Fungal Infections Drug Treatment Guide PDF

**Polyenes** - Polyenes, like amphotericin B (an IV medication), bind to fungal membrane sterols, increasing membrane permeability and causing cell death, with a primary use against systemic mycoses.  - Common side effects include nephrotoxicity and infusion-related reactions. Hydr...

**Polyenes** - Polyenes, like amphotericin B (an IV medication), bind to fungal membrane sterols, increasing membrane permeability and causing cell death, with a primary use against systemic mycoses.  - Common side effects include nephrotoxicity and infusion-related reactions. Hydration and slow infusion rates can mitigate these risks.  - Prescribing considerations include carefully monitoring renal function and electrolytes, with dosage adjustments based on client tolerance and infection severity.  **Azoles** - Azoles, like itraconazole, inhibit ergosterol synthesis, disrupting fungal cell membrane integrity, and are used for a broad range of fungal infections.  - Adverse effects can include liver enzyme elevations and QT prolongation, necessitating monitoring of liver function and electrolytes.  - Prescribing considerations include potential drug interactions due to azoles\' inhibition of cytochrome P450 enzymes, requiring dose adjustments or alternative therapies for clients on concurrent medications.  **Echinocandins** - Echinocandins, like caspofungin, inhibit fungal cell wall synthesis by blocking β-(1,3)-D-glucan synthesis, offering a targeted approach for Candidiasis and Aspergillosis.  - Side effects are relatively mild but include gastrointestinal symptoms and histamine-mediated reactions.  - They are preferred for specific fungal infections, especially in clients intolerant to other antifungals, with adjustments needed for hepatic impairment.  **Pyrimidines** - Pyrimidine analogs, such as flucytosine, disrupt fungal DNA and RNA synthesis and are often used with other antifungals to treat Cryptococcosis and Candidiasis.  - Significant side effects include bone marrow suppression and hepatotoxicity, requiring regular monitoring of blood counts and liver function.  - Prescribing considerations emphasize the need for dosage adjustments in renal impairment and resistance risks when used as monotherapy.  **Allyamines** - Allylamines, like terbinafine, target squalene epoxidase, critical for ergosterol synthesis, effectively treating dermatophyte infections.  - Common adverse reactions include gastrointestinal upset, liver enzyme elevation, and taste disturbances.  - Monitoring liver function is crucial, and clients should be advised about the potential for drug interactions and the importance of adherence to treatment regimens.  **Others** - Nystatin binds to ergosterol, creating pores in the fungal cell membrane, used topically for cutaneous and mucosal Candida infections.  - Side effects are minimal but can include local irritation and gastrointestinal upset when used orally for intestinal Candidiasis.  - Nystatin\'s role is primarily for superficial infections, with no systemic absorption, making it a safe option for mucocutaneous Candidiasis.  Management of Herpes Simplex Virus and Varicella-Zoster - Acyclovir is the drug for managing herpes simplex virus and varicella-zoster, inhibiting viral DNA polymerase and incorporating it into viral DNA to terminate replication.  - Treatment initiation within 24 hours of symptom onset is crucial for maximizing efficacy, especially in reducing the duration and severity of outbreaks.  - Client education on medication adherence and strategies to prevent transmission is vital, given the recurrent nature of these infections.  Management of Influenza - Antivirals like oseltamivir target the neuraminidase enzyme, preventing the release of new influenza viruses from infected cells.  - Starting antiviral treatment within 48 hours of symptom onset is recommended to reduce illness severity and duration.  Management of COVID-19  - Ritonavir and nirmatrelvir (Paxlovid) target the SARS-CoV-2-3CL protease, inhibiting viral replication, with early initiation post-diagnosis critical for high-risk patients to prevent severe outcomes.  - Common side effects include altered taste, gastrointestinal upset, and potential hypersensitivity reactions; monitoring for liver enzyme elevations is advised due to the risk of hepatotoxicity.  - Prescribers must consider significant drug interactions due to ritonavir\'s potent inhibition of CYP3A enzymes, requiring careful review of the client\'s medication regimen to avoid toxicity and adjust doses as necessary, especially in clients with renal or hepatic impairment.