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    Antifungal Agents

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    Quolette Constante
    Monitor for adverse effects and drug interactions. Teach patients about proper administration and importance of completing full treatment course. Assess for therapeutic response and resolution of symptoms.

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    Antifungal Agents

    Uploaded by

    Quolette Constante
    294 views22 pages
    Monitor for adverse effects and drug interactions. Teach patients about proper administration and importance of completing full treatment course. Assess for therapeutic response and resolution of symptoms.

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    © Attribution Non-Commercial (BY-NC)

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    Monitor for adverse effects and drug interactions. Teach patients about proper administration and importance of completing full treatment course. Assess for therapeutic response and resolution of symptoms.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    294 views22 pages

    Antifungal Agents

    Uploaded by

    Quolette Constante
    Monitor for adverse effects and drug interactions. Teach patients about proper administration and importance of completing full treatment course. Assess for therapeutic response and resolution of symptoms.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 22

    Antifungal Agents

    Antifungal Agents
    Drugs used to treat infections caused
    by fungi
    • Systemic and topical
    Fungi
    • Also known as mycoses
    • Very large and diverse group of
    microorganisms
    • Broken down into yeasts and molds
    Yeasts
    • Single-cell fungi
    • Reproduce by budding
    • Very useful organisms
    – Baking
    – Alcoholic beverages
    Molds
    • Multicellular
    • Characterized by long, branching
    filaments called hyphae
    Mycotic Infections
    Four General Types
    • Cutaneous
    • Subcutaneous
    • Superficial
    • Systemic*
    *Can be life-threatening
    *Usually occur in
    immunocompromised host
    Mycotic Infections
    Candida albicans
    • Due to antibiotic therapy, antineoplastics,
    or immunosuppressants
    • May result in overgrowth and systemic infections
    Mycotic Infections
    In the mouth:
    • Oral candidiasis or thrush
    • Newborn infants and immunocompromised
    patients
    Mycotic Infections
    Vaginal candidiasis:
    • “Yeast infection”
    • Pregnancy, diabetes mellitus, oral contraceptives
    Antifungal Agents

    Systemic
    • Examples: amphotericin B, fluconazole,
    ketoconazole, itraconazole

    Topical
    • Examples: clotrimazole, miconazole, nystatin
    Antifungal Agents
    Broken down into four major groups
    based
    on their chemical structure
    • Polyenes: amphotericin B and nystatin
    • Flucytosine
    • Imidazoles: ketoconazole, miconazole,
    clotrimazole, fluconazole
    • Griseofulvin
    Antifungal Agents:
    Mechanism of Action
    Polyenes: amphotericin B and nystatin
    • Bind to sterols in cell membrane lining
    • Allow K+ & Mg++ to leak out, altering fungal cell
    metabolism
    • Result: fungal cell death
    Antifungal Agents:
    Mechanism of Action
    flucytosine
    • Also known as 5-fluorocytosine (antimetabolite)
    • Taken up by fungal cells and interferes with DNA
    synthesis
    • Result: fungal cell death
    Antifungal Agents:
    Mechanism of Action
    Imidazoles
    ketoconazole, miconazole, clotrimazole,
    fluconazole

    • Inhibit an enzyme, resulting in cell


    membrane leaking
    • Lead to altered cell membrane
    • Result: fungal cell death
    Antifungal Agents:
    Mechanism of Action
    griseofulvin
    • Disrupts cell division
    • Result: inhibited fungal mitosis (reproduction)
    Antifungal Agents: Side
    Effects
    amphotericin B
    “Shake and Bake”
    fever chills headache anorexia
    malaise nausea hypotension
    tachycardia
    muscle and joint pain
    lowered potassium and magnesium levels

    *renal toxicity
    *neurotoxicity: seizures and paresthesias
    Antifungal Agents: Side
    Effects
    fluconazole
    • nausea, vomiting, diarrhea, abdominal pain,
    • increased liver function studies

    flucytosine
    • nausea, vomiting, anorexia

    griseofulvin
    • rash, urticaria, headache, nausea, vomiting,
    anorexia
    Antifungal Agents:
    Nursing Implications
    • Before beginning therapy, assess for
    hypersensitivity, possible
    contraindications, and conditions that
    require cautious use.
    • Obtain baseline VS, CBC, liver function
    studies, and ECG.
    • Assess for other medications used
    (prescribed and OTC) in order to avoid
    drug interactions.
    Antifungal Agents:
    Nursing Implications
    • Follow manufacturer’s directions
    carefully
    for reconstitution and administration.
    • Monitor VS of patients receiving IV
    infusions every 15 to 30 minutes.
    • During IV infusions, monitor I & O and
    urinalysis findings to identify adverse
    renal effects.
    Antifungal Agents:
    Nursing Implications
    amphotericin B
    • To reduce the severity of the infusion-related
    reactions, pretreatment with an antipyretic
    (acetaminophen), antihistamines, and
    antiemetics may be given.
    • A test dose of 1 mg per 20 mL 5% dextrose in
    water infused over 30 minutes should be
    given.
    • Use IV infusion pumps and the most distal
    veins possible.
    Antifungal Agents:
    Nursing Implications
    • Tissue extravasation of fluconazole
    at the IV site may lead to tissue
    necrosis—monitor IV site carefully.
    • Oral forms of griseofulvin should be
    given with meals to decrease GI
    upset.
    • Monitor carefully for side/adverse
    effects.
    Antifungal Agents:
    Nursing Implications
    Monitor for therapeutic effects:
    • Easing of the symptoms of infection
    • Improved energy levels
    • Normal vital signs, including temperature

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