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adrenal steroid synthesis -Metabolism in liver and excreted -Menstrual -Shouldn’t be used in
Decreased testosterone and in bile irregularities pregnancy
cortisol -Frank hepatitis
Fluconazole -Inhibits synthesis of fungal -Prophylactic for -given orally or IV -Nausea -Dose should be reduced
membrane ergosterol reducing fungal -Absorbed really well -Vomiting in pts with renal
infections in recipients -Penetrates CSF well -Rash insufficiency
of BM transplants -Poorly metabolized -Hepatitis -Shouldn’t be used in
-DOC: C. neoformans, -Excreted via kidneys pregnancy
Candidemia, -Inhibits CYP450 enzymes
Coccidioidomycosis
Itraconazole -DOC: Blastomycosis, -Well absorbed orally -Nausea -Synthetic triazole
Sporotrichosis, -Requires acid for dissolution -Vomiting -Should be avoided in
Paracoccidioidomycosis, -Extensively bound to plasma -Rash pregnancy
Histoplasmosis proteins -Hypokalemia -Inhibits metabolism of
-Effective in AIDS- -Extensively metabolized by liver -HTN ANTICOAGULANTS,
associated -Edema STATINS, QUINIDINE
histoplasmosis -Headache
Voriconazole -Invasive aspergillosis -IV or oral administration -Transient visual
-Scedosporium -Metabolized by a variety of disturbance w/in 30
apiospermum CYP450 minutes of dosing
-Fusarium
Posaconazole -Candida and -Oral -Nausea -Contraindicated with:
Aspergillus in -Inhibits CYP3A4 -Vomiting ERGOT ALKALOIDS,
immunocompromised -Should be given with full meal or -Diarrhea PIMOZIDE, QUINIDINE
pts nutrition supplement -Abdominal pain
-Oropharyngeal -Prophylaxis of Candida and -Headache
candidiasis (daily Aspergillus: 3 times daily -HUS, Thrombotic
dosing) thrombocytopenic
-Mucor infections purpura, PE (when
used with
CYCLOSPORINE,
TACROLIMUS)
Caspofungin -Interferes with synthesis of fungal -Aspergillus -highly bound to serum proteins -Fever -Echinocandins
cell wall by inhibiting synthesis of -Candida -1/2 life: 9-11 hours -Rash -Shouldn’t be
β(1,3)-D-Glucan Lysis and cell -given IV -Nausea coadministered with
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Antifungals
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