Infection fungal infections Flashcards
Aspergillosis: fungus that commonly affects lungs, can be caught from soil, rotting leaves, damp buildings.
how is it treated?
Voriconazole
(or amphotericin B as second line)
symptoms of Crytptococcosis include headache, confusion, cough, rash
treatment?
Amphotericin B
treatment for vaginal candidasis/ thrush?
and if resistant?
clotrimazole/ fluconazole
resistant: itraconazole oral
Oropharyngeal candidiasis/ thrush tx?
and if resistant?
NYSTATIN/MICONAZOLE/FLUCONAZOLE. RESISTANT? ITRACONAZOLE
treatment for skin and nail infections
topical. if not, systemic:
itraconazole/ terbinafine
broader spectrum of activity and require a shorter duration of treatment comp to eg griseofulvin
TERBINAFINE KEY POINTS? 3
Apply thinly
Report liver dysfunction- dark urine/ stools, jaundice, N&V, abdominal pain
Continue use-> monitor liver function
TERBINAFINE OTC
Age?
16+
TERBINAFINE OTC
TREATMENT PACK SIZE for…
Tinea pedis OR Tinea pedis+cruris?
Tinea pedis+cruris+corporis?
feet/ feet+ groin: 15g
feet + groin + body: 30mL spray/30g gel
FUNGAL INFECTIONS
what do the following terms refer to
TINEA (ringworm)
Capitis?
Corporis?
Cruris?
Pedis?
Unguim/Oncyhomycosis?
head
body
groin
feet
nails
FUNGAL INFECTIONS
TINEA TREATMENT?
Topical antifungal cream
OR
Terbinafine
FUNGAL INFECTIONS
Amorolfine nail lacquer, initial terbinafine
AMOROLFINE OTC
Age?
How often?
Max. strength+pack size?
18+
once weekly for up to 1 year
5%, 3mL
long tx, waiting for nails to grow out, bottom to top while applying the lacquer
when to refer pt with fungal nail infections to GP?
U2PD
under 18
>2 nails affected
preg/ breastfeeding
diabetic
ANTIFUNGAL MEDICATIONS- SIDE-EFFECTS
QT PROLONGATION/HEPATOXICITY? less of a risk in fluconazole, more risk in what? VIK
KETOCONAZOLE !!
VORICONAZOLE
ITRACONAZOLE
ANTIFUNGAL MEDICATIONS
CARBONATED DRINKS CAN IMPROVE BIOAVAILABILITY OF..?
ITRACONAZOLE
ANTIFUNGAL MEDICATIONS
LIFE-THREATENING HEPATOTOXICITY associated with which and what to do?
KETOCONAZOLE- oral treatment suspended,
*Oral ketoconazole for Cushing’s syndrome and topical products containing ketoconazole are not affected by this advice
ANTIFUNGAL MEDICATIONS
PHOTOTOXICITY occurs uncommonly with which?
VORICONAZOLE- avoid sunlight exposure
ANTIFUNGAL MEDICATIONS
AMPHOTERICIN B
Cautioned in which pts?
renal failure
Anaphylactic risk test for IV amphotericin B?
Test dose with 30mins obs
if ok, continue with doses. bc anaphylaxis risk!
AMPHOTERICIN B
Why maintain same formulation between conventional, liposomal, lipid complex forms?
Serious harm/fatal OD, all.
diff BA
with amphotericin B what can you give to pts who have had prev reactions (not anaphylaxis, just bad reaction)
prophylactic antipyretics or hydrocortisone
Terbinafine risk?
Hepatotoxicity
check out bnf
https://bnf.nice.org.uk/treatment-summaries/antifungals-systemic-use/
triazole, imidazole… more detail
