ANTIFUNGAL AGENTS These drugs ave used for Superfivel and dap Systeme) Rifengal bet OPE ‘ reeled " 4 LD pe Lyte ‘ec ees - Classification’ Awkibiobies Anki-melatolite . Attylamine : Pe 7 Blaeatostes + Teabbccatinte yenes plaid yt €5-Fe Ye) : Echinocandings Heteroey de + Amphotericin B (amis) Caspofungin bengzo furan + Micafungin’ + Gtico Rix oF * Avithutakingen = oH BUSS. yaad Ne ncsictaad mee Bg ee eacblad + Sodium thiasulfate ridzoles : C5ystemie) Fe Tolnaftate = See Pl calla. gole, ath ern alse Crelopicox, clomine. ‘Thacodarele, + Voriconaale Pocaconazole » Ketsconagole A polyene Antibiotics = (PRS oe falda te dal i t nal Said Ambhoterionn & CAMB) = SO AVIQ pis Baleseibed.. we. Hhrey. apibteype, VN Se Sau. TE fe. obtained From the bacterin StreptomycesChemistry - > Th a a : ring, one side oF shin iy Diguig> Whophik, polyenes possess a — macroeyelic ; he = Several Conjugated double bonds and. white r me ether Side ig hydvophive with «many of -grouks.,, Moa _ Fhe polyenes have high afBinity. for ergasteel present i- Bengals Celt) omdmbed AMB + Ergesteral aitbenre L zB a Cells plenageh ily US {3 Wereased [isdte Tons , amino acids and Other woter-soluble Substances move out = is a bitiees by membrant spores! belweek “the “AMG moletules 9m cs “anal pate Memauomelce * Bk the” bore’ eee —> cholesterol - host Cell membrone- polyenes bind © lesser affinity = ' ¥ fee ioe Selectivity of action of potyena % Dood 3 ) : most toxic Systemically balyenes,. ie dan Ads “ane HUnobbecte d a. Setar AM Boo fe though it > Bacteria do Polyénes. Sie fnAMB- enhances inn munity = BY Aid \munocombromisedh individuals, mW animals Fungal infection Hate ees Cai, Ve , 2 be i : AMB is, active against Oo wide ranges of Pic y and angi oak : 1 gis Ai sdk “Comdida albicans ., ; , a i aaa Histoplasma —Cahsutatum ot TNS RS A ile A yptoeeccus neoformal ” t Whdl op tH ste ied oy + Blartomyees hermaktex s ! * Coceidivides immilze” fragt na rege gas y* % 2 Towables kako eOS s40SVOC . euasamrasttun ap osu este utc, aaah ‘6g tb treat, SONNET ale OR oo EME ee eateC —« Rogie” ie high onal Kida} teyaee Make at tivo Cancenbrabing © leueobeii Cancer pote anny Candids i algo ackive on Varfour yi Sh leishmania, 0 probexoa. ye am aia nee absorbed’. Gratty es ithe Gyan tot v _BadsiAdming abn a “Cane “Saphention made EBs “the halprag body.” baihory esas Varad Fay, vom baleresvainy gas om so eae Th. ver iefllmagenfiditaial-. %e Geasnetes) > Cnercation - slowlyoboth ti urine ondibile, sim ty a ee buk urinary). Contenbatton.* aly ockve drug is low.Adminishation and Dose - eee stat Fae Grally (30 -t00mgq @iD) ~ intestinal moniliasts ie Topicatty - Vaginitis : otomyeosis. Fowotzene one aif ear chops Conventional Formulation of AM Cc-AMB) - D> Systemic mycosis - CAMB as dry powder along J for extemboraneous dusbersion FUNENZONE WwTRAVENODS , MYCOL Some vial “> xt is heat Suspended a tombe woaterscond Phe diluted 3)" ‘s0érf with — gluse solution (Qrline makes dhe Suspeneion Coarse, shaulel. be ‘aveidted), os Lok sini oy pe angie aad Sodan abolldide © S > Inihally. Img dest dose is. njected iv over 20min Sk no |S 1 ey ~Sidacd? en anlged reaction Tllows jo3mglkg ts Infined vey ABBY. Haiigie be gradually | weredned a “aah seal “he faent. otal dose 2 B-Ug given over’ 2-8 'ridaths ein M paleranen ~ Inthrothecsl wjectin oh OSM bwice tweety Aurgedoinmeningthisiit cor 28 RH etn ui osomal snipbeledein B Cena) been Abtadaccd ~ prove! TBberaBiLity ager onsutty Yond “ehiete berg ok HAs reduce 8S poco mes ‘ ze ode Up Neate sake < ‘ i, few abate ts Sey, Mas, SMa oP? gureel "5 Shectad Feabures’ of this prepanati um | Fredsees wilder Bade reat ¥ nephrotoxte! mal. Awoendion . se tor. pme incorporated in uniform Sed, aertga ta! On, yc aiafusion a! eile se pedis ibespleen - exfertalty Vahucbld Ry Kala azor”aad ta. “imadunacombromised patients, te otal in babiah not tbleahng. CAMB. Bese = -S-5mg Ig felay | >» wh og aor, head 6 ete “t > Shera indicated fhe empirical therapy. > Pelé melabropentsi-obents cnot veabonding Sty intel alibhds, Chay sill. deeb oS ged kalo: “agar Ampoi st BH Nelwsips “eget Hk eontnisoue ceaeis) 1oma" amg womarber Wal! infe wo reddiiue om beeen anette: TOmglaent omg homb’, rooragleont inj » ei4y/), mybadode an, Ande) AEC" Colloidal ashe 22800135 dents sie mh om seleeapattens = a wont boas 2 + G1 cach ck — ANG F cholesteryl: Sulfate 4 not Subenor ai Effects i" The * Sane a AMB ° ig)! ‘high } gue do nae ante Sins, * Acute Rendon = Consists 3 he obit pipes tin’ q + Fever dearsiies ap sissael ches dnd pain all over dixe 48° thea. [ ty qytokines’ \L epedh iagt 2% gaananecy ausea SE . % roy Jeckedd Veive ~ hus yer ba. Be rere Hh eis GY Be ia a ame = ! atau 0 Rani Sears web Gi mare cad Tae RE ity. eddies the 8 Atvombophlebits . 6PK imate adh steak phd Se py ed Se senider ° pishen the , reach dete Sas “> Enjection’s o” Wijdiocortis © Tikendibye ork © veaekon * long Pterm™ tote + Nephuctoanily - dete is $ he r slo Tou PRY bs idol £2 gal Suga) a is “glo qiera Ayeagre brie sapentes yerekid vdles ype 2 NED ~ dened ayn -inmbalance Cee inability do, Gut. uring) een Araemio - due Bellas ifort Weatrmieee) F BAS 24 Seabee WS . Heactacht!) Vondshnagy v nerves, botsiey, Conwudsions (oseuynet So psTRE hata “Sowly Sake es SE afer ee + Therapy. Lee, faye hs ld wher oat / Uses. CD pevtlinasbeh Jon ebacslang Applied — topically for oval, Vagival and. G - obmmycasis. i, fi > AMB Gu be Cardiciasig> asc a . tigers 9s Ub bootha! tls Most’ ebbeetre ™ dug! foe 1 Varisla , APE. | Sustemts,., MYEBE A > Because of 2 . higher toututy oy AHB, the at ee bes: Seebeed bre ferredl proach at of A Atte (ia cenktbiohia Conditions where), helt. el feaiey * Febrile neubopava - iy AHB — Fever abt rubdading, t,cu| bacericits + Leishmamrasis - aHQ - Host effechre Resistant Corey. okey eee 3 {au an. mucoubanestss © STeihmanioas- Trteractions— as <2 Son “ete EMBRE Piao taal) oo gun & feral Best AHR S Flucytosint- Supe -aldditive achion + MBS Aminoglycoside ; é wy Vancomycin ws » Ggdoshorine;, : Slee wet impairemant: fo aksola phos thes nephrotoute drugs. | wre Welltnieys oon see Nystatin - 1 : Sonny : Ree tere Watt ipsa meet te Tigh Foote oe Sei i cat aed IP “membrane, whhaws) fk > Nystatin: a heorly ier Sree Tk is ailabh HYCOSTATIN § lakh Utab » 4 lakh U Tinea tab» Aa e oom Nystin eye lakh vlg obthalamic oint Uses = : Topical, for eral, oropharyngeal, Corneal , Conjunclwal r Candidiasis. SAS oval table” or, intestinal... Condidiogts ond. Gndido.,cass eo eo : Micksacond * saree Ay ersten aginib's! hud en} om, eIS — Nausea: Biller taste Corticosteroid — aerosols Ceq: beclomethasone) Can Cause otal Candide: mrletn effective me preveting? at uaell) og) beablAge thatit ona mo : Piyetsades 4m teala)o! Qe is, Be gs MRI Ringel ik “ye developed th techn, Similas bo wystedin , but more weiter Soluble. = ARS use is reabicled 40 topical abpllealls! 65) ebay thrusliyne Geton cour’ Candidiaste: NP 86h moni ye a Trichomonas Yagi bt; Se Se ohomycesis, by” Achegillus HAHYCIU. Sheth og out, 2lakh Umi Susp fe -fobicel wee, ; Hebb vague oveler ECHINOCANDINS - 0 a ba . > potent _ Semisynthcke - anbiRngal antibiotics. with a Gmblee oydic Upopeptide a4 os SPiscine Confoda "pub, je Imo ob prege yinnnnd's swracheseny caren): MBRup ogee VCHRERN ond LN? 2 Mon atemenee igs ia CARAT Capokingin S 2s Pt 3 glucan ——> Saidhossun ertyrHemrabif > = redudes rch ok Hergetch Avbstoscieg Lal esfodsinl” roa soqcets 4 ilndanined Be fe cries? — ipa nle baw pbibne’) — faniope Sh seats 3s eb Sr “Sistem pohNhe nh onstltben slide 4) ih, Pharmaacokinehes - > FEES nok alprbed erabty, saad ie ? Distrubuted ido tissues, istered bY hv infusion, ¥ Sits: ants dof}. tho corse, borg, > Dees nok enter csr * Hetabolism. eulensive : x Shae CWisbawefbinad cad readily extibad) * Grerebion - urme oy well at Facces * plasma tie - tohrs wi eo byduls vol t Uses - ; te a ze é > hae por o) aptise * Deep andi Wnvarive condidiasis. fs ep i ae * eesopbageal Candidiasis, i J * Selyeds,,ctheraby sob, Nemespensive buasive aspergilei® Sve ate « Febale ne bape Adveice Cfeels 4. Side - ; ~ e phevites ok Wjecked” Vern } © Roh + Vomiting ; : + Dyspreco : + hypekotewio. + Tele pain | : ae Dose - omg Leading dose - infused iv over she, A ae sae CANCIOAS Fomg ta Jord ard 5Dmg In toml inj, ae - ; ae Moke Shame of Candido thot have become resistant 4p _otoles sc ee Spacey ECHR asset koe ‘ HETEROCYCLIC BENZOFURAN- i oe 2h9 tein? Fesngictabic Fon smash: satel eis is wahoo” “Trichobhgton) | a My Coren Mier rh Tk dec= Gai 1 ore alec stimmhsttive: ck tines apa qeitho pti aE NE dyekteetive SPRAY sail nd Moin empganed a ' Moa ~ a de Boa He polyinerc bed “baieldtublites “vsaf nls orl endl wel OM Nate tla, dedeedaclehigudle awabidt . anidoege é Girieeolvin™ se x atl oe aba ph aol by 2 abeara Ylliarcl 2 Serinas 22 ar - 9200 feats pmattobie 6b ata et d ia Chiatghdte alles pew hore apart of mare only shart distance’) Mulkinulgeateds + Sturted, 4. 2 Sangat hyphae are Mon ol slod jedod ultvom abel 3 afian pail ni hone Confi Aprormal = sie Conquest, a i geesthadedebat s npisr = ih Si Comaepet Bonnie vod Iasvtiopsr iasdvad aseil J unlike , typical mitotic sple inhibitorotiedlehnih, Vinca alkaloids) it dou not vtilos oanil = Cause “metaphese arrest. NelesieaY isainptid: wt Plomecctinctee Ud st don hud. Sook as Jslats PA SPO ep osbluble plibep thetic che sabia! om githss Sombuked ai oovitths a EL very Trrequiou. enn brake > “Taking with Fathy foods + aha tats Amin impro Ae : "chs batotl Ravan -famirgt calnt Skinghale and nailes ‘ sf No if wri Free bnkeleedniGilhid QRH 2TH coladoasics> « : Aube : Hetalothatiin Lor dayratukiorerine) love § i + Exerchion_- urine Sa sot | Plasma mete versubka Hest - wakhets lett, eprk etn d)etidendonad “| “Use - siuodlides a ager > Gyiscofulvin is uted orally fee "dem aof ps nabs sa bub Eh eM getting defusited tm “the Skin. though Cirtulatiin, ft pesbentesl + Gangal invasion o& — Keratin, Because Tk tS fungistaht andicrebihtabl S * Janchenrs) tian bead fied + eorohjop2 gwd boby -the MWe mewsly formed — erat 18 nabielovadedoal a °“S ae shoo, ba he fungus persis a already utyaefeebed ™ Sedreatra Hy, Shed of? the Site DP Ah the dsakion satya ithecctngel Fed penton pt ether ube ai % akan Sapeckion . Aheneat ob isktbeehigl avert gel He umover 4 ‘ Site Dee - 125 -250mg @ID uith meals; dlvation olepeuds om the Site mein ot eres alia ‘eis 240 Seat: hoiowdd > Upadeatlandlult dw sandgye Jo gat bets, Seles 1S 313.8 yee Tanger dail, 6 -toi8 months “S : ; Tee nastemUA iaatoge , ra FBer tice Gagan) Mfcching — rete, = A COR hess cai ‘ Tien barbae 3 refered” Jon wok $4 Cebinbeiie pom, Corpora didi sly sihoine doridut . sfilrw neo beckis. desre — s2edqastsin > i < ST is ctfeetue om athletes fook but not im pilyriacts Versicolov. ~ tits: “eSudemt enckrig ancl tedifagids ontedieduntly alemnianer., Ebiiocons ata Proferedl noo. Sabopsni Gimeolmnee— ywMANroRsdeALe go Ome AabHy 4 abock wtsT tie patdat « ovagmi Interactions — teficn bea sted (ide “ills, peioeh _nitnssat prctalnnas) + enaume + Grrizesfuten 28", cypuso ire Widlfvinb mlctalaliom 2285 > * Indeac om ss Orel Contraseh bres) Sls yn04, rtp en faifoerd * + PhenckevbitontanRedsge otrel shel, fottys sk ee ee eonseld + Aleshet= tatoleronce sa Adverse Effects = TARA sodiehubabees: facts pew + CNS™ Symptoms 4 peripheral near Hs 0) bo rises gatlisg Daves’, vitor ys fon. noiseyni Lega?+ Rashes + photoaltergy + Giynaccomasta - reported (osodapih & dibokes) extnedurhed Transient leukopenia Y tm) onbidanbepls Albuminuva (without renal ainaych infrequent a: Llu J apr het 4 oom Aiscontqrustio i) sas") Fatah Lisorvtien ntimetabolite : "Fiel todu) ot sauhen Ob G alaonmedyyr SEMA S Fs tline CSAECY 219} stoned + Jospminam died ) Jt spreimseanar PTE Ao byrinidingy aylimelgbeate uinhich, 1s fnagtce a5 Chat Marmalion Cells, Cercelek to Ro Some a! trarrala .., Cells)’ h ¥ fen kg: les Convert S-Fe into 5 Flarowac:l) ape depaufites . boa pboviensbed deebt F 5-FC Fungal Cells @ Sipalisla 7 L slegons3 — pwloeobienL 5: #lucroura ert Inaiqed |) slogenoi tH L Joynmosiloxe & forded } foro Josgnered 1 Be Feed ee ate aud Fie cad eee peak S cbs snoredl + shozoncrul? olezeid ou! Tem Ms test “pe "dull SI SSosum —Sirrhopd veh “slasanssedo3 f a ; ‘ A re a of Owa-ApaMhacebi® rand bed 419 pack Antifungal ~ shesbum Active ageing ti! 7 : Cryptococcus neeformons 2¢ Torula + Chromoblastomyces + Few strains of Candida Soe andinn Vackdaas hinge Jinganathe, ote Melasdaioy CF Feels nN samnd CO «lower that of Ama, Shp ei 3° "ed Such Cobasty stmroad? Ie pata Leen ivon Uepeatiton ountssd? board & > Narrow Sheeteum > fungistabic, : ea pildt ors. se “ eB bibagd + Gower tqr09) 2ieoaym dork ai bsvloval ipnud * Bibvegola + bittemdeis! + > AOM SHY. 4. oatBone ™avrous depression Calose -deplsihaedyro.th Saomen | Gt divhubances b Sparalica Centers + diarrhoea) heer —Gitsam- neni tk i : 3 Pinadodusd jy, a ‘ lysPunchion Caild & tevebsible.) L cogat trot Atwedtinay oSiutin ses Des Fe 7S Aine s siilodal Cryptoeoeeosis > to reduce the total dora Choth meningeal + the, mote toare. AHBA’) onicat nonmeninge at) = > tRedapy? 2 SEE. # galatctty: ihingabarites fyvibionaed wets of CRA SG FeGlmede H ALallsdve bsnl sone beatdan2> atlga Adak tary M IMEDAZOLES AWO tarazé vowel 2 cto 99-2). dvavnod tes fons), F ¢ =F ~> Most yi c Extensively used antifungal dnigs : Clotvimagote i als) Lapa soo 228, Imidagzoles Cuoncfile + = Nicronaaole — }.topicalt \ di is eaoreul + 4 oxaliconazgele 2 Ketoconazole + orol + tobreal 4 Boldt ; i, hee aubtouesbanlier ee > : - Two triazole, Fluconaade + TMraconazate~ fave largely” replaced Ketoconazole 6, Systemic wong ee oe aay ee ate cHicacy, Aavigey te and taser dees Sheds. AYO. Jo nortididnl : Antifing al Shectrum- 5 > Broad Spectrum — antfurigal’ activity. Covering + Dermatophy tes “apnwetoog2 | Jnpraital + Candida RET Swoon « + Fungi involved im deeb mycosis Cexcept mucor) + Nocardia amiepe ‘ovr : jg aromistoan” “buassaahypy) + + Leishmania : SOT intinsT aoopmetebldomorld * MOA 2. Tea phibas) ts + the mechanism eniavde ust siimid sober od ord. ne triage TSto. Bae Agtonas nk” he Samed! sgaet93. aanvbh Bayete dedh seo!Ioodtvatod I vine nt on dtbendsteret rid 4 gp i 7 ae Lmidagoles Levert d + op vipat 1 fyedb de J F : + ° Canosterbtriqel-| isfle ngs? a) phorval ~etenstepe oo Lz , Seager nd | Corr IN dgmethy lage ; ah Coye! BUBs eae PME! EHC) wand janodebd V1 aadons SAA! j Ergoster ot bso sles nmidoly of stleent 29d 4 Nas the lowe host toniaty 2h — trlagotes Compared, fo irnitaacles wal Svibsths vided hos Correlated with there lower oles srafabek inarmmalien CYPA5O —engymes And — lesser —broebensity 2 inhibit mamma lie | ae pn Skerol Synthesis. demedt Je . wHieipey ni Sosomitoly af wwirsdat <- Resistance — Hutabn oh the gene, encoding “Ba Lamgad Wt demethefand teste ach eee ee elandl 2? woof) senvbA ou ” "¢ cw unc es a s Bye MBSE abs JF Jeoiph emoet trio «jf a205auco3 + Fluconazole resistance- among Candia Causing ecobhageal and other > shor. deeb — Candidlasis. ae Condidle resiskant 4 Fluconazole watt ee Bye tideitt ‘ ial Clobimazole - Ziemnphd + was Tk is effective tobically. eS 2iboo) Jenigsvorly gna euoamtty) + uses ee. on ey Bos od? ne path nugdo alpni? + eizerpmedrpre + + Tindadivinfectipdd, — Yhe oBingworasni fines Prats ob gig aming sete ine Crusis s 4 ie Tee Corborts; [e# has beansffitents, 9 60-100'[- Cure rates ia Hinea Caprtts Cseatb) atime en, nosZTingg Versialty — guowpiey 210 =P GnatS y a ungurar Athlete's foot ; 8% ~hezenerixO ee. obomycnsts 7 vol, resbonse Ai ovis «- ics. % . “eral cutaneous [vaginal Cénaiarasrs- See Vagini ts = 100mg vaginal 48b OD ¥ 9 ae a irs enibs aciaslei setduteneh (gotta giled tn t dideavis) «x.do Mg Arache “Beatimes SD] fopen | 32 fssSi¥ledt 4 orebhorungea | Kantian = 2PR9 ERS Aa ea pring AARRYE SELES infechions Caused by UCN ynelinwkeras, 2200 planigels ~ eotbaiiyghSide ee Reet > Well tolerated * Local initahen @ skinging + LurdywgleSensabiag tn Some, >No systemic Aeviaty is Seen alter [op ienl ssssein ) sdegdd Urey) Caevoi rf Soe SUREAZ, cLoveRH I. Lotion , Cream powder j sevng i Econazole - Sossdeop 8 Rath, is Similar ty clotrima zal, - “ght eee graders), erlogvitt Jo uptisingt “Yideod i puol s/f : dermatighe Pets, rs) sisi cdliar oo bsboloned em rl . otenearet Fidided wiensdeorf — asees/ ban, 2rmpen> OSG + oral thrush eiesdinpe Jord dnferiog — clobimarole in — Vaginits See a3 b SBE Lapis scot wiborns ansp alk i Sadat ND Adverse etheck treet pee i jet de midotult — synede Sashes oi ECOWALE Lf. oink, 150mg Vaginal tab; Uden A! Gl — seve | Micsnar tt? be Jereerlios> prieus) sae, Sbibrsd peomes - Sa slospaow ees bibrs) dank - “ > Hie 1 EFF ure vate)‘ Highly ke CRA Lae wossnosult. ot # redeianr + Tinea * Pibyriats: "Versi colar pbk = slestemide + okomycesis Mf Wssidab oy ie + Cutaneous and vulvovaginel Candiasis ellgoiglet Fc lasts ai, 3U * onychomycosis - Single abplicatin en Skin ach tee Few daisy =: 9 Comparision. _ lotr 1 Jkigneroinprde sae Vagihabnfiitelyn; rete? © betadel en! 3} cere) 8208 rogre> Bail 3522) 2H @) Bontt mi ienogre A Nicarylem et Ci biuetenv apeniTScen, anuiupnsd 6907 olga os a > Cffective mm, senodery | oey [ + Tinea + Vaginet Candidiasts 2peb Fxao dé- nae emoot ni ales. ogthee dere atop hytic imfeckiou. Webel | }Ao zsmikene cecal OxIz0N, ZO0ERH: oxicanaaole Vl. With eaeenh go, $a sf codon - topieatly once grates «pA Bes: a OR, re sn RE ee a