Antifungals are medications used to treat fungal infections. The most common fungal infections are candidiasis (aka yeast infection), tinea pedis (aka athlete's foot), tinea cruris (aka jock itch), tinea barbae (aka folliculitis barbae), tinea versicolor (aka pityriasis versicolor), tinea corporis and tinea capitis (aka ringworm), and tinea unguium (aka onychomycosis or old man's nails).
Fungal infections are difficult to clear up. Unlike bacteria or viruses, fungi usually attack nonliving tissue, i.e. tissue without a blood supply, such as the nails or the epidermis, which consists of a layer of dead skin cells. Sometimes fungi also grow on mucous membranes, such as the mouth or vaginal mucosa. This in itself is not dead tissue, but the fungus generally grows on the surface of these areas, feeding on mucus, shed skin cells and other debris. This makes it difficult to get the antifungal distributed throughout the fungal population in order to kill all of it, and leads to very very long treatments as well as frequent recurrences.
There are topical as well as systemic antifungals. Most of the systemic antifungals are highly toxic drugs with a host of side effects, and require careful monitoring of the patient and lab work to prevent serious sequelae.
Antifungals
Brand/Generic Drug Names
amphotericin B, fluconazole, griseofulvin, ketoconazole, miconazole, nystatin
Common uses
histoplasmosis, blastomycosis, coccidiomycosis, cryptococcosis, aspergillosis, phycomycosis, candidiasis, sporotrichosis causing severe meningitis, septicemia or skin infection
Pharmacology
increase cell membrane permeability in susceptible organisms, decrease potassium, sodium, nutrients in cell
Class contraindications
severe bone marrow depression, hypersensitivity
Class precautions
kidney and liver disease, pregnancy
Interactions
varies by drug
Adverse Reactions
renal tubular acidosis, permanent renal impairment, anuria, oliguria, hemorrhagic gastroenteritis, acute liver failure, blood dyscrasias, hypokalemia, nausea, vomiting, headache, anorexia, fever, chills
Additional Information
Assess vital signs every 15-30 min during infusion, intake and output, weekly weight
Assess blood studies, renal- and hepatotoxicity, ototoxicity
Assess for allergic reaction
Administer only after culture and sensitivity confirmation of organism
Administer IV using filter in distal vein, check every 8 hours
Protect from light during infusion
Evaluate therapeutic response: decreased fever, rash, malaise, negative culture and sensitivity for infecting organism
Date of most recent Update
August 07, 2002
Further information is available in the writeup for the
specific name(s) of this medication class