Antifungals on the NCLEX
Fluconazole, ketoconazole, amphotericin B: indications and toxicities.
Antifungals divided into azoles (-azole), polyenes (amphotericin B), and echinocandins. NCLEX tests fluconazole for Candida, amphotericin B nephrotoxicity, and CYP interactions.
Azoles (-azole)
Fluconazole, itraconazole, voriconazole, posaconazole, ketoconazole. Treat Candida, Cryptococcus, dimorphic fungi. CYP450 inhibition, many drug interactions.
Amphotericin B
Broad-spectrum, IV. Nephrotoxicity (significant). Infusion reactions (premedicate). 'Ampho-terrible' nickname for toxicity.
Echinocandins
Caspofungin, micafungin, anidulafungin. IV. Used for invasive candidiasis. Better tolerated than amphotericin.
Topical
Nystatin (oral thrush, candidal diaper rash). Clotrimazole, miconazole (skin, vaginal).
Frequently asked
Best for oral thrush?
Nystatin swish-and-swallow. Fluconazole oral for severe.
Antifungal for systemic Candida?
Echinocandin or fluconazole based on species and severity.
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