Herbs that are effective against skin infections: Tea tree oil (Melaleuca alternifolia) and

Garlic (Allium sativum). not to be ingested but effective topically.

Patients at risk for candidal infections are those who have diabetes, are pregnant, are
taking oral contraceptives, antibiotics, or corticosteroids
Fungicidal: destroy fungi
Fungistatic: able to slow fungi
candidiasis: Yeast infections
Thrush: Infection of the mouth by the microorganism C. albicans
mycotic infections: Fungi that cause disease in humans may be yeastlike or moldlike
Helminthic infections: Parasitic worms
Protozoal infections: Single-cell parasites
Amebiasis: A parasitic GI disorder
Fluconazole (Diflucan) inhibits DNA and RNA synthesis in the fungus.
Griseofulvin (Grisactin) exerts its effect by being deposited in keratin precursor cells,
which are then gradually lost (because of the constant shedding of top skin cells) and
replaced by new, noninfected cells.
Clotrimazole (Lotrimin, Mycelex) binds with phospholipids in the fungal cell membrane,
increasing permeability of the cell and resulting in a loss of intracellular components.
Miconazole treats vulvovaginal "yeast" infections and is representative of all the vaginal
antifungal agents.
AMPHOTERICIN B: is given only under close supervision in the hospital setting. Its use
is reserved for serious and potentially life-threatening fungal infections. The IV solution
is light sensitive and should be protected from exposure to light. If the solution is used
within 8 hours, there is negligible loss of drug activity. Therefore, once the drug is
reconstituted, the nurse should administer the medication immediately, because the
typical IV infusion is for a period of 6 hours or more.
N/V, hypotension, tachypnea, fever and chills (rigors) may occur with 15-20mins
Most serious adverse reaction to the use of amphotercin B: Renal damage
ANTI FUNGAL DRUGS: Used prophylactically in immunocompromised patients. (HIV,
TRANSPLANT, CHEMO PATIENTS)

Superficial and deep fungal infections

Systemic infections such as aspergillosis, candidiasis, and cryptococcal
meningitis

Superficial infections of nailbeds and oral, anal, and vaginal areas

ADVERSE REACTIONS:

Headache
Rash
Anorexia and malaise
Abdominal, joint, or muscle pain
Nausea, vomiting, diarrhea

CONTRAINDICATIONS:
Most of the systemic antifungal medications are contraindicated during pregnancy and
lactation.
Fluconazole-be cautious when giving to the older adult.
Griseofulvin- is not recommended for those with severe liver disease.
Voriconazole- is contraindicated when patients are taking the following medications:
terfenadine, astemizole, sirolimus, rifampin, rifabutin, carbamazepine, ritonavir, ergot
alkaloids, or long-acting barbiturates.
Both voriconazole and itraconazole are contraindicated in patients taking cisapride,
pimozide, or quinidine. The
itraconazole- should not be used to treat fungal nail infections in patients with a history of
heart failure.
PRECAUTIONS:
RENAL DYSFUNCTION OR HEPATIC IMPAIRMENT
Use amphotericin B cautiously in patients who have electrolyte imbalances or who
currently use antineoplastic drugs (because severe bone marrow suppression can result).
Administer griseofulvin cautiously with penicillin because of possible cross-sensitivity.
Itraconazole should be used with caution in patients with human immunodeficiency virus
(HIV) infection or hypochlorhydria (low levels of stomach acid).
Oral thrush infections (candidiasis) may be treated with oral solutions. The patient is
instructed to swish and hold the solution in the mouth for several seconds (or as long as
possible), gargle, then swallow the solution.
Before administering fluconazole to an elderly patient or a patient with renal impairment,
the primary health care provider may order a creatinine clearance test.

Itraconazole: The drug is taken with food. Therapy continues for at least 3 months until
infection is controlled. Report unusual fatigue, yellow skin, darkened urine, anorexia,
nausea, and vomiting.
The ongoing assessment involves careful observation of the patient every 2 to 4 hours for
adverse drug reactions when the antifungal drug is given by the oral or parenteral route.
Antithelmintic Drugs: used against invasion of parasitic worms (Helminthiasis)
Antiprotozoal Drugs: used against invasion of single celled parasites
ANTIHELMINTIC: USES:
Roundworms, pinworms, whipworms, hookworms, and tape- worms are examples of
helminths. The most common parasitic worm across the world is the roundworm. In the
United States, the most common worm seen is the pinworm.
Serious adverse effects is Rash to pyrantel, which is OTC
Used cautiously in patients:
With hepatic/renal impairment, malnutrition or anemia
Antiprotozal: ACTION:
Used for the treatment of Malaria
ADVERSE REACTIONS:

Headache and dizziness

Visual disturbances or tinnitus
Hypotension or changes detected on an electrocardiogram (ECG; associated with
chloroquine)
CINCHONISMa group of symptoms associated with QUININE administration,
including tinnitus, dizziness, headache, GI disturbances, and visual disturbances.
These symptoms usually disappear when the dosage is reduced.

CONTRAINDICATED IN PATIENTS: With known hypersensitivity; during pregnancy

Used cautiously: with bone marrow depression
Quinine not prescribed for: Patient with myasthenia gravis
Several stool specimens may be necessary before parasite is seen and identified. Monitor
VS ever 4H
When taking the drug pentamidine, patients should be placed in a reclining or supine
position to prevent adverse effects should a sudden decrease in blood pressure occur.