need to know for fungus

What is the treatment for candidemia

echinocandin first line

What is the treatment for uncomplicated VVC

topical azoles, fluconazole 150mg x1, Ibrexafungerp 300mg x2

What is the treatment for severe VVC

fluconazole 150mg q72 hr x2-3 doses, topical azole longer duration

What is the treatment for mild OPC

clotrimazole troches 10mg 5x/day

What is the treatment for moderate/severe OPC

po fluconazole 100-200mg

What is the duration of treatment for OPC

7-14 days

What is the treatment for EC

Fluconazole 200mg-400mg po daily 14-21 days

What is the treatment for invasive pulmonary aspergillosis

Voriconazole iv or po 6mg/kg q12h x 1day then 4mg/kg q12h

What is the duration for IPA treatment

6-12 weeks

What is the preferred regimen for prophylaxis of IPA

posaconazole

What is the preferred TOPICAL treatment for onychomycosis

ciclopirox 8% nail lacquer qhs x48 weeks

What is the preferred SYSTEMIC treatment for onychomycosis

Terbinafine 250mg po daily x 6 weeks (finger) x 12 weeks (toe)

What antifungals require dose adjustments for renal dysfunction

Fluconazole, Posacoazole, Flucytosine

What antifungals require dose adjustments for hepatic dysfuntion

caspofungin, isavuconazole

What is not recommended in renal and hepatic impairment

terbinafine

what are the common drug drug interactions with caspofungin

immunosupressants, CYP3A4 inducers

What are the common drug drug interactions with micafungin

sirolimis, nifedipine, itraconazole

What are the drug interactions with amphotericin B

antineoplastic agents, digoxin, corticosteriods, muscle relaxants, flucytosine

What are the drug interactions with fluconazole

CYP3A4, 2C9, 2C19 inhibitor, QT interval prolonging drugs

What are the drug interactions with voriconazole

CYP2C9, 2C19, 3A4 inhibitor

What are the drug interactions with posaconazole

CYP3A4

What are the drug interactions with Isavuconazole

inhibitor os CYP3A4, 2C9, 2C19, 2D6, P-gp, BCRP, OCT2

What are the drug interactions with oteseconazole

BCRP inhibitor

What are the drug interactions with Flucytosine

bone marrow suppressing agents

What are the drug interactions with terbinafine

inhibitor of CYP450 2D6(tricyclic antidepressants, SSRI, Beta blockers, MAOIs)

What are the resistance mech for echinocandins

FKS1 mutation

What are the resistance mechanisms of azoles

increased efflux, upregualtion of ERG11, Alter in sterol composition, decreased azole binding due to ERG11 mutations

Why dont we use flucytosine as monotherapy

resistance can develop on treatment