GRISEOFULVIN dan

Amfoterisin B

GRISEOFULVIN TABLET 250 MG
Harga
Rp. 28.458/ kemasan
Kandungan
Griseofulvin (termikronisasi).
Perhatian
Interaksi obat :
- efek dikurangi oleh Barbiturat.
- pemberian bersama dengan kontrasepsi oral dan Warfarin
menyebabkan kemanjuran obat-obat tersebut menurun.
Efek Samping
Gangguan saluran pencernaan, sakit kepala, fotosensitifitas.
Jarang : lupus eritematosus sistemik, ruam kulit.
Indeks Keamanan Pada Wanita Hamil
C: Penelitian pada hewan menunjukkan efek samping pada janin (
teratogenik atau embriosidal atau lainnya) dan belum ada penelitian
yang terkendali pada wanita atau penelitian pada wanita dan hewan
belum tersedia. Obat seharusnya diberikan bila hanya keuntungan
potensial memberikan alasan terhadap bahaya potensial pada janin.
Dosis

Dewasa : 500 mg per hari.
Anak dengan berat badan lebih dari 25 kg : 125-250 mg/hari.
Anak dengan berat badan 15-25 kg : 62,5-125 mg/hari.
Anak berusia kurang dari 2 tahun : 5 mg/kg berat badan/hari.
Griseofulvin is effective orally against dermatophyte infections caused
by epidermophyton, microsporum, and trichophyton. It is ineffective
against candida and P orbiculare.
The usual adult dosage of the micronized ("microsize") form of the
drug is 500 mg daily in single or divided doses with meals;
occasionally, 1 g/d is indicated in the treatment of recalcitrant
infections.
The pediatric dosage is 10 mg/kg of body weight daily in single or
divided doses with meals. An oral suspension is available for use in
children.
Griseofulvin is most effective in treating tinea infections of the scalp
and glabrous (nonhairy) skin. In general, infections of the scalp
respond to treatment in 46 weeks, and infections of glabrous skin
will respond in 34 weeks.
Adverse effects seen with griseofulvin therapy include headaches,
nausea, vomiting, diarrhea, photosensitivity, peripheral neuritis, and
occasionally mental confusion
It is contraindicated in patients with porphyria or hepatic failure or
those who have had hypersensitivity reactions to it in the past
Amphotericin B

Pharmacokinetics
Amphotericin B is poorly absorbed from the gastrointestinal tract.
Oral amphotericin B is thus effective only on fungi within the lumen
of the tract and cannot be used for treatment of systemic disease.
The intravenous injection of 0.6 mg/kg/d of amphotericin B results in
average blood levels of 0.31 mcg/mL; the drug is more than 90%
bound by serum proteins.
Although it is mostly metabolized, some amphotericin B is excreted
slowly in the urine over a period of several days.
The serum t
1/2
is approximately 15 days.
Mechanism of Action
Amphotericin B is selective in its fungicidal effect because it exploits
the difference in lipid composition of fungal and mammalian cell
membranes.
Ergosterol, a cell membrane sterol, is found in the cell membrane of
fungi, whereas the predominant sterol of bacteria and human cells is
cholesterol.
Amphotericin B binds to ergosterol and alters the permeability of the
cell by forming amphotericin B-associated pores in the cell membrane
Amphotericin B remains the antifungal
agent with the broadest spectrum of
action.
It has activity against the clinically significant yeasts, including
Candida albicans and Cryptococcus neoformans; the organisms
causing endemic mycoses, including Histoplasma capsulatum,
Blastomyces dermatitidis, and Coccidioides immitis; and the
pathogenic molds, such as Aspergillus fumigatus and mucor.
For treatment of systemic fungal disease, amphotericin B is given by
slow intravenous infusion at a dosage of 0.51 mg/kg/d.
The toxicity of amphotericin B can be divided into two broad
categories: immediate reactions, related to the infusion of the drug,
and those occurring more slowly.