Summary
Highlights
Antifungal medications primarily treat candida fungal infections. Azoles, ending in "-azole" like fluconazole and ketoconazole, are used for nail and skin fungal infections. Remember "NAZOL" for nail fungus. These medications are typically taken for 2-6 weeks and are very liver toxic. It's crucial to distinguish azoles from metronidazole (Flagyl), as azoles do not treat C. diff infections; metronidazole treats C. diff.
Amphotericin B is reserved for serious fungal infections due to its severe side effects, notably renal injury. Key indicators of renal distress include a creatinine level over 1.3 and urine output of 30 ml/hr or less, or oliguria.
Nystatin treats candida infections of the mouth, GI tract, skin, and vagina. It's important not to confuse it with lovastatin, a cholesterol medication. When administering nystatin, shake the liquid suspension well for even distribution. Nurses should inspect mucous membranes for irritation, remove and soak dentures (as they can harbor infection), and instruct patients to swish the medication in their mouth for several minutes before swallowing (for esophageal candida). Patients must continue the medication for approximately 48 hours after symptoms subside to prevent reinfection.
The video reviews three common NCLEX questions: 1) Metronidazole (dazole) treats C. diff, not azoles (nazole). 2) Nystatin is used to treat oral candidiasis and requires denture removal and soaking. 3) Amphotericin B and aminoglycosides (like vancomycin and neomycin) are highly nephrotoxic and ototoxic, indicated by elevated creatinine, low urine output, and tinnitus.