Lecture 8 Cases Cellulitis and Meningitis

Question 1

Mechanism of Action: Amphotericin

Answer 1

It is fungistatic and can be fungicidal in high concentration. Amphotericin binds onto ergosterol in the fungal cell membrane and inhibits the function of the cell membrane as a selective barrier. This caused leakage of the intracellular content of the fungus and dies.

Question 2

Place in therapy: Amphotericin

Answer 2

This medicine is active against a wide range of yeasts and yeast-like including Candida albicans.

Question 3

Common adverse effects: Amphotericin

Answer 3

Chills, headache, flushing, dizziness, hair loss, or thinning, lack of energy, etc.

Question 4

Precautions: Amphotericin

Answer 4

Orally administered amphotericin B is not to be used for the treatment of systemic fungal infections.

Question 5

Contra-indication: Amphotericin

Answer 5

FUNGILIN is contraindicated in patients with a history of hypersensitivity to amphotericin B or any other component of the FUNGILIN formulation.

Question 6

MOA: Fluconazole /miconazole

Answer 6

Fluconazole is fungistatic. It acts by inhibiting the Cytochrome P450 dependent of lansterol. This inhibition will disrupt the synthesis of sterol in fungal cell membrane and causing the membrane to become permeable and die.

Question 7

Place in therapy: Fluconazole /miconazole

Answer 7

Fluconazole is used in the treatment of various infections caused by Candida, including candidemia and disseminated candidiasis.

Question 8

Common adverse effects

Answer 8

• Headache
• Nausea
• vomiting
• diarrhoea
• bloating
• indigestion

Question 9

Precautions: FLuconazole

Answer 9

• Sensitive to fluconazole

- causes hepatic impairment

Question 10

Contra-indication: Fluconazole

Answer 10

• Co-administration of terfenadine is contraindicated in patients receiving fluconazole at multiple doses of 400 mg per day or higher based upon results of a multiple dose interaction study.

Question 11

Common adverse effects: Miconazole

Answer 11

local irritation and hypersensitivity reactions

Question 12

Precautions: Miconazole

Answer 12

avoid contact with eyes and mucous membranes; topical miconazole may be absorbed systemically—potential for systemic drug interactions (including warfarin)

Question 13

Contra-indication: Miconazole

Answer 13

Cream applied to the genital area may damage latex condoms and diaphragms.

Question 14

MOA: Nystatin

Answer 14

Binds to sterols protein found in the fungal cell membrane and inhibit the function of selectivity and causes the fungal cell to be permeable and die from the leaking intracellular content.

Question 15

Place in therapy: Nystatin

Answer 15

Nystatin is an antifungal antibiotic, produced by a strain of Streptomyces noursei, active against yeasts and yeast like fungi, including Candida albicans.

Question 16

Common adverse effects: Nystatin

Answer 16

• feeling sick or nausea
• vomiting
• stomach upset
• diarrhoea

Question 17

Precaution: Nystatin

Answer 17

avoid contact with eyes and mucous membranes

Question 18

PK: Nystatin

Answer 18

Nystatin is absorbed very sparingly following oral administration when given in the recommended doses. The minimal absorption from oral dosage forms may however, be sufficient to provoke an allergic reaction in hypersensitive patients.

Question 19

MOA: Terbinafine

Answer 19

It is fungistatic and can be fungicidal in high concentration. Amphotericin binds onto ergosterol in the fungal cell membrane and inhibits the function of the cell membrane as a selective barrier. This caused leakage of the intracellular content of the fungus and dies.

Question 20

Place in Therapy: Terbinafine

Answer 20

Used in dermatophyte infections of the nails; candida and tinea infections (including tinea pedis, cruris, corporis) where oral therapy appropriate (due to site, severity or extent).

Question 21

Common adverse effects: Terbinafine

Answer 21

abdominal discomfort, anorexia, nausea, diarrhoea, dyspepsia, headache,

Question 22

Precautions: Terbinafine

Answer 22

psoriasis (risk of exacerbation); autoimmune disease (risk of lupus-erythematosus-like effect)

Question 23

Contra-indication: Terbinafine

Answer 23

Patients with active or chronic liver disease.