C H A P T E R 1 1
Antifungal agents
161
■■
Adverse effects may include hepatic and renal
failure.
■■
Local fungal infections include vaginal and oral yeast
infections (
Candida
) and a variety of tinea infections,
including athlete’s foot and jock itch.
■■
Topical antifungals are agents that are too toxic to be
used systemically but are effective in the treatment of
local fungal infections.
■■
Proper administration of topical antifungals improves
their effectiveness. They should not be used near
open wounds or lesions.
■■
Topical antifungals can cause serious local irritation,
burning and pain. The drug should be stopped if
these conditions occur.
Knowing your strengths and weaknesses helps you to
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to find out how you measure up!
ONLINE RESOURCES
An extensive range of additional resources to enhance teaching
and learning and to facilitate understanding of this chapter may
be found online at the text’s accompanying website, located on
thePoint at
These include Watch and
Learn videos, Concepts in Action animations, journal articles,
review questions, case studies, discussion topics and quizzes.
BIBLIOGRAPHY
Brouwer, A. E., Rajanuwong, A., Chierakul, W., Griffin, G. E.,
Larsen, R. A., White, N. J., et al. (2004). Combination
antifungal therapies for HIV associated cryptococcal meningitis:
A randomised trial.
Lancet, 363
, 1764–1767.
Chen, S. C. A. & Sorrell, T. C. (2007). Antifungal agents.
Medical
Journal of Australia
, 187, 404–409.
Dempsey, J., Hillege, S. & Hill, R. (2014).
Fundamentals of
Nursing and Midwifery: A Person-centred Approach to Care
(2nd Australian and New Zealand edn). Sydney: Lippincott
Williams & Wilkins.
Farrell, M. & Dempsey, J. (2014).
Smeltzer & Bare’s Textbook
of Medical-Surgical Nursing
(3rd edn). Sydney: Lippincott,
Williams & Wilkins.
Jen, L., Piacenti, F. J. & Lyakhovetskiy, A. G. (2003). Voriconazole.
Clinical Therapeutics, 25,
1321–1381.
Johnson, M. D. & Perfect, J. R. (2003). Caspofungin: First
approved agent in a new class of antifungals.
Expert Opinion on
Pharmacotherapy, 4
,
807–823.
Kontoyiannis, D. P., Mantadaki, E. & Samonis, G. (2003). Systemic
mycoses in immune-compromised host: An update in antifungal
therapy.
Journal of Hospital Infection, 53
,
243–258.
McKenna, L. (2012).
Pharmacology Made Incredibly Easy
(1st Australian and New Zealand edn). Sydney: Lippincott
Williams & Wilkins.
McKenna, L. & Mirkov, S. (2014).
McKenna’s Drug Handbook for
Nursing and Midwifery
(7th edn). Sydney: Lippincott Williams
& Wilkins.
Pfaller, M. A. (2012). Antifungal drug resistance: Mechanisms,
epidemiology, and consequences for treatment.
American Journal
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S3–S13.
Porth, C. M. (2011).
Essentials of Pathophysiology: Concepts
of Altered Health States
(3rd edn). Philadelphia: Lippincott
Williams & Wilkins.
Porth, C. M. (2009).
Pathophysiology: Concepts of Altered Health
States
(8th edn). Philadelphia: Lippincott Williams & Wilkins.
Van Onselen, J. (2012). Prescribing for superficial fungal skin and
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Nurse Prescribing, 10,
229–234.
C H E C K Y O U R U N D E R S T A N D I N G
Answers to the questions in this chapter can be found in
Appendix A at the back of this book.
MULTIPLE CHOICE
Select the best answer to the following.
1.
A person with a fungal infection asks the health
professional why she cannot take antibiotics. The
health professional explains that the reason for this
is that a fungus is resistant to antibiotics because:
a.
a fungal cell wall has fewer but more selective
protective layers.
b.
the composition of the fungal cell wall is highly
rigid and protective.
c.
a fungus does not reproduce by the usual
methods of cell division.
d.
antibiotics are developed to affect only bacterial
cell walls.
2.
When administering a systemic antifungal agent, the
nurse or midwife incorporates understanding that all
systemic antifungal drugs function to:
a.
break apart the fungus nucleus.
b.
interfere with fungus DNA production.
c.
alter cell permeability of the fungus, leading to
cell death.
d.
prevent the fungus from absorbing needed
nutrients.
3.
After assessing a person, the nurse or midwife would
question an order for amphotericin B to prevent the
possibility of serious nephrotoxicity if the person
was also receiving which of the following?
a.
digoxin
b.
oral anticoagulants
c.
phenytoin
d.
corticosteroids
