-
This formulation of amphotericin B is dosed at 0.1-1.5 mg/kg/day
Conventional amphotericin B
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This formulation of amphotericin B is dosed at 3-6 mg/kg/day
Liposomal amphotericin B (AmBisome)
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Conventional amphotericin B requires premedication to reduce infusion-related reactions which are fever, chills, headache, malaise, rigors, nephrotoxicity and reduction of these two electrolytes
K and Mg
-
Hypokalemia may increase the risk of this drug toxicity
Digoxin
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This azole agent is the only one that requires renal dose adjustment
Fluconazole (Diflucan)
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This azole is considered a drug of choice for Aspergillus
Voriconazole (Vfend)
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All brands are topical: Nizoral, Extina, Xolegel
Ketoconazole
-
-
Sporanox, Onmel
Itraconazole
-
Capsule and solution of this agent are NOT interchangeable.
Capsule/tablet: take with food
Solution: take on empty stomach
Itraconazole (Sporanox, Onmel)
-
Due to risk of hepatotoxicity, use of this agent orally is only considered when other antifungal therapy is unavailable or not tolerated
Ketoconazole
-
Use of this agent is C/I for treatment of onychomycosis in patients with ventricular dysfunction or a history of HF
Itraconazole (Sporanox, Onmel)
-
Side Effects: elevated LFT, QT prolongation, hypoK, hyperTG, HTN, headache, N/V, abdominal pain, rash/pruritus, edema, dizziness, hair loss (or hair growth)
Azoles
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This azole agent carries warnings for:
Liver damage
Visual disturbances
Embryofetal toxicity
QT prolongation
Phototoxicity
CNS toxicity (hallucination)
Voriconazole (Vfend)
-
"Caution driving at night, avoid direct sunlight, hold tube feeding, do not refrigerate oral suspension" are counseling points for this azole
Voriconazole (Vfend)
-
This azole is C/I with atorvastatin, lovastatin, simvastatin
Posaconazole (Noxafil)
-
Take this azole with full meal
Posaconazole (Noxafil)
-
All the azole antifungals can cause low level of K and Mg while causing elevation of this
LFT
-
Cresemba
Isavuconazonium sulfate
-
Due to possible particulates with Cresemba, this is required during administration
A filter
-
All azoles can increase INR. Greatest risk with these three azoles
- Fluconazole
- Ketoconazole
- Voriconazole
-
-
-
-
Echinocandins are caspofungin, micafungin, and anidulafungin. All are IV, given once daily and do not require renal dose adjustment. Side effects include hypotension, elevated LFTs and low level of these two electrolytes
K and Mg
-
This antifungal agent is C/I in pregnancy. Side effect includes elevated LFT, dizziness, photosensitivity. It has possible cross reaction with PCN allergy. Advise to take with a fatty meal to increase absorption or with food/milk to lower GI upset
Griseofulvin (Grifulvin V, Gris-PEG)
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