©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
NURS 5334 UTA – antifungals Exam Study
Guide.
4 classes of antifungal drugs - answer✔Polyene antibiotics
Azoles
Echinocandins
Pyrimidine analogs
opportunistic fungal infections - answer✔candidiasis
aspergillosis
cryptococcosis
mucormycosis
nonopportunistic fungal infections - answer✔sporotrichosis
blastomycosis
histoplasmosis
coccidioidomycosis
amphotericin B black box warning - answer✔highly toxic. only to be used in setting of life
threatening infections (infusion reaction and renal damage occur in many patients)
amphotericin B uses - answer✔-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
, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
Amphotericin B adverse effects - answer✔-Infusion reactions (caused by release of
proinflammatory cytokines - symptoms begin 1-3 hours after start of infusion and last for about 1
hour. pre-treat with diphenhydramine + acetaminophen, IV meperidine or dantrolene can be
given if rigors occur, hydrocortisone can be given with caution)
-Nephrotoxicity (likely 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)
Fuconazole - answer✔Fungistatic
inhibits the synthesis of ergosterol and disrupts the fungal cell membrane
10/10/2024 11:44 AM
NURS 5334 UTA – antifungals Exam Study
Guide.
4 classes of antifungal drugs - answer✔Polyene antibiotics
Azoles
Echinocandins
Pyrimidine analogs
opportunistic fungal infections - answer✔candidiasis
aspergillosis
cryptococcosis
mucormycosis
nonopportunistic fungal infections - answer✔sporotrichosis
blastomycosis
histoplasmosis
coccidioidomycosis
amphotericin B black box warning - answer✔highly toxic. only to be used in setting of life
threatening infections (infusion reaction and renal damage occur in many patients)
amphotericin B uses - answer✔-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
, ©SIRJOEL EXAM SOLUTIONS
10/10/2024 11:44 AM
Amphotericin B adverse effects - answer✔-Infusion reactions (caused by release of
proinflammatory cytokines - symptoms begin 1-3 hours after start of infusion and last for about 1
hour. pre-treat with diphenhydramine + acetaminophen, IV meperidine or dantrolene can be
given if rigors occur, hydrocortisone can be given with caution)
-Nephrotoxicity (likely 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)
Fuconazole - answer✔Fungistatic
inhibits the synthesis of ergosterol and disrupts the fungal cell membrane
