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Antifungals
Name | Dose (Adults) | Dose (Paediatric) | Available as | Precautions |
| Amphotericin B | 50mg in 500ml D5% over 4-6hrs-OD Add Hydrocortisone 50mg in infusion Premedication with Avil and Paracetamol | 1mg/kg | Monitor K, Creatinine and Magnesium. Give K and Mg replacement. Renal toxicity with Amikacin, CSA, Teicoplanin and contrast media W/F Chills, fever, hypotension Infuse 1 lit NS, prior to ampho if patient can tolerate PL cutoff- 20,000/cmm | |
| Liposomal Amphotericin | 3-5mg/kg- in 500ml D5% over over 2hrs-OD | 3-5mg/kg- OD | 50% decreased risk of nephrotoxicity, Saline loading is not necessary Monitor creat, K, Mg, CBC W/F infusion reaction | |
AMB lipid complex | 5 mg/kg/d IV daily | |||
| Fluconazole | 150mg-400mg- OD PO/IV | 6mg/kg- OD | Tab. 50, 150, 200mg | Renal correction, avoid with arsenic trioxide, warfarin, headache, QTc prolongation |
| Voriconazole | 200mg- BD-PO Or 6 mg/kg IV, every 12 hours for 2 doses, followed by 4 mg/kg every 12 hours | To be taken 1hr before or 1 hr after food, hepatic correction, avoid IV in renal impairment, Monitor RFT, K, Mg Can cause gastrointestinal disturbance (nausea, vomiting, or diarrhea), skin rashes Therapeutic drug monitoring is recommended. Target: 1–5.5 mg/mL | ||
| Posaconazole | 5ml- TID PO with ghee | W/F Nausea, diarrhoea, hypokalemia, and pyrexia, Monitor LFT, hepatotoxicity, prolonged QTc | ||
| Itraconazole | W/F nausea, vomiting, hypertriglyceridemia, hypokalemia, hypertension, hepatotoxicity, negative inotropic effects (avoid in patients with CCF and those with low EF) | |||
| Isavuconazole | 200-mg PO, 3 TID for 6 doses, followed by 200 mg OD thereafter | W/F nausea, vomiting, diarrhea, hepatic toxicity | ||
| Caspofungin | 70mg stat and then 50mg OD- IV | Hepatic correction, avoid with CSA W/F Thrombophlebitis in infused vein, Fever, diarrhea, shivering, rash, respiratory failure |
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