Comprehensive Nursing Pharmacology Q 175
Which of the following must always be present before beginning antifungal therapy?
A. Coagulation profile
B. Confirmed diagnosis
C. Biopsy of the infected site
D. Urinalysis
Correct Answer: B. Confirmed diagnosis
The diagnosis of fungal infection, as opposed to infection caused by virus or bacteria, is necessary before beginning therapy with antifungal agents. Clinically, fungal infections are best categorized first according to the site and extent of the infection, then the route of acquisition, and finally, the virulence of the causative organism. These classifications are essential when determining the most effective treatment regimen for a particular mycosis.
Option A: Mycoses classify as local (superficial, cutaneous, subcutaneous) or systemic (deep, bloodborne). The acquisition of the fungal infection is either an exogenous (airborne/inhalation, cutaneous exposure, percutaneous inoculation) or endogenous process (normal flora or reactivated infection).
Option C: The virulence of the organism is classified as either a primary infection (disease arising in a healthy host), or opportunistic infection (disease arising in human hosts that have a compromised immune system, or other defenses).
Option D: Polyene antifungals (e.g., amphotericin B) bind to ergosterol, a steroid-alcohol unique to Fungi. The polyene-ergosterol complex creates pores in the fungal cell membrane, ultimately leading to electrolyte leakage, cell lysis, and cell death.