Antifungal drugs

• Published in: Side Effects of Drugs Annual Vol. 18; pp. 278 - 285
• Main Authors: Lepakhin, V.K., Astakhova, A.V.
• Format: Book Chapter
• Language: English
• Published: Elsevier Science & Technology 1994
• ISBN: 9780444819390; 0444819398
• ISSN: 0378-6080; 0378-6080
• DOI: 10.1016/S0378-6080(05)80272-7

This chapter discusses several antifungal drugs and their side effects. Amphotericin has been infrequently reported to cause tachycardia, ventricular extra beats, and torsade de pointes. Ventricular dysrhythmias have been reported only after rapid infusions of large doses of amphotericin in patients with hyperkalemia and severe renal failure but not in patients with normal serum creatinine and potassium concentrations, even when they received the drug over one hour. The risk/benefit ratios of the oral antifungal drugs griseofulvin, ketoconazole, itraconazole, and terbinafiner emphasize the possibility of liver damage. All oral antifungal agents cause minor gastrointestinal upsets, headache, and skin reactions. There is also a rare incidence of reversible hepatic damage. Although the incidence of abnormal liver function tests with oral antifungal therapy is extremely low, patients should be advised to inform their physician if any warning symptoms are noticed such as nausea, vomiting, abdominal pain, or a change in the color of the urine, in which case the drug must be withdrawn.