ICARE: ID FINAL Antifungals
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binds to ergosterol and alters permeability
- BROAD (candida, aspergillus)
- but bad with toxicities: K, Mg wasting, infusion-related, nephrotoxicity --> developed lipid formulations (Ambisome, Amphotec, from Acelcet?)
- COMBO therapy
- bone marrow suppression
reduction of ergosterol synthesis by inhibition of fungal cyp450 --> potential drug interactions!
- cryptococcus neoforman
- Aspergillis (itra and vori conazole)
- not used much
- TOO MANY drug interactions!
- onychomycosis - nail bed infections
- CONTRAINDICATED IN CHF
- CYP3A4 inhibitor/substrate
spectrum + pk/absorption
- Widely used
- Candida ALBICANS
- not for glabrata or krusei --> don't use if you don't know!!!
- BA excellent IV:PO
- like itraconazole
- visual effects (wavy lines, flashing, blurry vision)/visual hallucinations
- IV 200 MG DO NOT USE WITH CRCL <50 ML/MIN
- inhibit synthesis of 1-3 glycans of fungal cell walls
- BROAD - all candida and aspergillus
- overall extremely well tolerated
- used over ampho B
- disseminated and mucocutaneous candidal infections
- empiric antifungal therapy during febrile neutropenia
- invasive aspergillosis
- like griseofulvin but cidal
- SQUALENE EPOXIDASE (inhibits ergosterol biosynthesis)
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