Fluconazole - Revision history

Aidan: /* Dosing */

2021-11-12T23:25:37Z

Dosing

← Older revision		Revision as of 23:25, 12 November 2021
Line 119:		Line 119:

	* Invasive candidiasis: fluconazole 6 to 12 mg/kg PO/IV q24h		* Invasive candidiasis: fluconazole 6 to 12 mg/kg PO/IV q24h
			*[[Candidemia]]: 12 mg/kg IV load followed by 6 mg/kg PO/IV daily
			**Can use 800 mg daily for isolates that show dose-dependent susceptibility
			*[[Vaginal candidiasis]]: 150 mg PO once, with or without intravaginal [[clotrimazole]]
			*[[Oral thrush]]: 100 mg po daily for 7 to 14 days
			*[[Esophageal candidiasis]]: 200 mg PO daily for 14 to 21 days
			*[[Urinary tract infection]]: 200 mg po daily for 7 to 14 days
			*[[Intra-abdominal infections\|Intraabdominal infection]]: 400 mg PO daily

	===Monitoring===		===Monitoring===

Aidan at 23:34, 15 November 2020

2020-11-15T23:34:29Z

← Older revision		Revision as of 23:34, 15 November 2020
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	\|}		\|}

	==~~Monitoring~~==		== Dosing ==

			* Invasive candidiasis: fluconazole 6 to 12 mg/kg PO/IV q24h

			===Monitoring===

	*ECG for QT prolongation		*ECG for QT prolongation

Aidan: /* Clinical Breakpoints */

2020-09-13T15:10:58Z

Clinical Breakpoints

← Older revision		Revision as of 15:10, 13 September 2020
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	\|-		\|-
	!S		!S
⚫	!I
	!SDD		!SDD
		⚫	!I
	!R		!R
	!S		!S
⚫	!I
	!SDD		!SDD
		⚫	!I
	!R		!R
	\|-		\|-
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	\|0.5		\|0.5
	\|≤2		\|≤2
⚫	\|—
	\|4		\|4
		⚫	\|—
	\|≥8		\|≥8
	\|≥17		\|≥17
⚫	\|—
	\|14-16		\|14-16
		⚫	\|—
	\|≤13		\|≤13
	\|-		\|-
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	\|[[Candida glabrata]]		\|[[Candida glabrata]]
	\|8		\|8
⚫	\|—
	\|—		\|—
	\|≤32		\|≤32
		⚫	\|—
	\|≥64		\|≥64
⚫	\|—
	\|—		\|—
	\|≥15		\|≥15
		⚫	\|—
	\|≤14		\|≤14
	\|-		\|-
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	\|1		\|1
	\|≤2		\|≤2
		⚫	\|4
	\|—		\|—
⚫	\|4
	\|≥8		\|≥8
	\|≥17		\|≥17
⚫	\|—
	\|14-16		\|14-16
		⚫	\|—
	\|≤13		\|≤13
	\|-		\|-
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	\|1		\|1
	\|≤2		\|≤2
⚫	\|—
	\|4		\|4
		⚫	\|—
	\|≥8		\|≥8
	\|≥17		\|≥17
⚫	\|—
	\|14-16		\|14-16
		⚫	\|—
	\|≤13		\|≤13
	\|-		\|-

Aidan at 14:41, 10 September 2020

2020-09-10T14:41:59Z

← Older revision		Revision as of 14:41, 10 September 2020
Line 10:		Line 10:
	*Efficacy predicted by AUC/MIC ratio		*Efficacy predicted by AUC/MIC ratio

	=== Breakpoints ===		===Clinical Breakpoints===
	{\| class="wikitable"		{\| class="wikitable"
	! rowspan="2" \|Species		! rowspan="2" \|Species

Aidan at 11:03, 26 August 2020

2020-08-26T11:03:31Z

← Older revision		Revision as of 11:03, 26 August 2020
Line 130:		Line 130:
	*Beware [[Adverse drug reaction::drug-drug interactions]], especially with new DOACs		*Beware [[Adverse drug reaction::drug-drug interactions]], especially with new DOACs

	[[Category:~~Antifungals~~]]		[[Category:Triazoles]]

Aidan: added ECVs

2020-08-21T20:38:27Z

added ECVs

← Older revision		Revision as of 20:38, 21 August 2020
Line 10:		Line 10:
	*Efficacy predicted by AUC/MIC ratio		*Efficacy predicted by AUC/MIC ratio

			=== Breakpoints ===
	{\| class="wikitable"		{\| class="wikitable"
	! rowspan="2" \|Species		! rowspan="2" \|Species
			! rowspan="2" \|ECV (μg/mL)
	! colspan="4" \|Breakpoints (μg/mL)		! colspan="4" \|Breakpoints (μg/mL)
	! colspan="4" \|Breakpoints (mm)		! colspan="4" \|Breakpoints (mm)
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	\|-		\|-
	\|[[Candida albicans]]		\|[[Candida albicans]]
			\|0.5
	\|≤2		\|≤2
	\|—		\|—
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	\|14-16		\|14-16
	\|≤13		\|≤13
			\|-
			\|[[Candida dubliniensis]]
			\|0.5
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
	\|-		\|-
	\|[[Candida glabrata]]		\|[[Candida glabrata]]
			\|8
	\|—		\|—
	\|—		\|—
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	\|≥15		\|≥15
	\|≤14		\|≤14
			\|-
			\|[[Candida guilliermondii]]
			\|8
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
	\|-		\|-
	\|[[Candida krusei]]		\|[[Candida krusei]]
			\|
	\| colspan="4" \|intrinsically resistant		\| colspan="4" \|intrinsically resistant
	\| colspan="4" \|intrinsically resistant		\| colspan="4" \|intrinsically resistant
			\|-
			\|[[Candida lusitaniae]]
			\|1
			\|
			\|
			\|
			\|
			\|
			\|
			\|
			\|
	\|-		\|-
	\|[[Candida parapsilosis]]		\|[[Candida parapsilosis]]
			\|1
	\|≤2		\|≤2
	\|—		\|—
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	\|-		\|-
	\|[[Candida tropicalis]]		\|[[Candida tropicalis]]
			\|1
	\|≤2		\|≤2
	\|—		\|—
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	\|14-16		\|14-16
	\|≤13		\|≤13
			\|-
			\|[[Cryptococcus neoformans]]
			\|8
			\| colspan="8" rowspan="2" \|
			\|-
			\|[[Cryptococcus gattii]]
			\|16-32
	\|}		\|}

Aidan: added breakpoints table

2020-08-21T20:26:30Z

added breakpoints table

@@ Line 9: / Line 9: @@
 *Fungistatic
 *Efficacy predicted by AUC/MIC ratio
 ==Monitoring==

Aidan at 16:16, 21 August 2020

2020-08-21T16:16:33Z

← Older revision		Revision as of 16:16, 21 August 2020
Line 3:		Line 3:
	*Antifungal in the triazole family with excellent bioavadilability but limited efficacy outside of ''Candida''		*Antifungal in the triazole family with excellent bioavadilability but limited efficacy outside of ''Candida''

	=== Pharmacokinetics and Pharmacodynamics ===		===Pharmacokinetics and Pharmacodynamics===

	* Good oral bioavailability		*Good oral bioavailability
	* Good CNS penetration		*Good CNS penetration
	* Fungistatic		*Fungistatic
			*Efficacy predicted by AUC/MIC ratio
	* Susceptibility breakpoints for [[Candida albicans]] are:		*Susceptibility breakpoints for [[Candida albicans]] are:
	** Susceptible MIC ≤2
	** Susceptible ~~dose-dependent~~ MIC 4		**Susceptible MIC ≤2
	** ~~Resistant~~ MIC ≥8		**Susceptible dose-dependent MIC 4
			**Resistant MIC ≥8

	==Monitoring==		==Monitoring==

Aidan at 16:16, 21 August 2020

2020-08-21T16:16:04Z

← Older revision		Revision as of 16:16, 21 August 2020
Line 1:		Line 1:
			==Background==
	== Classification ==

	* Antifungal in the triazole family with excellent bioavadilability but limited efficacy outside of ''Candida''		*Antifungal in the triazole family with excellent bioavadilability but limited efficacy outside of ''Candida''

		⚫	=== Pharmacokinetics and Pharmacodynamics ===
	== Indications ==

		⚫	* Good oral bioavailability
	* Fungal infections
		⚫	* Good CNS penetration
			* Fungistatic
			* Susceptibility breakpoints for [[Candida albicans]] are:
			** Susceptible MIC ≤2
			** Susceptible dose-dependent MIC 4
			** Resistant MIC ≥8

	== Monitoring ==		==Monitoring==

	* ECG for QT prolongation		*ECG for QT prolongation
	* Liver enzymes for hepatitis		*Liver enzymes for hepatitis

		⚫	==Adverse Drug Reactions==
⚫	== Pharmacokinetics ==

⚫	* Good oral bioavailability
⚫	* CNS penetration

		⚫	*Best side effect profiles of the antifungals
⚫	== Adverse Drug Reactions ==
		⚫	*Before starting, check:
⚫	* Best side effect profiles of the antifungals
		⚫	**Liver enzymes as baseline ([[Adverse drug reaction::hepatitis]])
⚫	* Before starting, check:
		⚫	**Creatinine (requires renal dosing)
⚫	** Liver enzymes as baseline ([[Adverse drug reaction::hepatitis]])
			**EKG ([[Adverse drug reaction::QTc prolongation]])
⚫	** Creatinine (requires renal dosing)
	** ~~EKG (~~[[Adverse drug reaction::~~QTc~~ ~~prolongation~~]])		*Beware [[Adverse drug reaction::drug-drug interactions]], especially with new DOACs
	* Beware [[Adverse drug reaction::drug-drug interactions]], especially with new DOACs

	[[Category:Antifungals]]		[[Category:Antifungals]]

Aidan: /* Adverse Drug Reactions */

2020-02-18T03:15:38Z

Adverse Drug Reactions

← Older revision		Revision as of 03:15, 18 February 2020
Line 20:		Line 20:
	* Best side effect profiles of the antifungals		* Best side effect profiles of the antifungals
	* Before starting, check:		* Before starting, check:
	** Liver enzymes as baseline ([[Adverse drug reaction::hepatitis]]		** Liver enzymes as baseline ([[Adverse drug reaction::hepatitis]])
	** Creatinine (requires renal dosing)		** Creatinine (requires renal dosing)
	** EKG ([[Adverse drug reaction::QTc prolongation]])		** EKG ([[Adverse drug reaction::QTc prolongation]])