomach pain
Fluconazole Tech Note
- Contraindicated in pregnancy
- NO GRAPEFRUIT
- Many drug interactions
Generic: itraconazole
Sporanox
- RX
- For systemic infections, nail fungus, or solution may be used for esophageal candidiasis
Generic: ketoconazole
Nizoral
tablets or cream
- RX
- For systemic infections, nail fungus, or dermal fungal infections
ketoconazole and itraconazole ADR’s
- Liver toxicity
- Nausea/vomiting
- GI upset
ketoconazole and itraconazole Warming Labels
- AVOID ALCOHOL
- AVOID GRAPEFRUIT PRODUCTS
- TAKE WITH FOOD (except itraconazole solution: empty stomach)
Generic: posaconazole
Posanol
-RX
Warning Labels:
-TAKE WITH FOOD
Generic: voriconazole
Vfend
- RX
- For treatment or prevention of systemic candidiasis or Aspergillus
Warning Labels:
-TAKE ON AN EMPTY STOMACH
posaconazole and voriconazole ADR’s
- Liver toxicity
- Nausea/vomiting
- GI upset
posaconazole and voriconazole Warning Labels
-AVOID ALCOHOL
Generic: terconazole
Terazol
- RX
- Vaginal cream
Generic: efinaconazole
Jublia
- RX
- topical for nail fungus
Allylamine Antifungals
-stunt the growth of fungi by blocking an enzyme needed for the synthesis of ergosterol
Generic: terbinafine
Lamisil
-RX
Allylamine Antifungals ADR’s
- Liver toxicity
- Headache
- Taste and smell disturbances
Allylamine Warning Labels
-AVOID ALCOHOL
Polyene Antifungals
-Inhibit the synthesis of the fungal cell membrane
Generic: amphotericin B
Fungizone
- treats systemic infections caused by candidiasis, histoplasma, and aspergilla
- iv and light sensitive
Generic: nystatin
Mycostatin, Nilstat, Nyaderm
- Treats candida infections on the skin and mucous membranes
- Topical cream and ointment are OTC
- Oral tablets, suspension, and vaginal products are RX
Thiocarbamates
- Tolnaftate is the only thiocarbamate
- Stunts growth of susceptible dermatophytes
Generic: tolnaftate
Tinactin
- OTC
- Used to treat jock itch, athlete’s foot, and ringworm
Echinocandin Antifungals
- anidulafungin
- caspofungin
- micafungin
Generic: anidulafungin
Eraxis
-Used to treat infections caused by Candida and Aspergillus
MUST REFRIGERATE
Generic: caspofungin
Cancidas
-Used to treat infections caused by Candida and Aspergillus
MUST REFRIGERATE
Generic: micafungin
Mycamine
-Used to treat infections caused by Candida and Aspergillus
MUST REFRIGERATE
Misc Antifungals
ciclopirox
Generic: ciclopirox
Loprox (cream and lotion), Penlac (nail laquer),
Stieprox (shampoo)
-Used to treat tinea infections and mild onychomycosis
Generic: clioquinol/flumethasone
Locacorten Vioform
