68WM6 Ph 2 Test 3-Anti-fungal
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| What is the purpose of antifungal use | 1)treatment of fungal infections
2)treats infection of mucous membranes with topical or vaginal preparation
3)treat deep-seated/system infections with oral or parenteral therapy
4)new forms of amphotericin use liquid encapsulation to decrease toxicity.
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| What is the actions of antifungal | To kill (fungicidal) or stop growth of (fungistatic) susceptible fungi by affecting the permeability of the fungal cell membrane or protein synthesis within the fungal cell itself
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| Name the 2 categories of Antifungals | 1)Systemic
2)Topical/Local
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| Name 3 types of Systemic Antifungals | 1)amphtericin B cholesteryl sulfate (Amphotec):fungistatic or fungicidal, depending on the dosage.
2)fluconazole (Diflucan)
3)ketoconazole (Nizoral)
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| Name 3 types of Topical/Local Antifungals | 1)butenafine (Lotrimin Ultra)
2)clotrimazole (Lotrimin)
3)ketoconazole (Nizoral)
4)miconazole (Litrimin AF, Maximum Strength Desenex/Monistat-Derm)
5)nystatin (Mycostatin)
6)terbinafine (Lamisil AT)
7)tolnaftate (Tinactin)
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| Antifungal Contraindications | previous hypersensitivity
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| Antifungal Precautions | 1)cautious use in pt with depressed bone marrow reserve.
2)Amphotericin B commonly causes renal impairment.
3)Fluconazole requires dosage adjustment for the renal impairment pt.
4)Adverse reactions to fluconazole may be more server in HIV-positive pt
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| Antifungal Side Effects/Adverse Reactions | 1)Systemic
a)CNS:headache
b)GI:N/V/D
c)F and E:hypokalemia
2)Topical/Local: burning, itching, local hypersensitivity reactions.
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| Antifungal Assessment | 1)increased skin irritation may indicate need to discontinue medication
2)Monitor VS q 15-50min during 1st infusion, not changes in BP and pulse.
3)Decreased urine output/changes in specific gravity/>2lb/wk, stop use to prevent renal tubule damage.
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| Renal toxicity | increased BUN (>40mg/dl), creatine (>3mg/dl). Drug may be disacontinued or dosage reduced.
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| Hepatotoxicity | increased AST, ALT, alk phos, bilirubin
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| Opportunistic disease | Some fungi are part of normal tissue(e.g.,Candia albicans). This is when the pt becomes infected with these organisms.
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