| Question | Answer |
| symptoms of vulvovaginal candidiasis | itching sore, irriating, burning w/ urination, cheese like discharge, gram stain similar to UTI |
| vulvovaginal bug | candida albicans |
| risk factors for vulvovaginal candidiasis | oral genital contact, initial sex (diaphram or spermicide use), abx use, douching, tight cloths |
| vulvovaginal candidiasis pharm therapy...uncomplicated | uncomplicated (OTC): butoconazole (3 days), clotrimazole (1-7 days), miconazole (1-7 days), ticonazole (1 day).....uncomplicated RX: econazole (1tab), nystatin (14days), terconazole 1-7 days |
| treat systmeically vulvovaginal candidiasis | Fluc (150), itra 200 twice |
| are oral and topical therapies equivalent for azoles? | yes |
| what makes a vulvovaginal candid complicated? | C glabrata, immunocompromised, DM, pregnant, recurrent more than 4 epi/year, severe symp |
| how should itra be taken? | with acidic drink |
| signs and symp of oropharyngeal candid | could have pain, white thick plaques around mouth, burning or pain, taste changes |
| what is the bug for oropharyngeal candid? | C albicans....but 30-60% are colonized |
| what are the 3 categories of risk factors for oropharyngeal condid? | disease related (DM, immunodiff (aids), hypothyroid, adrenal disfunction.....med related (immunosuppressants, radiation, dentures, broad spec abx)....gen conditions (premature, elderly, malnutrition, newborns |
| how to treat oropharyngeal candid..ROUTE? | topical preferred, clotrimazole troche (4-5 times/day for 7-14 days)...nystatin susp, fluc tabl, itra susp |
| how to treat esophageal? | fluc 14-21 days (preffered), itra 14-21 days, imporve in 2-3 days, resolve in 7-10 days |
| name the 3 dermatophytic infections? | jock itch, ringworm, athletes foot |
| treat of dermatophytic? | clotrimazole cream, econazole cream, ketoconazole cream, miconazole cream, nystatin cream, terbinafine cream, tolnaftate cream |
| how to treat toenail and fingernail infxn | oral therapy..monitor LFT's....terbinafine (fingernails: 6 weeks, toenails 3-4 months), itraconazole: fingernailes 200mg /2months 1 week, toenails 3-4 months) |
| invasive candidiasis risk factors (lots) | any cath/lines....GI procedure or mech ventilation....DM, Solid tumor, CV....immunosuppression, chemo, ICU, pancreatitis, TPN, corticosteroid administration |
| what to do if fungal infection suspected systemically?? | TREAT IMMEDIATELY....fluc for albicans...know susceptibility |
| what are the most common bugs for invasive candidiasis and other bugs? | albicans, krusei, glabrata |
| what are the key patient and institutional charactoristics for antifungal therapy? (3) | common fungal species in your area, patient underlying conditions abx steroid use and length of ICU stay...other fungal risks |
| what is onychomycosis? | fungal infection of the nails |
| why is onychomycosis usually treated? | cosmetic reasons, sometimes pain |
| how to treat onychomycosis?route? | ORAL only, terbinafine (fn: 6 weeks, tn: 3-4 months), itraconazole (fn: 2months 1 wk, tn: 3-4 monts) |
| treat candiduria? | ampho B, fluc |
| what drug to not use in candiduria | echinocandins |
| when would you treat candiduria? | if cath is positive (pull then retest), if high risk for systemic disease (renal transplant, obstruction, immunocompromised) |
| echinocandins (3) | micafubgin, capsofungin, anidulafungin |
| echinocandins moa | |
| do drug activity ones again | |
