Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Fluconazole is an anti-fungal medication
related to clotrimazole (Lotrimin), ketoconazole (Nizoral), itraconazole
(Sporanox), and miconazole (Micatin, Monistat). It prevents growth of fungi by
preventing production of the membranes that surround fungal cells. The Food and
Drug Administration approved fluconazole in January 1990.
STORAGE: Store tablets and dry powder below 86 F (30 C). Store
injection and reconstituted suspension between 5-30 C (41-86 F). Discard unused
portion of the reconstituted suspension after 2 weeks. Protect from freezing.
PRESCRIBED FOR: Fluconazole is used for treating
vaginal,
oral, and
esophageal fungal infections caused by Candida. It may also be effective in
treating urinary tract infections,
peritonitis, pneumonia and disseminated
infections caused by Candida. Fluconazole is also used for treating cryptococcal
meningitis, and prevention of
Candida infections in patients treated with
chemotherapy or
radiation after bone marrow transplantation.
DOSING: The usual adult dose is 50-400 mg daily depending on the type
of infection. Although symptoms of oral candida infections may subside in a few
days treatment is continued for 2 weeks. Esophageal Candida infections are
treated for 3 weeks or longer. Treatment of cryptococcal meningitis may last for
10-12 weeks after cerebrospinal fluid cultures become negative.
DRUG INTERACTIONS:Hydrochlorothiazide significantly increases the
blood concentration of oral fluconazole by reducing the elimination of
fluconazole by the kidneys. This interaction may increase the side effects of
fluconazole. Rifampin (Rifadin, Rimactane,
Rifadin,
Rifater,
Rifamate) reduces the blood concentration of oral fluconazole,
probably by reducing the metabolism of fluconazole in the liver; therefore,
reducing the effectiveness of fluconazole. Fluconazole may increase the
concentration of warfarin
(Coumadin) in blood by reducing the metabolism of warfarin.
Therefore, the effect of warfarin may increase, leading to increased tendency to
bleed. Fluconazole also increases the concentration of phenytoin
(Dilantin), cyclosporine,
zidovudine (Retrovir),
theophylline (Theo-Dur,
Respbid, Slo-Bid, Theo-24, Theolair, Uniphyl, Slo-Phyllin), tolbutamide,
glyburide
(Micronase, Diabeta, Glynase), glipizide, triazolam
(Glucotrol), and midazolam
(Versed).
PREGNANCY: There are no adequate studies in
pregnant women. There are
reports of harmful effects to the fetus when high dose fluconazole was
administered to pregnant women for a few months. Use of fluconazole during
pregnancy is not usually recommended.
NURSING MOTHERS: Fluconazole is secreted in
breast milk. Use of
fluconazole by nursing mothers is not recommended.
SIDE EFFECTS: Common side effects include headache, nausea, and
abdominal pain. Other side effects included diarrhea, dyspepsia, dizziness,
rash, and taste disturbance. Rarely, serious allergic reactions, including
angioedema (swelling of tissues), may also occur. Liver dysfunction (jaundice,
hepatitis) has also been associated with fluconazole.
Yeast vaginitis is a yeast infection of the vagina. Symptoms include itching, burning, soreness, pain during intercourse and urination, and vaginal discharge. Yeast infections can be treated with over-the-counter and prescription medications.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.
The term "ringworm" or "ringworms" refers to fungal infections that are on the surface of the skin. A physical examination of the affected skin, evaluation of skin scrapings under the microscope, and culture tests can help doctors make the appropriate distinctions. A proper diagnosis is essential to successful treatment. Among the different types of ringworm are the following: tinea barbae, tinea capitis, tinea corporis, tinea cruris, tinea faciei, tinea manus, tinea pedis, and tinea unguium.
Athlete's foot (tinea pedis) is a skin infection caused by the ringworm fungus. Symptoms include itching, burning, cracking, peeling, and bleeding feet. Treatment involves keeping the feet dry and clean, wearing shoes that can breathe, and using medicated powders to keep your feet dry.
Thrush is an infection of the mouth caused by the candida fungus. Symptoms of Thrush include pain or difficulty swallowing, a feeling that food gets stuck in the throat, and fever.
Jock itch is an itchy red rash that appears in the groin area. The rash may be caused by a bacterial or fungal infection. People with diabetes and those who are obese are more susceptible to developing jock itch. Antifungal shampoos, creams, and pills may be needed to treat fungal jock itch. Bacterial jock itch may be treated with antibacterial soaps and topical and oral antibiotics.
Folliculitis is a skin condition that causes small red bumps to form around the hair follicles. Skin bacteria such as Staphylococcus and Pseudomonas my infect the follicles. Treatment involves over-the-counter bacterial washes, topical antibiotics, and/or topical steroids.
Fungal nails (onychomycosis) may be caused by many species of fungi but the most common is Trichophyton rubrum. Distal subungal onychomycosis starts as a discolored area at the nail's corner and slowly spread toward the cuticle. In proximal subungal onychomycosis, the infection starts at the cuticle and spreads toward the nail tip. Yeast onychomycosis is caused by Candida and may be the most common cause of fungal fingernail.
Encephalitis is a brain inflammation that causes sudden fever, vomiting, headache, light sensitivity, stiff neck and back, drowsiness, and irritability. Meningitis is an infection that causes inflammation of the meninges that surround the brain and spinal cord. Symptoms of meningitis include high fever, headache, nausea, vomiting, and stiff neck.
Yeast infections are caused by an overgrowth of a type of fungus called Candida. Oral thrush is a yeast infection of the mouth and throat. Oral thrush and yeast infections are treated orally or topically with an antifungal antibiotic called Nystatin.
Valley fever (coccidioidomycosis) is a disease caused by the inhalation of the Coccidioides immitis or C. posadasii fungus. Symptoms are flu-like and resolve over two to six weeks. Infection typically requires no treatment, though there are many antifungal drugs to treat valley fever.
Cholesterol occurs naturally in the body. High blood cholesterol levels increase a person's risk of developing heart disease, heart attacks, strokes, TIAs, and more. In addition to medication (fibrates, statins, bile acid sequestrants, and niacin), lifestyle changes can be made to lower blood cholesterol levels
Cryptococcosis is an infection caused by the Cryptococcus fungus. Cryptococcus is spread through inhalation of airborne fungi. Symptoms and signs include fever, headache, altered mental status, coughing, and shortness of breath. Treatment depends upon the severity of infection and the health status of the patient.
Pneumonia is a lung infection that can be caused by
different types of microorganisms, including bacteria, viruses, and fungi.
Symptoms of pneumonia include cough with sputum
production, fever, and sharp chest pain on inspiration (breathing in).
Pneumonia is suspected when a doctor hears abnormal
sounds in the chest, and the diagnosis is confirmed by a chest X-ray.
Bacteria causing pneumonia can be identified by sputum
culture.
A pleural effusion is a fluid collection around the
inflamed lung.
Bacterial and fungal (but not viral)
pneumonia can be treated with antibiotics.
What is pneumonia?
Pneumonia is an infection of one or both lungs which is usually caused by bacteria, viruses, or fungi. Prior to the discovery of antibiotics, one-third of all people who developed pneumonia subsequently died fro...
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