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Ketoconazole is a drug used in the management and treatment of fungal infections. It is in the imidazole antifungal class of medications. This activity describes the indications, actions, and contraindications of ketoconazole as a valuable agent in treating fungal infections. This activity will highlight the mechanism of action, adverse event profile, and other key factors pertinent to members of the interprofessional team in the treatment of patients with fungal infection. Objectives: Identify the mechanism of action of ketoconazole. Describe the adverse effects of ketoconazole. Review the appropriate monitoring of ketoconazole. Summarize some interprofessional team strategies for improving care coordination and communication to advance ketoconazole and improve outcomes. Access free multiple choice questions on this topic.

The Food and Drug Administration warns that oral dosing of ketoconazole can lead to hepatotoxicity and adrenal insufficiency and that ketoconazole-associated hepatotoxicity is common. There are many off-label uses for ketoconazole. Therefore, careful selection of ketoconazole as a treatment is necessary due to serious hepatoxic side effects.[21]

Managing the administration and usage of ketoconazole requires an interprofessional team of healthcare professionals, including nurses, laboratory technologists, pharmacists, and several physicians in different specialties. Since the usage of ketoconazole can result in adverse effects such as hepatotoxicity and adrenal insufficiency, it is important to monitor liver and adrenal function in patients considered for ketoconazole treatment. This monitoring requires that each member of the healthcare team monitor patient for signs of acute liver failure not only with laboratory evidence but also clinically by recognizing the signs of liver dysfunction. In addition, since there are off-label and over-the-counter uses of ketoconazole, it is important to educate patients about the adverse effects of this drug and the proper use of the medication. Therefore, the interprofessional model for patient care when using ketoconazole therapy is crucial to driving optimal patient outcomes while reducing the potential for adverse effects. [Level 5]