Term
| What is the drug of choice for most mycoses? |
|
Definition
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Term
| How does Amphotericin B act against the fungal cell? |
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Definition
| It binds to ergosterol in the membrane, making it more permeable. The resultant leakage of intracellular cations reduces cell viability |
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Term
| What causes much of the toxicity of amphotericin B? |
|
Definition
| Binding to cholesterol in host cell membranes |
|
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Term
| Why does systemic infection necessitate IV administration of amphotericin B? |
|
Definition
| Because oral absorption is poor |
|
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Term
| What medications can be given ahead of amphotericin B treatment to ameliorate adverse effects? |
|
Definition
Mild reaction - diphenhydramine plus and analgesic such as acetaminophen
Severe reaction - a glucocorticoid
Rigors - Meperidine or dantrolene |
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Term
| How can kidney damage from amphotericin B be minimized? |
|
Definition
| By infusing 1L of saline on the day the amphitericin B is infused. |
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Term
| Which drugs should amphotericin B NOT be combined with? |
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Definition
| other nephrotoxic drugs such as aminoglycosides, cyclosporins, NSAIDs |
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Term
| What does P450 inhibition, a characteristic of azole antifungals, mean? |
|
Definition
| they inhibit the sythesis of ergosterol, an essential component of the cell membrane. Membrane permeability increases, causing cellular components to leak out. |
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Term
| What advantages does Itraconazole have over amphotericin B? |
|
Definition
| lower toxicity and oral dosing |
|
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Term
| What are the adverse effects of Itraconazole? |
|
Definition
| cardiosuppression and liver damage |
|
|
Term
| What is the drug of choice for many superficial mycoses caused by dermatophytes and Candida species? |
|
Definition
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|
Term
| What is the preferred treatment for onychomycosis? |
|
Definition
| Terbinafine or itraconazole |
|
|
Term
| What agent is the preferred treatment for vulvovaginal candidiasis? |
|
Definition
| a single dose of fluconazole (diflucan) |
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