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NURS 5334 UTA - antifungals Exam With Complete Solution
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NURS 5334 UTA - antifungals Exam With CompleteSolution 2024-2025
4 classes of antifungal drugs Polyene antibiotics
Azoles
Echinocandins
Pyrimidine analogs
opportunistic fungal infections candidiasis
aspergillosis
cryptococcosis
mucormycosis
nonopportunistic fungal infections sporotrichosis
blastomycosis
histoplasmosis
coccidioidomycosis
amphotericin B black box warning highly toxic. only to be used in setting of life
threatening infections (infusion reaction and renal damage occur in many patients)
amphotericin B uses -Drug of choice for most systemic mycoses
-Before ampho B, systemic fungal infections were usually fatal
Amphotericin B MOA -Answer- Binds ergosterol (unique to fungi); forms membrane
pores that allow leakage of electrolytes.
, Amphotericin "tears" holes in the fungal membrane by forming pores.
Amphotericin B side effects -Answer -Infusion reactions (due to release of
proinflammatory cytokines - symptoms begin 1-3 hrs after initiation of infusion and last
approximately 1 hr. pre-treat with diphenhydramine + acetaminophen, IV meperidine or
dantrolene can be administered if rigors occur, hydrocortisone can be administered
with caution)
Nephrotoxicity- probably if total dose exceeds 4g, avoid concurrent use of other
nephrotoxic drugs ex aminoglycosides and cyclosporines, monitor serum creatinine
every 3-4 days and reduce dosage of greater than 3.5 mg/dL)
Hypokalemia- results from damage to kidneys may need K+ supplements, monitor
serum K+ levels
Bone marrow suppression- anemia, monitor Hct
azoles- Answer broad-spectrum antifungal drugs
less toxic than ampho B
can be given orally
itraconazole use, MOA - Answer use: systemic mycoses
MOA: inhibits the synthesis of ergosterol and disrupts the fungal cell membrane
Itraconazole metabolism - Answer inhibits fungal cytochrome P450-dependent enzymes
Itraconazole side effects - Answer -cardiosuppression (transient decrease in ventricular
ejection fraction) *BBW: should not be used in patient with heart failure or other
indications of ventricular dysfunction*
-liver damage (can inhibit drug-metabolizing enzymes)
-GI effects (N, V, D)
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