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Itraconazole is a medication used in the management and treatment of fungal infections. It is in the antifungal class of drugs. Many of these fungal infections are rare; however, they can be detrimental to the immunocompromised. Some patient populations that frequently use itraconazole prophylaxis are patients with HIV, those receiving chemotherapy, or people who have had an organ transplant. This activity reviews the indications, mechanism of action, adverse event profile, and contraindications for itraconazole as a valuable agent in treating systemic fungal infections and other disorders, including off-label indications pertinent for healthcare team members in the treatment of patients with systemic fungal infections and related conditions. Objectives: Identify the mechanism of action of itraconazole. Describe the potential adverse effects of itraconazole. Review the appropriate monitoring of patients using itraconazole. Summarize some interprofessional team strategies for improving care coordination and communication to advance itraconazole and improve outcomes. Access free multiple choice questions on this topic.

Managing antifungal prophylaxis in immunocompromised patients requires the entire interprofessional healthcare team, including clinicians (MDs, DOs, PAs, NPs), infectious disease specialists in severe cases, nursing staff, pharmacists, and laboratory technologists. If itraconazole therapy is not adequately managed, patients are likely to contract life-threatening fungal infections or experience adverse side effects. Whether these patients are immunocompromised due to HIV, chemotherapy, or organ transplant, drugs like itraconazole can be lifesaving.[1] When an immunocompromised patient presents to the hospital, the physician and assigned nurse are responsible for coordinating care. This includes: Assessing the patient for any signs of current fungal infections Reviewing the patient’s cardiac history. If the patient has any history of arrhythmias or heart failure, consult cardiology. Ordering liver enzymes to evaluate the liver’s function.[2] Consult with an infectious disease physician to ensure that itraconazole provides adequate coverage for the patient. Consult with the pharmacist to ensure there are no drug-drug interactions between itraconazole and the patient’s current medications; in severe cases, an infectious disease specialty pharmacist can be a valuable addition to the interprofessional team. The management of itraconazole prophylaxis does not stop after the initial visit and therefore requires the efforts of an interprofessional healthcare team, including clinicians, infectious disease specialists, nursing staff, pharmacists, and other healthcare personnel. Following ordering/prescribing and administration of the drug, itraconazole levels require regular monitoring, and the patients require monitoring for the development of any adverse reactions. These patients may also benefit from a mental health counselor; many of these patients are very sick, which can take a toll on their mental health. Furthermore, social workers should be involved in the care of these patients. Many immunocompromised patients use many costly medications, which can be a burden. Social workers can help secure drug coverage or find other ways to assist these patients financially. Only by working together can an interprofessional team provide safe and effective itraconazole prophylaxis in immunocompromised patients.