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PHRM 865: Theraputics V > Lecture 24.2: > Flashcards

Lecture 24.2: Flashcards

1
Q

What is Oropharynegeal & Esophageal Candidasis?

A
  • Oropharynegeal Candidasis: Infection in mouth [most common OI]
  • Esophegeal Candidasis: Infection in throat

Albicans is the most common

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2
Q

What is the clinical presentation of Oropherynegeal Candidasis?

A
  • “Cottage Cheese” look on tougue, gums or throat [can be easily removed]
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3
Q

What is the clinical presentation of esophegeal candidaisis?

A
  • Hard too swallow, sore throat, chest pain
  • Fever with white plagues down throat
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4
Q

What is the treatment for Mild Oropharynegeal Candidiasis?

A
  • Clotrimazole 10mg, Nystatin 100,000 units, Miconazole 50mg
  • 7-14 day duration
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5
Q

What is the treatment for Moderate [systemic] Oropharynegeal Candidiasis?

A
  • Fluconazole 100mg [Preferred]
  • Itraconazole solu. 200mg
  • Posaconazole 100mg with food
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6
Q

What is the treatment for Esophageal Candidiasis?

A
  • Fluconazole 200mg
  • 14-21 days
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7
Q

What is Vulvovaginal Candidiasis?

A
  • Infection with or without symptoms that have C. Albicans
  • Highest risk between 30-40yo
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8
Q

What are some of the general clinical presentations for Vulvovaginal Candidiasis?

General? Symptoms? Signs? Labs? Others?

A
  • Both Vulva and Vagina
  • Itchy, sore, irritated, burns
  • “cheese” like disacharge
  • pH = Normal
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9
Q

What is the treatment for Uncomplicated Vulvovaginal Candidiasis?

A
  • OTC/Topical: Butoconazole, Clotrimazole, Miconazole, Ticonazole
  • Rx/Topical: Nystatin, Terconazole
  • Rx/PO: Fluconazole 150mg, Ibrexafungerp
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10
Q

What is the treatment for Complicated Vulvovaginal Candidiasis?

A
  • Fluconazole 150mg
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11
Q

What is the treatment for Non-neutronpenic Adults wiht Candidemia?

A
  • Echinocandins
  • Fluconazole 800mg LD; then 400mg qd

Remove ALL IV caths, Repeat blood cultres, treat for 14 days after first (-) culture

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12
Q

What is the treatment for Neutronpenic Adults with Candidemia?

Glabrata, Parapsilosis, Krusei?

A
  • Glabrata = Echinocandins
  • Parapsilosis = Flucon or L AMP B
  • Krusei = Echinocandin, L AMOP B, or Voricon

14 days & remove caths

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13
Q

What is the emperic treatment for Invasive candidiasis in Non-netropenic adults in ICU?

A
  • Echinocandins [alt: flucon, L AMP B]

Treat for 2w from firsts negatvie cultues

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14
Q

What is the emperic treatment for Invasive candidiasis in Netropenic adults in ICU?

A
  • L AMP B, Echinocandins, IV Voricon [Alt: Flucon or Itracon]
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15
Q

Should you treat Asymptomatic Cadiduria [UTIs]?

A
  • NOT recommended unless high risk of dissemination
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16
Q

What is the treatment for Symptomatic Candida Cystitis [UTIs]?

A
  • Fluconazole 200mg [flucon -susceptible]
  • AMP B, 5-FC [flucon - resistance]
17
Q

What is the treatment for ImmunoCOMPETENT host for Histroplasmosis?

“Acute Pulmonary Hisoplasmosis”

A
  • Asymptomatic: NO THERAPY
  • Mild-Mod: Itraconazole for 6-12 weeks [Alts: Posacon or Flucon]
  • Mod-Severe: L AMP B for 12 weeks
18
Q

What is the treatment for ImmunoCOMPROMISED host for Histroplasmosis?

“Disseminated Histoplasmiosis”

A
  • Mod-Severe: L AMP B for 12 months
  • Less Severe: Itraconazole for 12 months
19
Q

What is the treatment for Pulmonary Blastomycisis in an ImmunoCOMPETENT patient?

A
  • Mod-severe: L AMP B for 6-12 months
  • Mild-Mod: Itraconazole for 6 months
  • CNS: induction = L AMP B & consolidation = fluconazole for > 12 months
20
Q

What is the treatment for Pulmonary Blastomycisis in an ImmunoCOMPROMISED patient?

Acute? Suppressive?

A
  • Acute Disease: L AMP B for > 12 months
  • Suppressive: Itraconazole for 12 months
21
Q

What is the treatment for Coccidiodomyciosis?

A
  • Primary Respiratory: Flucon or Itracon for 3-6 months
  • Symptomatic Pneumonia: Flucon or Itracon
  • Diffuse Pneumonia: AMP B for 12 months
22
Q

What is the treatment for Disseminated Coccidiodomycosis?

A
  • Nonmeningeal: Itracon or Flucon, AMP B
  • Meningeal: Fluconazole 400-1200mg IV/PO qd
23
Q

What is the treatment for Non-HIV infected, non-transplant host crytococcal meningeitis?

A
  • Induction: AMP B [or L AMP B + 5-FC]
  • Consolidation: Fluconazole 400-800mg
  • Maintenance: Fluconazole 200-400mg
24
Q

What is the treatment for HIV infected crytococcal meningeitis?

A
  • Induction: L AMP B + 5-FC
  • Consolidation: Fluconazole 800mg
  • Maintenance: Fluconazole 400mg
25
Q

What are some of the alternative regimens for HIV-infected patietns with cryptococcal meningitis?

A
  • AMP B or L AMP B for 4-6w
  • AMP B + Fluconazole, then Fluconazole alone
  • Fluconazole 800-1200mg + 5FU
  • Fluconazole 1200mg
26
Q

What is the treatment for Invasive Pulmonary Aspergillosis?

A
  • Voriconazole [Alts: L AMP B, Isavuconn, Voricon + Echincandin]
27
Q

What is the prohylaxis of aspergillosis?

A
  • Posaconazole

PHRM 865: Theraputics V (42 decks)

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