Pre-Existing Liver Disease and Toxicity of Antifungals

Pre-existing liver disease in patients with invasive fungal infections further complicates their management. Altered pharmacokinetics and tolerance issues of antifungal drugs are important concerns. Adjustment of the dosage of antifungal agents in these cases can be challenging given that current ev...

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Bibliographic Details
Published in:Journal of fungi (Basel) 2018-12, Vol.4 (4), p.133
Main Authors: Spernovasilis, Nikolaos, Kofteridis, Diamantis P
Format: Article
Language:English
Subjects:
antifungal agent
Antifungal agents
antifungal drug
Decision making
Dosage
Drug dosages
Enzymes
Fungal infections
hepatic impairment
invasive fungal infection
Lipids
liver disease
Liver diseases
Metabolism
Metabolites
Patients
Pharmacodynamics
Pharmacokinetics
Review
Toxicity
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Summary:Pre-existing liver disease in patients with invasive fungal infections further complicates their management. Altered pharmacokinetics and tolerance issues of antifungal drugs are important concerns. Adjustment of the dosage of antifungal agents in these cases can be challenging given that current evidence to guide decision-making is limited. This comprehensive review aims to evaluate the existing evidence related to antifungal treatment in individuals with liver dysfunction. This article also provides suggestions for dosage adjustment of antifungal drugs in patients with varying degrees of hepatic impairment, after accounting for established or emerging pharmacokinetic⁻pharmacodynamic relationships with regard to antifungal drug efficacy in vivo.
ISSN:2309-608X
2309-608X
DOI:10.3390/jof4040133