DOC

ANTIFUNGAL(II)

By Maria Brown,2014-09-04 04:46
6 views 0
ANTIFUNGAL(II)ANTI

ANTIFUNGAL(II)

    ; LEARNING OBJECTIVE

    ; At the end of lecture students should be bale to know about, ; Echinocandins,

    ; Terbinafine ,

    ; Griseofulvine,

    ; Nystatin.

; ECHINOCANDINS

    ; Are the newest class of anti fungal agents eg Capsofungin. ; Chemically they are large cyclic peptides linked to a long-

    chain fatty acid.

    ; They are active against Candida and Aspargillus. ; MODE OF ACTION

    ; Echinocandins act by inhibiting the synthesis of beta glucan

    of the fungal cell wall resulting in disruption of fungal cell wall

    and cell death.

; ECHINOCANDINS

    ; They are available in only intravenous formulations, water

    soluble and highly protein bound.

    ; The half life of Capsofingin is 9-11 hours and of Micafungin

    is 11-15 hours.

    ; The metabolites are excreted by the kidneys and

    gastrointestinal tract.

    ; Dosage adjustments are required only in severe hepatic

    insufficiency.

; Clinical uses

; Capsofungin is currently licensed for

    ; Disseninated and mucocutaneous candida infection.

    ; Empiric antifungal therapy during febrile neutropenia. ; As salvage therapy in invasive Aspergillosis. ; Adverse effects

    ; Minor gastrointestinal side effects and flushing reported

    infrequently.

    ; Drug interaction combination of Caspofungin and

    Cyclosporine should be avoided.

    ; DRUGS FOR CUTANEOUS MYCOTIC INFECTIONS

    ; Fungi that cause superficial skin infection are called

    dermatophytes .

; TERBINAFINE

; It is primarily fungicidal.

    ; It is the drug of choice for treating dermatophytosis and

    oncomycosis.

; MODE OF ACTION

    ; It inhibits fungal squalene epoxidase there by decreasing the

    synthesis of ergosterol.

    ; Secondly accumulation of toxic amounts of squalene results

    in the death of the fungal cells.

    ; PHARMAKOKINETICS

    ; Given orally, bioavailability is only 40% due to first pass

    metabolism.

    ; 99% plasma protein bound.

    ; It is deposited in the skin nail and fat.

    ; Terbinafine accumulates in the breast milk should not be

    given to nursing mothers.

    ; Prolong terminal half life of 200 to 400 hours. ; Extensively metabolized in the liver and excreted in the urine.

; ADVERSE EFFECTS

    ; Gastrointestinal disturbance, headache and rash. ; Taste and visual disturbances and transient increase in

    serum liver enzyme levels have been reported. Rarely may

    cause hepatotoxicity and neutropenia.

; GRISEOFULVINE

; It is fungistatic.

    ; It accumulates in newly synthesized keratin containing

    tissues.

; MODE OF ACTION

    ; It causes disruption of the mitotic spindle and inhibition of

    fungal mitosis.

    ; It is given orally and absorbed adequately from G I tract. ; Griseofulvin induces cytochrome P 450 activity. ; It may exacerbate intermittent porphyria.

    ; NYSTATIN

; Polyene antibiotic.

    ; It has only topical use. never used parenterally. ; As an oral agent (swish and swallow). It is used for oral

    candidiasis

    ; Excretion in feaces is only quantitative.

; MICONAZOLE AND CLOTRIMAZOLE

; Are topically active drugs.

    ; M.O.A AND ANTI FUNGAL SPECTRUM

; Are same as ketoconazole

    ; Miconazole is a potent inhibitor of Warfarrin metabolism. ; Azole and Nystatin are used in vulvar candidiasis ; THANKYOU

Report this document

For any questions or suggestions please email
cust-service@docsford.com