Final - Chapter 36 - Anti-fungals

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Name common drugs used for systemic fungal infections:
- nystatin
- diflucan
- amphotericin B
What are the serious adverse effects of amphotericin b?
- agranulocytosis
- nephrotoxicity (80% of pts)
- ototoxicity
- hepatotoxicity
- cardiotoxicity
Labs to monitor amphotericin b:
- BMP (electrolytes)
- BUN
- LFT's
- CBC
What is the mechanism of action of amphotericin b (Fungizone)?

fungal-cell membrane
What are the adverse effects at the beginning of amphotericin b (Fungizone) treatment?
- fever
- chills
- vomiting
- HA
What is the mechanism of action of fluconazole (Diflucan)?

interferes with synthesis of ergosterol
What are the adverse effects of fluconazole (Diflucan)?
- FEW
- N/V/D
- hepatotoxicity
What are the adverse effects of topical antifungals?
- no serious side effects
- pruritis
- stinging
What are the adverse effects of IV azole antifungals?
- fever
- chills
- rash
- N/V/D
- hepatotoxicity
- anaphylaxis
- blood dyscrasias
What are the adverse effects of ketoconazole?
- fever
- chills
- N/V/D
- abd pain
- hepatotoxicity
- blood dyscrasias
- anaphylaxis
- nephrotoxicity
- ototoxicity
What forms are ketoconazole available?
- oral
- topical
- NO IV
What is the mechanism of action of metronidazole (Flagyl)?
- disrupts nucleic acid synthesis
- antiprotazoal drug
- also has ABX activity against anaerobic bacteria
What are the adverse effects of metronidazole (Flagyl)?
- NO ETOH (hepatotoxicity)
- leukopenia
- N/V/D
- dizziness
- disulfiram (unpleasant reaction to alcohol)
- anorexia
- HA
- metallic taste
- turns urine brown
What is the mechanism of action of mebendazole (Vermox)?

broad spectrum antihelminthic drug
What are the adverse effects of mebendazole (Vermox)?
- abd pain
- distension
- diarrhea
What is the mechanism of action of chloroquine (Aralen)?

concentrates in food vacuoles of Plasmodium residing in RBC's
What are the adverse effects of chloroquine (Aralen)?
- few at low doses
- N/D
- CNS and cardio toxicity at higher doses
What are the critical BUN and creatinine numbers to hold amphotericin B?
- BUN >40mg/dl
- Creatinine >3mg/dl
Why push oral fluids with Amphotericin B?

prevent renal impairment
Name S/S of hepatotoxicity
- dark urine
- light stools
- jaundice
what are the disadvantages of using fluconazole (Diflucan)?

narrow specturm - candida albicans only
What are the "azole" drugs specific for?
- systemic
- cutaneous
- superficial fungal infections
What population are the "azoles" contraindicated in?

ETOH - toxic to liver
What is the correct way to take nystatin for oral thrush?

swish the liquid orally and swallow
What are the signs of protozoan (amoebas) infections?

diarrhea (think dysentery)
Which drug do you have to skip happy hour?

flagyl
What are the adverse effects of antihelminthic (worms) drugs (Vermox)?
- as worms die, abdominal pain
- distension
- diarrhea
What is the dosing of Vermox?

one treatment

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Final - Chapter 36 - Anti-fungals

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Final - Chapter 36 - Anti-fungals

Updated

2017-04-25T03:33:35Z

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