This document discusses drugs used to treat leishmaniasis, trypanosomiasis, and toxoplasmosis. It describes amphotericin B, an antifungal drug extracted from soil bacteria that is used as treatment of last resort for visceral leishmaniasis and amoebic meningoencephalitis. It also discusses miltefosine and its use and side effects in treating visceral leishmaniasis. For toxoplasmosis, the standard treatment of pyrimethamine, sulfadiazine, and folinic acid is outlined, with alternative regimens for sulfonamide allergy or pregnancy.
I am Dr. Anil. this is my Lecture delivered to 3rd year MBBS for the subject of Pharmacology. These slides cover basics of Antifungal drugs mainly its pharmacology.
I am Dr. Anil. this is my Lecture delivered to 3rd year MBBS for the subject of Pharmacology. These slides cover basics of Antifungal drugs mainly its pharmacology.
Pharmacology- anti-fungal drugs.Classification and details on polyenes, echinocandins, griseofulvin, azoles, terbinafine, and topical azoles.
Their uses, side effects, adverse effects are mentioned with the mechanism of action.
Brief information about Tuberculosis, drugs used for its treatment including recent advances and drug regimen for patients of different categories of TB suggested by WHO (DOTS therapy) including national and international programes for preventing TB.
Pharmacology- anti-fungal drugs.Classification and details on polyenes, echinocandins, griseofulvin, azoles, terbinafine, and topical azoles.
Their uses, side effects, adverse effects are mentioned with the mechanism of action.
Brief information about Tuberculosis, drugs used for its treatment including recent advances and drug regimen for patients of different categories of TB suggested by WHO (DOTS therapy) including national and international programes for preventing TB.
PHARMACOVIGILANCE Of MUCORMYCOSIS DISEASE ON AMPHOTERICIN B PRASAD SANJAY PAW...PrasadPawar66
The PPT is all about the disease mucor mycosis and it's pharmacovigilance.
It also describes about the drug amphotericin B and it's uses and it's general overall overview
2. AMPHOTERICIN
an alternative therapy for visceral
leishmaniasis, especially in parts of India with
high-level resistance to sodium
stibogluconate, but its use is limited in
developing countries by difficulty of
administration, cost and toxicity.
3. AMPHOTERICIN
Amphotericin B
(Fungilin, Fungizone, Abelcet, AmBisome, Fungisome,
Amphocil, Amphotec) is a polyene antifungal
drug, often used intravenously for systemic fungal
infections.
It was originally extracted from Streptomyces
nodosus, a filamentous bacterium, in 1955 at the
Squibb Institute for Medical Research from cultures
of an undescribed streptomycete isolated from the
soil collected in the Orinoco River region of
Venezuela. Its name originates from the chemical's
amphoteric properties.
5. Cont.
Two amphotericins, amphotericin A and
amphotericin B are known, but only B is used
clinically, because it is significantly more active
in vivo. Amphotericin A is almost identical to
amphotericin B (having a double C=C bond
between the 27th and 28th carbons), but has
little antifungal activity.
7. Uses
Antifungal
Oral preparations of amphotericin B are used to
treat thrush; these are virtually non-toxic, in
contrast to typical intravenous therapy (IV) doses.
Antiprotozoan
use as a drug of last resort in otherwiseuntreatable parasitic protozoan infections such as
visceral leishmaniasis and primary amoebic
meningoencephalitis.
8. MOA
• The primary site of action of amphotericin B on L. donovani
promastigote cells appears to be membrane sterols that
result in a loss of the permeability barrier to small
metabolites
• Amphotericin B is highly lipophilic and easily absorbs into
membrane lipids where it interacts with membrane
sterols(cholesterol in mammals and ergosterol in fungi) to
create channels in the membrane, which allows small
molecules to be lost, eventually leading to cell death
• Inhibition of respiration by the drug was a comparatively
slower process
9. Interactions
• Flucytosine: Toxicity of flucytosine is increased
and allows a lower dose of amphotericin B.
Amphotericin B may also facilitate entry of
flucystosine into the fungal cell by interfering
with the permeability of the fungal cell
membrane.
• Diuretics : Increased renal toxicity and
increased risk of hypokalemia
• Corticosteroids: Increased risk of hypokalemia
10. Side-effects
Amphotericin B is well known for its severe
and potentially lethal side effects. Very often,
a serious acute reaction after the infusion (1
to 3 hours later) is noted, consisting of high
fever, shaking chills, hypotension, anorexia,
nausea, vomiting, headache, dyspnea and
tachypnea, drowsiness, and generalized
weakness
11. MILTEFOSINE
• It has shown efficacy for the treatment of
visceral leishmaniasis.
• Given in a dose of 2.5 mg/Kg for 28 days it
provided excellent clinical results.
• A 100 mg daily dose is recommended in
adults,
• Vomiting and diarrhea are common but
generally short-lived toxicities.
12. Cont.
• Transient elevations in liver enzymes are also
seen.
• The drug should be avoided in pregnancy
because of its teratogenic effects.
13. DRUGS FOR TOXOPLASMOSIS
• Pyrimethamine plus sulphadiazine plus folinic
acid.
Why folic acid?
• Folinic acid (Leucovorin) protects the bone
marrow from the toxic effects of pyrimethamine.
What for those with sulfa allergy?
• If the patient has a hypersensitivity reaction to
sulfa drugs, pyrimethamine plus clindamycin can
be used instead.
15. Cont.
• Management of maternal and fetal infection
varies depending on the treatment center. In
general, spiramycin is recommended (for the
first and early second trimesters) or
pyrimethamine/sulfadiazine and leucovorin
(for late second and third trimesters) for
women with acute T. gondii infection
diagnosed at a reference laboratory during
gestation.