Term
| Antifungals Systemic Mycoses |
|
Definition
-Most dangerous!
-Opportunistic:
*Candidiasis
*Aspergillosis
*Cryptococossis
*Mucormycosis
-Non-opportunistic:
*Sporotrichosis
*Blastomycosis
*Histoplasmosis
*Coccidioidomycosis |
|
|
Term
| Amphotericin B Characteristics |
|
Definition
-Broad spectrum
-Fungicidal or fungistatic
-Drug of choice (DOC) for systemic fungi infections but highly toxic
-Only used for progressive & fatal infections
-All doses given IV infusion |
|
|
Term
| Amphotericin B Adverse Effects |
|
Definition
-Infusion rxn: fever, chills, nausea & HA starting 1-3 hours after starting infusion & persist for up to an hours (so give Benadryl, Tylenol or aspirin)
-Phlebitis: change IV sites, give through a large central vein & pretreatment with heparin
-Nephrotoxicity: in almost all pts. (dose dependant over tx period) usually reversible unless dose is over 4 grams.
-Check kidney fxn every 3-4 days.
-Hyperkalemia
-Bone marrow suppression |
|
|
Term
| Amphotericin B Drug Interactions |
|
Definition
-Aminoglycosides
-Cyclosporine
-NSAIDs
-Flucytosine |
|
|
Term
|
Definition
-Fluconazole (Diflucan)
-Itraconazole (Sporanox)
-Ketoconazole (Nizoral)
-Miconazole (Monistat IV)
-Clotrimazole
-Econazole
-Voriconazole |
|
|
Term
|
Definition
-Antifungal
-Alt. to Amphotericin B
-Take w/ food & cola
-Not for superficial infection
- |
|
|
Term
| Itraconazole Adverse Effects |
|
Definition
-Cardio suppression – dec ventricular ejection fraction but return to normal in 12 hours after dosing
-Liver injury
-Inhibits liver metabolizing enzymes |
|
|
Term
| Itraconazole Drug Interactions |
|
Definition
-Inhibits CYP-450 enzyme
***cisapride, pimozide dofetilide & quinidine (potential vent. dysrhythmias)***
-Warfarin (check PT time)
-Cyclosporine, digoxin
-sulfonylurea-type oral hypoglycemics (hypoglycemia)
-H2 antag & PPI’s dec absorption (so give 1h ac or 2h pc)
-Phenytoin ( CNS toxicity)
-Tacrolimus (inc nephrotoxicity)
-Lovastatin, simvastatin (rhabdomyolysis) |
|
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