Therapeutics Final -- Fungals

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mp
ID:
272754
Filename:
Therapeutics Final -- Fungals
Updated:
2014-05-01 19:16:56
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Therapeutics Final Fungals
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Therapeutics Final -- Fungals
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  1. Candida
    • Fluconazole -- less critically ill
    • Echinocandin -- critically ill
  2. Thrush (oral candidiasis)
    • Oral fluconazole
    • Alternatives: clotrimazole and nystatin susp.
  3. Esophageal Candidiasis
    Fluconazole or itraconazole
  4. Vulvovaginal Candidiasis
    • Oral fluconazole
    • Alternative: Topical azoles
  5. Histoplasmosis (Mississippi and Ohio)
    • mild-moderate pulmonary or less severe disseminated -- itraconazole
    • moderate-severe disseminated and meningitis -- ampho B then itraconazole
  6. Blastomycosis (East, Great Lakes)
    • Mild-moderate pulmonary and disseminated -- itraconazole
    • Moderate-severe pulmonary or disseminated and meningitis -- ampho B then itraconazole
  7. Coccidiomycosis (Southwest, Valley Fever, rash)
    • Mild/pneumonia -- fluconazole
    • Severe, non-meningitis -- ampho B then azole
    • Meningitis -- Fluconazole IV, lifelong suppression
  8. Cryptococcosis (pigeon droppings)
    • Symptomatic -- fluconazole
    • Meningitis -- Ampho B + flucytosine then fluconazole
  9. Aspergillosis (Crescent sign on CT)
    • Voriconazole (DOC)
    • 2nd line -- ampho B
  10. Mucormycosis
    • Treat hyperglycemia
    • Surgical debridement
    • Lipid ampho B then posaconazole with fatty meal
  11. Prophylaxis in severe neutropenia:
    • Fluconazole
    • Posaconazole
    • Caspofungin

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