Triazole Anti-Fungals Flashcards
Give 2 examples of triazole anti-fungals
- Fluconazole
- Itraconazole
What is the mechanism of action of triazole anti-fungals?
Inhibit fungal cytochrome P450 3A enzyme, which converts lanosterol to ergosterol (key component of fungal cell membrane), hence fungal cell replication is prevented
Are triazole anti-fungals broad or narrow spectrum?
Variable - some are broad, others are only effective against specific pathogens
What are the routes of delivery of triazole anti-fungals?
- PO
- IV
- Topical
What are the indications for triazole anti-fungals?
- Fungal respiratory tract infections, e.g. aspergillosis
- Candidiasis
- Skin and nail infections
- Prophylaxis against fungal infections in immunocompromised patients
When are triazole anti-fungals contraindicated?
Acute porphyrias
When should triazole anti-fungals be used with caution?
QT interval prolongation
When should triazole anti-fungals be avoided?
- Liver disease
- Pregnancy
Why should triazole anti-fungals be avoided in liver disease?
May cause hepatotoxicity
Describe the use of triazole anti-fungals in pregnancy?
Avoid fluconazole, only use itraconazole in life-threatening conditions
What might triazole anti-fungals interact with?
- Warfarin
- CCBs
- Sulphonylureas
- Colchine
Why should triazole anti-fungals be given with CCBs?
Negative inotrope, can precipitate heart failure
What might happen if triazole anti-fungals are given with warfarin?
Increased anticoagulant effect
What might happen if triazole anti-fungals are given with sulphonylureas?
Increased sulphonylurea concentration in plasma
What might happen if triazole antifungals are given with colchicine?
Increased risk of colchicine toxicity, hence colchicine should be withheld while anti-fungal is being taken
