Final - Chapter 36 - Anti-fungals

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  1. Name common drugs used for systemic fungal infections:
    • nystatin
    • diflucan
    • amphotericin B
  2. What are the serious adverse effects of amphotericin b?
    • agranulocytosis
    • nephrotoxicity (80% of pts)
    • ototoxicity
    • hepatotoxicity
    • cardiotoxicity
  3. Labs to monitor amphotericin b:
    • BMP (electrolytes)
    • BUN
    • LFT's
    • CBC
  4. What is the mechanism of action of amphotericin b (Fungizone)?
    fungal-cell membrane
  5. What are the adverse effects at the beginning of amphotericin b (Fungizone) treatment?
    • fever
    • chills
    • vomiting
    • HA
  6. What is the mechanism of action of fluconazole (Diflucan)?
    interferes with synthesis of ergosterol
  7. What are the adverse effects of fluconazole (Diflucan)?
    • FEW
    • N/V/D
    • hepatotoxicity
  8. What are the adverse effects of topical antifungals?
    • no serious side effects
    • pruritis
    • stinging
  9. What are the adverse effects of IV azole antifungals?
    • fever
    • chills
    • rash
    • N/V/D
    • hepatotoxicity
    • anaphylaxis
    • blood dyscrasias
  10. What are the adverse effects of ketoconazole?
    • fever
    • chills
    • N/V/D
    • abd pain
    • hepatotoxicity
    • blood dyscrasias
    • anaphylaxis
    • nephrotoxicity
    • ototoxicity
  11. What forms are ketoconazole available?
    • oral
    • topical
    • NO IV
  12. What is the mechanism of action of metronidazole (Flagyl)?
    • disrupts nucleic acid synthesis
    • antiprotazoal drug 
    • also has ABX activity against anaerobic bacteria
  13. What are the adverse effects of metronidazole (Flagyl)?
    • NO ETOH (hepatotoxicity)
    • leukopenia
    • N/V/D
    • dizziness
    • disulfiram (unpleasant reaction to alcohol)
    • anorexia
    • HA
    • metallic taste
    • turns urine brown
  14. What is the mechanism of action of mebendazole (Vermox)?
    broad spectrum antihelminthic drug
  15. What are the adverse effects of mebendazole (Vermox)?
    • abd pain
    • distension
    • diarrhea
  16. What is the mechanism of action of chloroquine (Aralen)?
    concentrates in food vacuoles of Plasmodium residing in RBC's
  17. What are the adverse effects of chloroquine (Aralen)?
    • few at low doses
    • N/D
    • CNS and cardio toxicity at higher doses
  18. What are the critical BUN and creatinine numbers to hold amphotericin B?
    • BUN >40mg/dl
    • Creatinine >3mg/dl
  19. Why push oral fluids with Amphotericin B?
    prevent renal impairment
  20. Name S/S of hepatotoxicity
    • dark urine
    • light stools
    • jaundice
  21. what are the disadvantages of using fluconazole (Diflucan)?
    narrow specturm - candida albicans only
  22. What are the "azole" drugs specific for?
    • systemic
    • cutaneous
    • superficial fungal infections
  23. What population are the "azoles" contraindicated in?
    ETOH - toxic to liver
  24. What is the correct way to take nystatin for oral thrush?
    swish the liquid orally and swallow
  25. What are the signs of protozoan (amoebas) infections?
    diarrhea (think dysentery)
  26. Which drug do you have to skip happy hour?
    flagyl
  27. What are the adverse effects of antihelminthic (worms) drugs (Vermox)?
    • as worms die, abdominal pain
    • distension
    • diarrhea
  28. What is the dosing of Vermox?
    one treatment

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cbennett
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Final - Chapter 36 - Anti-fungals
Updated:
2017-04-25 03:33:35
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Final - Chapter 36 - Anti-fungals
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