This document summarizes various antivirals, antifungals, and anthelmintics. It describes several antiviral drugs including acyclovir for treating herpes viruses, famciclovir and valacyclovir given orally for genital herpes, amantadine for influenza, and ganciclovir or cidofovir administered intravenously for serious cytomegalovirus infections. It also outlines antifungal medications like nystatin, clotrimazole, fluconazole, and amphotericin B for treating various fungal infections. Finally, it discusses anthelmintic drugs used to treat different types of worms, including mebendazole,

1. Pharmacology
Slide-23
Antivirals, antifungals,
anthelmintics

2. Antivirals
• It is difficult to produce effective antiviral agent:
• 1-viruses live within human cell and they use
process of these cells to multiply so they’re not
readily accessible.
• 2-they are very sophisticated structures and not
easy to kill.
• 3-before patient develop symptoms the virus
have been duplicated already.
• 4-mutate rapidly and change they're defenses
and shape.

3. Antivirals
• 1- Acyclovir (zovirax*)
• Effective against herpes viruses, once it entre the
infected cell it changes to a powerful antiviral agent.
• 3% ointment for 5 days to treat ulceration of cornea
due to herpes simplex virus.
• Orally 5 times daily to treat genital herpes.
• I.V for generalized herpes simples infection.
• Also prescribed in herpes zoster for 7 days it should
be started within 48 hours from the onset of
symptoms.

4. Antivirals
• Contraindicated in pregnancy.
• Side effects: nausea, rashes, vomiting.
• 2-Famciclocir and valaciclovir:
• Given 2-3 times daily.
• Orally

5. Antivirals
• 3-Amantadine :
• Effective against influenza virus
• 4-Tribavirin:
• Used to treat respiratory tract viruses
• Given by nebulizer or aerosol inhalation.

6. Antivirals
• Serious infections such as cytomegalovirus:
• 1- Ganciclovir:
• I.V
• 2- Cidofovir: to treat cytomegalovirus rentitis
in AIDS.
• Its nephrotoxic

7. Antifungals
• Fungi include mushrooms, moulds, yeast and
rusts.
• 1- Nystatin
• Bind to wall of fungi, disrupting it integrity.
• Poorly absorbed after oral administration that’s
why it used to treat infections locally.
• Very effective in treating vaginal candidiasis one
pessary daily for 14 days.

8. Antifungals
• 2- Clotrimazole and miconazole
(Daktarine*)
• Treat vaginal candidiasis if applied locally as
pessaries.
• Miconazole available as gel to treat
oropharyngeal infections.
• 3- Ketoconazole (Nizoral*)
• For severe candida and other systemic fungal
infections.
• Orally , and can cause jaundice at high doses.

9. Antifungals
• 4- Itraconazole:
• Systemic Candida and dermatophyte infections.
• Capsules immediately after meals.
• 5-Fluconazole (Diflucan*)
• Effective in Candida and cryptococcus and for
vaginal candidiasis and for oropharyngeal
infections single oral dose.

10. Antifungals
• 6- Amphotericin B:
• I.V or as lozenges that given 4 times daily to
treat oral candida.

11. Treatment of Candidiasis
Oral candida:
• Acute : Nystatin or amphotericin B tabs every 6
hours.
• Oropharyngeal: fluconazol or itraconazole daily
for 14 days.
• Children: miconazol gel.
Esophageal, intestinal or systemic candida
• Fluconazole.

12. Treatment of Candidiasis
Vaginal candida:
• Fluconazle single dose , itraconazole twice daily
for 1 day.
• Treatment of systemic fungus
• Metronidazole (flagyl*)
• Given by oral or I.V injection
• Effective againit trichomonas vaginalis,
Entameba histolytica.

13. Anthelmintics
• Drugs that used to treat worm infestations.
Drugs used to treat threadworms:
• Live in cecal regions of the gut.
• 1-Mebendazole (vermox*)
• As single dose , shouldn’t be given to children
under 2 years or during pregnancy.
• A second dose can be given after 3 weeks to
prevent re-infection.

14. Anthelmintics
• 2- piperazine:
• Without side effects, prepared as elixir.
• Dose should be given for a week followed by
week of rest , then a week of treatment..
• Contraindicated in pregnancy and epileptic
patients.

15. Anthelmintics
Drugs used to treat strongyloides
stercoralis:
Common live in intestine.
• Tiabrndazole:
• 2-3 times daily.
• Cause nausea, vomiting and drowsiness.
• Not used during pregnancy.

16. Treatment of tapeworms:
• Several feet in length , lives in small intestine.
• Niclosamide:
• In morning the drug chewed and swallowed on
an empty stomach. After one hour the dose
repeated, 3 hours later a saline purge.
• Proceeded by meteloclopramide (pasil*)
• To reduce risk of vomiting.
Anthelmintics

17. Drugs used in treatment of roundworm:
• Live in small intestine.
• 1-piperazine:
• Causes paralysis in the muscle of the worm.
• Worm passes thru feces alive out side the body.
• Single dose in adults repeated after 14 days.
• 2- mebendazole:
• Twice daily for 5 days.
• Also used to treat hookworms
Anthelmintics

18. Anthelmintics
Drugs to treat filariasis:
• Diethylcarbamazine .