Polyenes

Question 1

Examples:

Answer 1

1. Amphotericin B
2. Nystatin - Too toxic for systemic use - Only topical use

Question 2

MOA:

Answer 2

1. Incorporated into fungal cell membrane
2. Creates pore
3. Leaks vital intracellular K and amino acids
4. Lethal

Question 3

Spectrum:

Answer 3

1. Broad spectrum antifungals
2. Life threatening fungal disease
3. Nystatin - Superficial candida infections - oral, vaginal, cutaneous candida

Question 4

Indications:

Answer 4

1. CCM
2. Coccidioidomycosis
3. Severe Histoplasmosis
4. Severe Blastomycosis
5. Invasive mold infection

Question 5

S/E - Amphotericin B:

Answer 5

1. Fever
2. Chills
3. Phlebitis
4. Nephrotoxicity - Improved with lipid formulations of Ampho B

Question 6

Stewardship:

Answer 6

1. No evidence of invasive fungal infection
2. Stop Ampho B within 1 week
3. De-escalate to oral agent