skin diseases

Question 1

nystatin
amphotericin B

Answer 1

polyene antifungal
N: thrush, vagina, skin (obese); mild skin irritation, poor GI absorb - never systemic; many forms - too toxic for parenteral
A: bind ergosterol in membranes - leaky; stronger - systemic, high alert drug! dilute + slow, tele; pretreat with drugs to decrease infusion symptoms; huge IV bag - monitor BUN and creatinine, given every other day for months

Question 2

flucytosine

Answer 2

pyrimidine
inhibit DNA synthesis
lower amphotericin B dose: decrease SE

Question 3

ketonazole
miconazole
clotrimazole
itraconazole
fluconazole

Answer 3

azoles
integrity of cell wall by interfering with ergosterol
superficial and less serious systemic
F: PO absorb fast and reach deep (bones, CNS, eyes, respiratory, urinary tract), narrow spectrum with many interactions; much less toxic than amphotericin; dont mix IV, watch for hypogly with sulfonylureas, increase haldol and dilantin levels
topical: redness, burning, itching
systemic: SEVERE GI, nvd, liver
take with food, 2 hrs from antacid - need acidic environment

Question 4

grisefluvin

Answer 4

inhibit mitosis, bind keratin, no cell membrane
resistant - scalp, skin, nails
SE: bone marrow suppression, rash, CNS changes, nvd, anorexia
inexpensive older