Description of Antifungal Drugs
Session 13: Description of Antifungal Drugs
Total Session Time: 120 minutes
Prerequisites module
Learning Tasks
By the end of this session students are expected to be able to:
Resources Needed:
SESSION OVERVIEW
Activity/
Step Time Content
Method
1 05 minutes Presentation Introduction, Learning Tasks
Presentation/ Indications of Systemic and Mucosal
2 20 minutes
Buzzing Antifungal Drugs
Presentation/ Contraindications of Systemic and Mucosal
3 20 minutes
Brainstorming Antifungal Drugs
Dose, Dosage and Course of Systemic and
4 30 minutes Presentation
Mucosal Antifungal Drugs
Presentation/ Side Effects and Adverse Effects of Systemic
5 20 minutes
Brainstorming and Mucosal Antifungal Drugs
Interactions and Precautions of Systemic and
6 15 minutes
Presentation Mucosal Antifungal Drugs
7 05 minutes Presentation Key Points
8 05 minutes Presentation Evaluation
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SESSION CONTENTS
STEP 1: Presentation of Session Title and Learning tasks (5 minutes)
READ or ASK students to read the learning tasks and clarify
ASK students if they have any questions before continuing.
STEP 2: Indications of Antifungal Drugs (20 Minutes)
Activity: Buzzing (5 minutes)
ASK students to pair up and buzz on the following question for 2 minutes
ALLOW few pairs to respond and let other pairs to add on points not mentioned
WRITE their response on the flip chart/board
CLARIFY and SUMMARIZE by using the content below
o Is useful agent for nearly all life-threatening mycotic infections
o It is often used as the initial induction regimen for serious fungal infections and is
then replaced by one of the newer fluconazole
o Is s especially important for immunosuppressed patients and those with severe fungal
pneumonia, cryptococcal meningitis with altered mental status, or sepsis syndrome
due to fungal infections
o Are useful agents in management of candida species, Cryptococcus neoformans, the
endemic mycoses (blastomycosis, coccidioidomycosis and histoplasmosis)
infections of the skin, scalp, hair and nails where topical therapy has failed or is
inappropriate
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STEP 3: Contraindications of Antifungal Drugs (20 Minutes)
Activity: Brainstorming (5 minutes)
Ask students to brainstorm on the following question:
ALLOW few students to respond
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
impairment and breast-feeding
erythematosus acute, porphyria, pregnancy (avoid pregnancy during and for 1 month after
treatment men should not father children within 6 months of treatment) and breast-
feeding
STEP 4: Dose, Dosage and Course of Systemic and Mucosal Antifungal
Drugs (30minutes)
for 10–15 days (continued for 48 hours after lesions have resolved); increased to 8 daily
in severe infection
o 2% cream for vaginal candidiasis. Applied twice a day for 7 days
o Topical: 2% cream, is used for vaginal candidiasis, vulvovaginal candidiasis and
candidal balanitis
o The drug is applied twice daily for 5 to 7 days
o Vaginal candidiasis, Vulvovaginal Candidiasis, and candidal balanitis, ADULT and
unusually difficult infections) given for 7–14 days in oropharyngeal candidiasis
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o In severe infection dose may be doubled, the dose need to be reduced when response
o Tinea capitis caused by Trichophyton tonsurans, 1g once daily or in divided doses
o Treatment should continue for not less than 21 days
o Treatment for adult and children suffering from oral pharyngeal candidiasis 100 000
units 4 times daily after food, usually for 7 days (continued for 48 hours after lesions
have resolved)
STEP 5: Side Effects and Adverse Effects of Antifungal Drugs
(20 Minutes)
Activity: Brainstorming (5 minutes)
Ask students to brainstorm on the following question:
ALLOW few students to respond
WRITE their responses on the flip chart/ board
CLARIFY and SUMMARISE by using the content below
o When given parenterally it causes anorexia, nausea and vomiting, diarrhoea,
epigastric pain, febrile reactions, headache, muscle and joint pain, anaemia
disturbances in renal function and renal toxicity
o The most common adverse reaction is relatively minor gastrointestinal upset and, very
rarely, clinical hepatitis
o Causes nausea, vomiting; rash; with buccal tablets
o Abdominal pain, taste disturbance, burning sensation at application site, pruritus, and
oedema; with oral gel, very rarely diarrhoea (usually on long term treatment),
hepatitis, toxic epidermal necrolysis, and Stevens-Johnson syndrome
o Causes nausea, abdominal discomfort, diarrhea, flatulence, headache and rash
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o Causes nausea, vomiting, diarrhea and headache
o Less frequently hepatotoxicity, dizziness, confusion, fatigue and sleep disturbances
occurs
STEP 6: Interactions and Precautions of Antifungal Drugs (15minutes)
o Increase neurotoxicity of aminoglycoside
o Increase cellular toxicity of flucytosine
o There is an increased risk of hypokalemia when used with loop diuretics
o Increases cardiac toxicity of digoxin.
o Enhance effect of alcohol
o Reduces effect of anti coagulants
o Its absorption is reduced by phenobarbitone
o Accelerate metabolism of oral contraceptives
STEP 7: Key points (5 minutes)
with severe fungal pneumonia, cryptococcal meningitis with altered mental status, or
sepsis syndrome due to fungal infections
interactions of griseofulvin
STEP 8: Assessment (5 minutes)
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References
Pharmacotherapy: a pathophysiologic approach (9th ed.). New York,.
McGraw-Hill Education
Ministry Of Health and Social Welfare. 2013. Standard Treatment Guidelines &
Sally S.R, Jeanne C.S. 2000. Introductory Clinical Pharmacology (6th ed)
New York, Lippincott Williams and Wilkins
School of Pharmaceutical sciences. 2011. Tanzania Pharmaceutical Handbook
(2nd ed.). Dar es Salaam, ARDHI University press.
The Royal Pharmaceutical Society of Great Britain. 2007. Martindale, the Extra
Pharmacopoeia (5TH ed). London, pharmaceutical press.
The Royal Pharmaceutical Society of Great Britain. 2009. British National Formulary
(59th ed). London, BMJ Group and RPS Publishing.
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