Antifungal Agents

Anti-Infectives

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Examples

fluconazoleamphotericin Bnystatinketoconazole

Prefix / Suffix: -azole / -fungin

Physiology

Fungal cell membranes contain ergosterol (instead of cholesterol in humans). Disrupting it kills the fungus.

Mechanism of Action

Azoles inhibit ergosterol synthesis; polyenes (amphotericin B, nystatin) bind ergosterol and disrupt the membrane.

Indications

Candidiasis (oral, vaginal, systemic)
Cryptococcal meningitis
Aspergillosis
Tinea infections

Side Effects / Adverse Effects

Hepatotoxicity (azoles)
Nephrotoxicity (amphotericin B — 'ampho-terrible')
Infusion reactions: fever, chills, rigors (amphotericin B)
Electrolyte imbalances (hypokalemia, hypomagnesemia)
GI upset

Contraindications

Severe hepatic impairment (azoles)
Pregnancy (azoles)

Nursing Considerations

Monitor liver function (azoles — hepatotoxicity)
Monitor renal function and electrolytes with amphotericin B
Premedicate with antipyretics/antihistamines before amphotericin B (reduces infusion reactions)
Nystatin 'swish and swallow' — hold in mouth before swallowing (oral candidiasis)
Many drug interactions with azoles (CYP450 inhibition)

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.