Need help to reply three post.

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1- Each reply should be at least 200 words.

2- One scholarly reference ( NO MAYO CLINIC/ AHA)

3- APA style needs to be followed.

4- Each response should have reference at the end

5- Reference should be within last 5 years

Need help to reply three post.

DO NOT JUST REPEAT SAME INFORMATION, DO NOT JUST SAY I AGREE OR THINGS LIKE THAT. YOU NEED TO ADD NEW INFORMATION TO DISCUSSION.

1-

Each reply should be at least 200 words.

2- One scholarly reference ( NO MAYO CLINIC/ AHA)

3- APA style needs to be followed.

4- Each response should have reference at the end

5- Reference should be within last 5 years

DQ-1

Amphotericin B is used to treat a variety of fungal infections, it was established as a therapeutic antifungal treatment in 1958. Amphotericin B is effective in treating a variety of fungal infections including the majority Aspergillus species, Absidia species, Basidiobolus species, Blastomyces dermatitidis, Candida species, Coccidioides immitis, Conidiobolus species, Cryptococcus neoformans, Histoplasma capsulatum, Mucor species, Paracoccidioides species, Rhizopus species, Rhodotorula, and against Sporothrix sc henckii (Bellman & Smusziewicz, 2017). Amphotericin B elicits fungicidal effects by disrupting fungal wall synthesis via binding to sterols (ergosterol), this causes pores to develop in which cellular components begin to leak (Drew, 2019). Lipid peroxidation and inhibition of the fungal proton-ATPase are further cytotoxic mechanisms of action (Bellman & Smuszkiewicz, 2017) The fungicidal properties of Amphotericin B are concentration-dependent, with a prolonged post-antifungal effect against various candida species (Drew, 2019). Amphotericin B is primarily given IV, it is highly bound to lipoproteins and has a biphasic half-life, and the dose clearance has a linear relationship to weight. Doses range from 0.1 to 1.5 mg/kg/day and serum levels are not affected by liver or renal functions or dialysis (Drew, 2019). One of the most serious side effects is nephrotoxicity, it is estimated that up to 40% of patients receiving amphotericin B will see their creatinine level double. The nephrotoxic effects are caused by afferent arteriole tubule vasoconstriction, which causes decreased renal blood flow, glomerular filtration rate and tubular injury. This results in depletion of potassium, magnesium, bicarbonate and amino acids (Drew, 2019). These electrolyte imbalances are magnified with concomitant administration of corticosteroids and diuretics. Corticosteroids potentiate hypokalemia and can also induce cardiomegaly and congestive heart failure when administered with amphotericin B (Gubbins & Heldenbrand, 2010). If patients are taking corticosteroids and amphotericin B at the same time, they should have their electrolytes monitored along with renal function, and assess for cardiac dysfunction by echocardiography and symptom assessment. The provider should also assess the effectiveness of therapy with amphotericin B in addition to prescribing the lowest possible dose of corticosteroid for the shortest duration that will be effective for the condition being treated.

Bellmann, R., & Smuszkiewicz, P. (2017). Pharmacokinetics of antifungal drugs: practical implications for optimized treatment of patients. Infection, 45(6), 737.

Drew, R.H. (2019). Pharmacology of amphotericin B. In J. Mitty (Ed.) UpToDate. Retrieved on March 19, 2020 from

https://www.uptodate.com/contents/pharmacology-of-amphotericin-b

Gubbins, P. O., & Heldenbrand, S. (2010). Clinically relevant drug interactions of current antifungal agents. Mycoses, 2, 95.

DQ-2

Several fungal infections are present in dark, warm, moist environments. There are several medications that can be prescribed in order to help control fungal infections. A common medication prescribed for fungal infections is clotrimazole cream. This medication is mainly used for skin fungal infections. This medication is also used for mucous infections and may be used topical on vaginal preparations. The action of this medication is to kill or stop growth fungi by affecting the fungi cell membrane permeability and protein synthesis. Instructions is to wash area with soap and water and rinse thoroughly. Before applying the topical cream make sure the area is dry. Contraindications to using this medication is hypersensitivity to active ingredients or additives on the medication. adverse effects associated with this medication is burning, itching, local hypersensitivity reaction with redness and stinging. Medications should be applied twice per day for 1-4 weeks. Application of a small amount to cover affected area completely. Avoid the use of occlusive wrapping or dressing unless directed by health care provider. Instruction to patients that some medications may stain clothing (Deglin,Vallerand,Sanoski,2018). Patient with athlete foot need to wear well ventilated foot ware. Socks and shoes need to be washed and changed frequently. Patients need to report increased irritation to area applied. For application of nail bed, patients need to trim excess nails and washed area completely. There are several combinations of medications that can be beneficial for certain disease circumstances. Honey gel may be added to clotrimazole for the treatment of vaginal candidiasis (Seifinadergoli,Nahidi,Safaiyan,Javadzadeh,Eteraf-Oskouei, 2018).

Deglin, J. H., Vallerand, A. H., & Sanoski, C. A. (2018). Daviss drug guide for nurses. Philadelphia: F.A. Davis (380-385).

Seifinadergoli, Z., Nahidi, F., Safaiyan, A., Javadzadeh, Y., & Eteraf-Oskouei, T. (2018). Comparison of the efficacy of honey gel and clotrimazole cream in the treatment of vaginal candidiasis symptoms: a randomized clinical trial. Electronic Physician, 10(6), 6904–6911.

https://doi.org/10.19082/6904

DQ-3

Micafungin inhibits the synthesis of beta 1 and 3 glucan, which is used for the structural makeup of the fungal cell wall (Kotsopoulo et al., 2019). This structural failure of the fungal cell wall leads to osmotic instability and cell death (Kotsopoulo et al., 2019). Micafungin is a favored antifungal medication due to its low potential drug-drug interactions when compared to other popular antifungal medications such as caspofungin and fluconazole (Kotsopoulo et al., 2019). There are no known food to drug interactions with Micafungin at this time (Kotsopoulo et al., 2019). Also, Micafungin does not require a loading dose, and does not require dose adjustments for renal or hepatic mild to moderate impairment (Kotsopoulo et al., 2019).
Micafungin is only approved for intravenous administration for the treatment of esophageal candidiasis, prophylaxis of Candida infection, candidemia, Candida peritonitis, Candida abscesses, and disseminated candidiasis (McKeny & Zito, 2020).
Some side effects of administering Micafungin is insertion site irritation, anaphylaxsis reactions, phlebitis, anemia, transaminitis, hyperbilirubinemia, renal failure, and fever (McKeny & Zito, 2020).

Some contraindications include sensitivity to previous Micafungin administration and to adequately assess the patient’s history for any reactions across the antifungal class of medications (McKeny & Zito, 2020). Another contraindication is sever hepatic and renal failure due to metabolism and excretion of Micafungin, when patients are in sever failure states, administration of Micafungin can push the body to multi-organ-system failure (McKeny & Zito, 2020).

Since Micafungin can only be administered IV, there is monitoring requirements when administering this medication (McKeny & Zito, 2020). IV administration can be done at an outpatient facility or in an acute care facility (McKeny & Zito, 2020). If done in either facility, vital signs and signs of phlebitis need to be monitored if the patient begins to have an adverse reaction (McKeny & Zito, 2020).

A point that has been made is that usually fungal treatment includes multiple antifungals to adequately treat the patient’s infection (McKeny & Zito, 2020). If this is the case, then the most appropriate antifungal needs to be ordered for treatment due to the global rapid increase of drug resistant fungi (McKeny & Zito, 2020).

References:
McKeny, P.T. & Zito, P.M. (2020). Antifungal Antibiotics. Treasure Island (FL): StatPearls Publishing.Retrieved from:

https://www.ncbi.nlm.nih.gov/books/NBK538168/

Kotsopoulou, M.,Papadaki, C., Konstantinos, A., Spyridonidis, A., Baltadakis, A., Papadaki, A., Angelopoulou, M., Pappa, V., Liakou, J., Tzanetakou, M., Moustaka, M., & Vassilopoulos, M. (2019). Effectiveness and Safety of Micafungin in Managing Invasive Fungal Infections among Patients in Greece with Hematologic Disorders: The ASPIRE Study. Infectious Diseases and Therapy, 2, 255.

https://doi-org.lopes.idm.oclc.org/10.1007/s40121-019-0236-3