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Antifungals

Antifungal Medications

QuestionAnswer
Prevent the synthesis of ergosterol, building block for fungal cell membranes, act by inhibiting fungal cytochrome P-450 Antifungal agents
Pulse dosing usually one week per month
Polyenes, Azoles, Echinocandins Classes of antifungal drugs
clotrimazole Mycelex
nystatin Mycostatin
clotrimazole and nystatin Used to treat oral thrush agents
used to treat skin and nail agents butenafine, ciclopirox, clotrimazole, clotrimazole-betamethasone, griseofulvin, ketoconazole
butenafine Lotrimin Ultra, Mentax
ciclopirox Loprox, Penlac
clotrimazole Desenex, Lotrimin AF
clotrimazole-betamethasone Lotrisone
griseofulvin Grifulvin V, Gris-PEG
ketoconazole Nizoral
miconazole Micatin, Neosporin AF
nystatin Nyamyc, Nystop
terbinafine Lamisil AT
used to treat systemic agents amphotericin B, caspofungin, fluconazole, flucytosine, itraconazole, ketoconazole, liposomal amphotericin B, micafingin, posaconazole, voriconazole
caspofungin Cancidas
fluconazole Diflucan
flucytosine Ancobon
itraconazole Sporanox
ketoconazole Nizoral
liposomal amphotericin B Abelcet, Amphotec, AmBisome
micafungin Mycamine
posaconazole Noxafil
voriconazole Vfend
used to treat vaginal agents butoconazole, clotrimazole, miconazole, tioconazole
butoconazole Gynazole-1
clotrimazole Gyne-Lotrimin
miconazole Monistat
tioconazole Vagistat-1
Which antifungals can be OTC for skin and nail agents butenafine (Lotrimin Ultra), clotrimazole (Desenex, Lotrimin AF), miconazole (Micatin, Neosporin AF), terbinafine (Lamisil AT)
Which antifungals are by RX only for vaginal agents (also has OTC version) butoconazole (Gynazole-1)
All systemic agent antifungals are by RX only
Which antifungal systemic agents come in injectable dosage form amphotericin B, caspofungin, fluconazole, liposomal, micafungin, posaconazole, voriconazole
Reports of anaphylaxis occurrence amphotericin B
drug interactions with Polyenes Amphotericin should not be used with foscarnet. Nystatin diminishes effects of probiotic Saccharomyces boulardii
Common Polyenes amphotericin B and nystatin
Common Azoles clotrimazole (Mycelex), ketoconazole (Nizoral), fluconazole (Diflucan), itraconazole (Sporanox), posaconazole (Noxafil), voriconazole (Vfend)
Common side effects of azoles orally: nausea, vomiting, abdominal pain, diarrhea topically: burning, discomfort, edema, pain
associated with transient vision changes, visual hallucinations, alopecia, nail changes or loss, skin rash voriconazole
should be taken with acidic food or drink, to improve absorption itraconazole capsules
should be taken with food posaconazole
Contraindications of azoles concurrent use of quinidine, benzodiazepines, statins
contraindicated in patients with milk protein allergy miconazole
black box warning for hepatotoxicity and QT prolongation ketoconazole
comes with 2 different box warnings : multiple drug cautions itraconazole
caspfungin and micafungin echinocandin class of antifungals
work by inhibiting the synthesis of D-glucan, which is integral component of the fungal cell wall echinocandins
caspofungin Cancidas
micafungin Mycamine
used to treat Aspergillosis and Candida caspofungin and micafungin
only available in IV form, for treatment of invasive Aspergillosis and Candida in patients unresponsive to other therapies caspofungin
associated with anaphylaxis and histamine related reactions echinocandins
drug interactions with echinocandins cyclosporine, Rifampin, pimozide, decreases activity of probiotic Saccharomyces boulardii
should not use if pregnant or have liver failure or porphyria griseofulvin
black box warning to use with extreme caution in patients w/ renal dysfunction flucytosine
echinacea and zinc alternative therapy for some fungal and some bacterial infections
Created by: ChemeketaPHM2021
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