Term
yeasts: Candida species
molds: Aspergillus spp.
dimorphic: Histoplasma capsulatum |
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Definition
| 3 types of mycoses and an example of each |
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Term
antibiotic use
damaged tissue
neutropenia (immunosuppression)
immunosuppression
hyperglycemia
prosthetic material/foreign material |
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Definition
| risk factors for fungal disease |
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Term
|
Definition
| when should candida always be treated? |
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Term
Candida albicans
Candida glabrata
Candida parapsilosis
Candida tropicalis
Candida krusei |
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Definition
| most common candida species |
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|
Term
Candida albicans - susceptible
Candida glabrata - susceptible/resistance
Candida parapsilosis - susceptible
Candida tropicalis - susceptible
Candida krusei - INTRINSICALLY RESISTANT |
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Definition
| susceptibility pattern of fluconazole to Candida species |
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|
Term
Candida glabrata - susceptible (glabrata is developing resistance to fluconazole)
Candida krusei - susceptible (krusei is intrinsically resistant to fluconazole) |
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Definition
| susceptibility pattern of echinocandins to Candida glabrata and Candida krusei |
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Term
| inhibit 14-alpha demethylase, a P450 dependent enzyme that makes ergosterol |
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Definition
| MOA of triazoles: fluconazole IV/PO, itraconazole PO, voriconazole IV/PO, posaconazole PO |
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|
Term
good against Candida and Cryptococcus
only azole that is renally eliminated |
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Definition
| spectrum and elimination of fluconazole IV/PO |
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|
Term
good against endemic dimorphic fungi (histoplasmosis)
highly variable bioavailability: need food and acidic pH |
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Definition
| spectrum of activity and bioavailability of itraconazole PO |
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|
Term
fluconazole has less drug interactions b/c it relies less on the liver for metabolism, 50% goes through the kidney
most drug interactions with azoles increase the serum concentration of other drugs through inhibition, but some inducers will lower the azole concentration |
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Definition
| which has fewer drug interactions, fluconazole or itraconazole? |
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Term
DO NOT INTERCHANGE
bioavailability of the oral solution is increased by 50-68% over the capsules
the oral solution is better absorbed on an empty stomach, where as the capsule should be taken with food |
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Definition
| are the oral solution of itraconazole and the capsules interchangeable? |
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|
Term
|
Definition
| what is the spectrum of activity of voriconazole IV/PO |
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|
Term
elevated liver enzymes: HAPPENS WITH ALL AZOLES
visual disturbances
drug interactions |
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Definition
| side effects of voriconazole IV/PO |
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|
Term
| prophylaxis of Candida and Aspergillus |
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Definition
| spectrum of posaconazole PO |
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|
Term
oral pyrimidine analog
disrupts fungal DNA synthesis by inhibiting thymidine synthetase
ONLY USE IN COMBINATION |
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Definition
|
|
Term
|
Definition
|
|
Term
binds ergosterol in fungal cell membranes
fungicidal, concentration dependent killing |
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Definition
|
|
Term
broad spectrum against yeast, mold, and dimorphics
Candida
Aspergillus
dimorphics |
|
Definition
| spectrum of amphotericin B IV |
|
|
Term
acute infusion toxicities: fever, chills, rigors (shake and bake)
chronic toxicities: NEPHROTOXICITY
additive toxicity with other nephrotoxins: aminoglycosides |
|
Definition
| ADRs of amphotericin B IV |
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|
Term
prehydrate with NS
premedicate with acetaminophen and diphenhydramine
lipid formulation of amphotericin B has less nephrotoxicity and less infusion reactions |
|
Definition
| how can the acute infusion related side effects (fever, chills, rigors) and chronic toxicities (nephrotoxicity) of amphotericin B be prevented? |
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Term
|
Definition
| spectrum of echinocandins |
|
|
Term
inhibit beta-D-glucan synthase
glucan is important in fungal cell wall synthesis |
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Definition
|
|
Term
minimal ADRs and drug interactions
minimal renal clearance |
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Definition
|
|
Term
treat all candidemias
Amphotericin B or echinocandins are DOCs for unstable patients |
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Definition
| DOC for treatment of serious candidiasis |
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|
Term
oral candidiasis: nystatin, clotrimazole troche, or fluconazole
esophageal candidiasis: fluconazole
vaginal candidiasis: topical agents or fluconazole
candidauria: fluconazole |
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Definition
| treatment of minor candida infections |
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|
Term
|
Definition
| treatment DOC for invasive Aspergillosis |
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|
Term
| Amphotericin B PLUS flucytosine |
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Definition
| DOC for cryptococcal meningitis |
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Term
|
Definition
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Term
|
Definition
| DOC for blastomycosis (endemic fungi) |
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Term
|
Definition
| DOC for coccidiodomycosis (endemic fungi) |
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|
Term
|
Definition
| DOC for superficial fungal infections: Tinea pedis, Tinea cruris... |
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|
Term
terbinafine PO
MONITOR LFTS |
|
Definition
|
|
Term
|
Definition
| what must be monitored with terbinafine PO? |
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