Lifespan Antifungal Agents PDF
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Uploaded by SkillfulOnyx4668
Chamberlain University
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Summary
This document discusses the use of azole antifungal agents across different age groups, including pregnancy, adolescents, and older adults. It highlights potential risks and considerations for various age groups, such as the embryotoxic effects in rats and rabbits related to some agents, reduced doses in pediatric patients and the possibility of achlorhydria, and altered pharmacokinetics in older adults. The document also emphasizes the importance of medication reconciliation and safety in polypharmacy.
Full Transcript
Many azole antifungal agents were previously classified as Pregnancy Risk Category C or D agents. Caspofungin is embryotoxic in rats and rabbits and was previously classified as a Pregnancy Risk Category C agent. Vulvovaginal Candidiasis occurs frequently during pregnancy. Only topical (intravagin...
Many azole antifungal agents were previously classified as Pregnancy Risk Category C or D agents. Caspofungin is embryotoxic in rats and rabbits and was previously classified as a Pregnancy Risk Category C agent. Vulvovaginal Candidiasis occurs frequently during pregnancy. Only topical (intravaginal) azole therapies applied for seven days are recommended during pregnancy. Oral Fluconazole might be associated with spontaneous abortion and congenital anomalies and, therefore, should not be used (CDC, 2021). Data regarding most antifungals and breastfeeding is lacking. Most antifungals are considered safe in low doses, except for Ketoconazole. Due to this agent's high potential for hepatoxicity, Ketoconazole should be avoided in breastfeeding clients. Consider altered pharmacokinetics related to pregnancy. Adolescents - Many antifungal agents are safely utilized to treat systemic and superficial mycoses at reduced recommended doses. - Itraconazole requires a lower dose in pediatric clients, with 5mg/kg twice daily as a starting dose. - Consider the ability of the family to manage a medication regimen. Older Adults - The risk for achlorhydria (absent or reduced gastric hydrochloric production) is greater in older adults. This condition could make the absorption of some antifungal agents unpredictable. - Plasma levels of commonly prescribed medications in older adults (such as warfarin, phenytoin, and oral hypoglycemic agents) are increased by azoles. Medication reconciliation and safety with poly-pharmacy practice should be prioritized. - Consider the ability of the client and support system to safely self-administer medications without skipping or doubling doses. - Consider altered pharmacokinetics based on age-related changes. - Consider polypharmacy and drug interactions
