Infectious Disease - Antifungals Flashcards
Amphotericin B
MOA
ADE
Premedicate
Formulation differences
Bids to ergosterol
Shaking, chills, hypotension, decrease K+, decrease Mg2+
tylenol, hydrocortisone, acetaminophen, diphenylhydramnie, meperidine (for shaking/chills)
Lipid formulation - less toxic but more expensive
Conventional -
How do you mix ampho-B
Reconstitute in NS then mix with D5W
Azole
MOA
ADE
PGx
Inhibit 450-dependent ergosterol synthesis
Hepatotoxicity
CYP450 inhibitor
When would you choose Lipid over conventional ampho B ?
If they have significant renal impairment
Which azoles need acidic environment?
Which penetrate CNS?
Itraconazole and ketoconazole
Itraconazole and fluconazole
Can you use fluconazole in pregnant women?
Yes, but only the topical version x7days for vulvovaginal yeast infections
Itraconazole
Brand
Dosage forms
Dose
ADE
Sporanox
PO, solution, IV
200mg QD x 12 weeks
Negative ionotrope (avoid in CHF), hepatotox
Ketoconazole
Brand
ADE
Dosage forms
Nizoral
Gynecomastia (can suppress testosterone)
Shampoo, cream, tabs
Voriconazole
DOC for..
Dosage form
Counseling
ADE
Aspergillosis
Injections, tab, suspension
Take on empty stomach
Vision issue, CNS, LFT, photosensitivity, QT prolongation
Isavuconazonium
Brand
Indication
Contraindication
Cresemba
Aspergillosis, mucormycosis
CYP3A4 inhibitors (cresemba is a major 3A4 substrate)
Caspofungin
Brand
MOA
Indication
Stability
Dosage formulation
Cancidas
Inhibit synthesisi of glucan
Invasive aspergillosis
NS or LR
IV only
Anidulafungin
MOA
Indication
Dosage
ROA
Eraxis
Inhibit cell wall formation
Serious candida infection
IV
Posaconazole
Brand
MOA
Indication
Dosage form
ADE
Inhibit ergosterol synthesis
prevention/treatment of invasive aspergillosis and candida
suspension, DR tabs, IV
LFT, QT prolongation
Clotrimazole
Dosage form and indication
Cream for athlete’s food
Lozenge for oral thrush
Gyne-lotrim cream for vaginal yeast infection
Vaginal tablet for vaginal yeast infectionN
Nystatin
Oral thrush counseling
Swish and SWALLOW QID
Miconazole
MOA
Dosage forms
Indication
Inhibits ergosterol synthesis
powder/liquid spray cream
Tinea corporis/pedis and vaginal candidiasis
Terbinafine
Brand
MOA
DOC for…
Lamisil
Inhibit ergosterol synthesis
Onychomycosis (fingernail and toenail)
Ciclopirox
Brand
Indication/dosage form
Dose/counseling
Penlac 8%
Topical nail lacquer for onychomycosis
Apply daily for 7 days and do not remove previous application
Efinaconazole
Brand
Indication
Dose
Jublia
Fungal nails
Daily for 48 weeks
Tavaborole
Brand
Indication
Dose
Kerydin 5% solution
Onychomycosis of toenail
Daily for 48 weeks
Luliconazole
Brand
Age
Luzu
> 18y.o
Flucytosine
Brand
Dosage form
ADE
Indication
Ancobon
PO
Myelosuppression
Synergistic with ampho B or fluconazole for cryptococcal meningitis
