Polyenes - Antifungal Class Flashcards
Name of drugs of polyenes
- Amphotericin B
- Lipid formulations of amphotericin B
- Topical nystatin
What toxicities is amphotericin B mainly known for?
- Nephrotoxicity
- Infusion-related reactions
If amphotericin B toxicities want to be avoided, what should be done?
Use lipid formulation amphotericin B
What is the MOA for polyenes?
Polyenes bind to the ergosterol in the cell membrane of fungi, disrupting its membrane
Polyenes have a good spectrum in which fungal organisms?
- Candida
- Cryptococcus
- Most aspergillus
- Some zygomycetes
- Many moulds
- Dimorphic fungi
(T/F) - Polyenes have a good spectrum in ALL candida spp
FALSE - not lusitaniae
What is another adverse effect that could occur with polyenes?
Electrolyte disturbances
How can nephrotoxicity be prevented other than giving lipid formulations?
- Maintain pt hydration AND
- Give pre- and post-infusion saline boluses
What signs/Sx could occur with infusion-related reactions?
- Fevers
- Chills/rigors
How can infusion-related toxicity be prevented other than giving lipid formulations?
- Give pre-meds such as APAP, diphenhydramine and if needed meperidine for infusion reactions and/or hydrocortisone
What is the dose of amphotericin deoxycholate?
0.5-1.5 mg/kg/day
What is the dose of lipid formulations?
3-6 mg/kg/day
What is meperidine specifically treating in the signs/Sx of infusion-related reactions?
Rigors
How is nystatin given (route of administration) and why?
Topically due to poor tolerance given systemically
What drug interacts with polyenes increasing nephrotoxicity?
- Aminoglycosides
- Cyclosporine
