Amphotericin B - ANSWER -polyene macrolide
-broad spectrum antifungal
*HIGHLY TOXIC*
-only given for infections that are progressive and potentially fatal
- given IV only
Amphotericin B Black Box Warning - ANSWER should only be used in the setting of a potentially life-threatening infectio...
-only given for infections that are progressive and potentially fatal
- given IV only
Amphotericin B Black Box Warning - ANSWER should only be used in the setting of a potentially life-
threatening infection
Amphotericin B side effects - ANSWER -infusion reactions (fever, chills,rigors, nausea, headache)
-neprhotoxic
-bone marrow suppression
Itraconazole (Sporanox) - ANSWER -alternative to amph b for systemic mycoses
- safer; oral dosing
- adverse effects cardiosupporession and liver injury
-causes transient decrease in EF
-administration with cola enhances absorption
Itraconazole Black Box Warning - ANSWER negative inotropic actions; should not be used for
superficial fungal infections, patients with HF, hx of HF or other indications of ventricular dysfunction
Drug interactions with Amphotericin B - ANSWER increased risk for kidney damage when used with
other nephrotoxic drugs such as:
Treatment for tinea corporis (ringworm) - ANSWER Topical anti-fungal medication
Terbinafine
Treatment for tinea cruris (jock itch) - ANSWER topical and oral antifungals
Terbinafine
may require systemic anti fungal (clotrimazole); topical or systemic glucocorticoids
Treatment for tinea capitis ("ringworm of the scalp" - ANSWER oral griseofulvin for 6-8 weeks
OR
oral terbinafine for 2-4 weeks
**topical tx will not work
Treatment for oral candidiasis - ANSWER nystatin, clotrimazole, and miconazole
OR
oral fluconazole or ketoconazole for immunocompromised
Treatment for Aspergillosis - ANSWER Voriconazole is tx of choice
Amphotericin B
itraconazole
micafungin
Drug interaction with Voriconazole and Phenobarbital - ANSWER SHOULD NOT BE COMBINED DUE
TO CYP450
Azoles for systemic mycoses - ANSWER itraconazole
ketoconazole
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