Recommended text books. Basic and Clinical pharmacology, 10th or 11th edition, B.G. Katzung , LANGE medical book. Lippincott´s ilustrated reviews: Pharmacology 3rd edition, R.A.Harvey, Champe P.C., R.D. Howland, M.J. Mycek, Lippincott -Raven ,.
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Basic and Clinical pharmacology, 10th or 11th edition, B.G.Katzung, LANGE medical book.
Lippincott´s ilustrated reviews: Pharmacology 3rd edition, R.A.Harvey, Champe P.C., R.D. Howland, M.J. Mycek, Lippincott-Raven,.
Pharmacology, 6th edition, H.P.Rang, M.M. Dále, J.M. Ritter, Churchill Livingstone, 2007.
Dr. Roshna S. Aziz
Department of Pharmacology
School of Medicine
University of Sulaimani
Systemic & topicalsome are fungistatic, while others are fungicidal
Systemic antifungal drugs for systemic infections
Produced by Streptomyses nodosum
High affinity for fungal ergosterol, forms “micropore” in fungal cell membrane through which ions, amino acids, & other water soluble substances move out.
Markedly increases cell permeability.
Cholestrol, present in host cell membranes, closely resembles fungal ergosterol & thus explains the high toxicity of AMB in humans
To reduce the severity of the infusion-related reactions, pretreatment with an antipyretic (acetaminophen), antihistamines, and antiemetics may be given.
Fever & chills,
K & Mg wasting
New lipid formulations
Amphotericin B is incorporated into lipid formulations to reduce toxicity & enhance efficacy. This allows higher dose to be used without increasing the toxicity.
Much more expensive than ordinary AMB.
Why the drug does not act on human cells?
Human cells are unable to convert the parent drug to its active metabolites.
Clinical use at present is confined to combination therapy, either with:
BROAD SPECTRUM OF ACTIVITY –
Abnormalities in liver enzymes
(inhibit cytochrome P450 enzymes)
Very rarely, clinical hepatitis
Systemic antifungal drugs for Mucocutaneous infections
It is deposited in newly forming skin where it binds to keratin, protecting the skin from new infection.
Interferes with spindle formation in dividing cells and therefore with mitosis
Rare, mild, self-limiting
Topical antifungal therapy