Recent Changes

Sunday, August 1

  1. page home edited TO MY PHARMACY INFORMATICS STUDENTS: Thanks for the sem. It was nice getting to know all of you…

    TO MY PHARMACY INFORMATICS STUDENTS:
    Thanks for the sem. It was nice getting to know all of you a little bit more.
    Hope to see you all around next semester. =)
    Remember not to quit despite all the hardships.
    God Bless and enjoy your sembreak!!
    -Mam Lianne =)
    ***

    Welcome to the Pharmacy Informatics Wiki!
    This was created for the following purposes:
    ...
    2. For the students to learn more about web publishing and how it will be useful to them as future pharmacists
    3. To be able to access resources that will be useful during class discussions and activities
    Some Useful Resources:Resources:**
    Learnthenet.com
    Mims.com
    (view changes)
    8:38 am

Wednesday, October 21

  1. page ANTIFUNGALS edited ... Known hypersensitivity to micafungin or any other ingredient contained in the formulation. FD…
    ...
    Known hypersensitivity to micafungin or any other ingredient contained in the formulation.
    FDA Pregnancy Category C
    .Amphotericin B
    From Wikipedia, the free encyclopedia
    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. Two amphotericins, Amphotericin A and Amphotericin B are known, but only B is used clinically because it is significantly more active in vivo. Currently the drug is available as plain Amphotericin B, as cholesteryl sulfate complex, as lipid complex, and as liposomal formulation. The latter formulations have been developed to improve tolerability for the patient but may show considerably different pharmacokinetic characteristics compared to plain Amphotericin B.
    Uses
    Antifungal
    Oral preparations of Amphotericin B are used to treat thrush; these are virtually nontoxic, in contrast to typical IV doses.
    One of the main intravenous uses is in treating various systemic fungal infections (e.g. in critically ill, comorbidly infected or immunocompromised patients), including cryptococcal meningitis.
    Amphotericin B is also commonly used in tissue culture to prevent fungi from contaminating cell cultures. It is usually sold in a concentrated solution, either on its own or in combination with the antibiotics penicillin and streptomycin.
    Antiprotozoan
    Another IV use is as a drug of last resort in otherwise untreatable parasitic protozoan infections such as visceral leishmaniasis[1][2] and primary amoebic meningoencephalitis.
    Mechanism of action
    As with other polyene antifungals, amphotericin B associates with ergosterol, the main component of fungal cell membranes, forming a transmembrane channel that leads to K+ leakage and fungal cell death. Recently, however, researchers found evidence that pore formation is not necessarily linked to cell death (i.e. Angewandte Chemie Int. Ed. Engl. 2004). The actual mechanism of action may be more complex and multi-faceted.
    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, generalised weakness. This reaction sometimes subsides with later applications of the drug and may in part be due to histamine liberation. An increase in prostaglandin-synthesis may also play a role. This nearly universal febrile response necessitates a critical (and diagnostically difficult) professional determination as to whether the onset of high fever is a novel symptom of a fast-progressing disease, or merely the induced effect of the drug. In order to decrease the likelihood and severity of the symptoms, initial doses should be low and increased slowly. Acetaminophen, pethidine, diphenhydramine and/or hydrocortisone have all been used to treat or prevent the syndrome, but the prophylactic use of these drugs is often limited by the patient's condition.
    Intravenously administered Amphotericin B has also been associated with multiple organ damage in therapeutic doses. Nephrotoxicity (kidney damage) is a frequently reported side-effect, and can be severe and/or irreversible. It is much milder when delivered via liposomes (AmBisome) if possible. Electrolyte imbalances (e.g. hypokalemia and hypomagnesemia) may also result. In the liver, increased liver enzymes and hepatotoxicity (up to and including fulminant liver failure) are common. In the circulatory system, several forms of anemia and other blood dyscrasias (leukopenia, thrombopenia), serious cardiac arrhythmias (including ventricular fibrillation), and even frank cardiac failure have been reported. Skin reactions, including serious forms, are also possible.
    Interactions
    Flucytosine : Toxicity of Flucytosine increased and vice versa
    Diuretics or Cisplatin : Increased renal toxicity and incrised risk of hypokalemia
    Corticosteroids : Increased risk of hypokalemia
    Cytostatic drugs : Increased risk of kidney damage, hypotension and bronchospasms.
    Other nephrotoxic drugs : Increased risk of serious renal damage. Monitor patients closely.
    Foscarnet, Ganciclovir, Tenofovir, Adefovir : Risk of hematological and renal side-effects of Amphotericin B increased.
    Transfusion of Leukocytes : Risk of pulmonal (lung) damage. Space intervals between the application of Amphotericin B and the transfusion and monitor pulmonary function.
    Liposomal and lipid complex preparations
    From studies it appears that liposomal amphotericin B preparations exhibit fewer side-effects while having similar efficacy. Various preparations have recently been introduced. All of these are more expensive than plain Amphotericin B.
    AmBisome is a liposomal formulation of amphotericin B for injection, developed by NeXstar Pharmaceuticals (acquired by Gilead Sciences in 1999). It is marketed by Gilead in Europe and licensed to Astellas Pharma (formerly Fujisawa Pharmaceuticals) for marketing in the USA, and Sumitomo Pharmaceuticals in Japan.
    Fungisome is a liposomal complex of Amphotericin B and being the latest and cheapest addition to the lipid formulations of Amphotericin B has many advantages. It is marketed by Lifecare Innovations of India. Other formulations include Amphotec (Intermune) and Abelcet (Enzon Pharmaceuticals).
    Abelcet is not a liposomal preparation but rather a lipid complex preparation.
    Ampholip is a lipid complex formulation of Amphotericin B marketed by Bharat Serums & Vaccines Ltd, Mumbai, India.
    Oral preparations
    A major barrier to the use of amphotericin in the resource-poor settings is that it has to be given intravenously (except for topical applications). An oral preparation exists but is not yet commercially available.[3]
    References
    ^ Kafetzis DA, Velissariou IM, Stabouli S, Mavrikou M, Delis D, Liapi G (January 2005). "Treatment of paediatric visceral leishmaniasis: amphotericin B or pentavalent antimony compounds?". Int. J. Antimicrob. Agents 25 (1): 26–30. doi:10.1016/j.ijantimicag.2004.09.011. PMID 15620822. http://linkinghub.elsevier.com/retrieve/pii/S0924-8579(04)00349-8.
    ^ Veerareddy PR, Vobalaboina V, Ali N (December 2008). "Antileishmanial activity, pharmacokinetics and tissue distribution studies of mannose-grafted amphotericin B lipid nanospheres". J Drug Target: 1. doi:10.1080/10611860802528833. PMID 19089691. http://www.informaworld.com/openurl?genre=article&doi=10.1080/10611860802528833&magic=pubmed||1B69BA326FFE69C3F0A8F227DF8201D0.
    ^ Wasan KM, Wasan EK, Gershkovich P, et al. (2009). "Highly Effective oral amphotericin B formulation against murine visceral leishmaniasis". J Infect Dis 200 (3): 357–360. http://www.journals.uchicago.edu/doi/full/10.1086/600105.
    External links
    AmBisome web site run by Astella Pharma
    "Special issue". Journal of Postgraduate Medicine 51 (Suppl). 2005. http://www.jpgmonline.com/showBackIssue.asp?issn=0022-3859;year=2005;volume=51;issue=5;month=October-December.
    Stomatological preparations (A01)
    Caries prophylactic agents
    Sodium fluoride - Sodium monofluorophosphate - Olaflur - Stannous fluoride
    Anti-infectives and antiseptics
    Hydrogen peroxide - Chlorhexidine - Amphotericin B - Polynoxylin - Domiphen - Oxyquinoline - Neomycin - Miconazole - Natamycin - Hexetidine - Tetracycline - Benzoxonium chloride - Tibezonium iodide - Mepartricin - Metronidazole - Clotrimazole - Sodium perborate - Chlortetracycline - Doxycycline - Minocycline - Eugenol
    Corticosteroids (Glucocorticoids)
    Triamcinolone - Dexamethasone - Hydrocortisone
    Other
    Epinephrine/Adrenalone - Benzydamine - Acetylsalicylic acid - Amlexanox
    Antidiarrheals, intestinal anti-inflammatory/anti-infective agents (A07)
    Intestinal anti-infectives
    Antibiotics (Neomycin, Nystatin, Natamycin, Streptomycin, Polymyxin B, Paromomycin, Amphotericin B, Kanamycin, Vancomycin, Colistin, Rifaximin)
    Sulfonamides (Phthalylsulfathiazole, Sulfaguanidine, Succinylsulfathiazole)
    Nitrofuran (Nifuroxazide, Nifurzide)
    Imidazole (Miconazole)
    Arsenical (Acetarsol)
    Oxyquinoline (Broxyquinoline)
    Intestinal adsorbents
    Charcoal · Bismuth · Pectin · Kaolin · Crospovidone · Attapulgite · Diosmectite
    Antipropulsives (opioids)
    Opium (Laudanum) · Codeine · Morphine (Paregoric)
    crosses BBB: Diphenoxylate · Difenoxin
    does not cross BBB: Loperamide
    Intestinal anti-inflammatory agents
    corticosteroids acting locally (Prednisolone, Hydrocortisone, Prednisone, Betamethasone, Tixocortol, Budesonide, Beclometasone)
    antiallergic agents, excluding corticosteroids (Cromoglicic acid)
    aminosalicylic acid and similar agents (Sulfasalazine, Mesalazine, Olsalazine, Balsalazide)
    Antidiarrheal micro-organisms
    Saccharomyces boulardii
    Other antidiarrheals
    Albumin tannate · · Octreotide · Ceratonia · Racecadotril
    Antifungals (D01 and J02)
    Wall/
    membrane
    Ergosterol
    inhibitors
    Azoles
    (lanosterol 14alpha-demethylase inhibitors)
    Imidazoles
    topical: Bifonazole, Clomidazole, Clotrimazole#, Croconazole, Econazole, Fenticonazole, Ketoconazole, Isoconazole, Miconazole#, Neticonazole, Oxiconazole, Sertaconazole, Sulconazole, Tioconazole
    Triazoles
    topical: (Fluconazole#, Fosfluconazole)
    systemic: (Fluconazole, Itraconazole, Posaconazole, Voriconazole)
    Benzimidazoles
    topical: Thiabendazole
    Polyene antimycotics
    (ergosterol binding)
    topical: (Natamycin, Nystatin#)
    systemic: (Amphotericin B#)
    Allylamines
    (squalene monooxygenase
    inhibitors)
    topical: (Amorolfine, Butenafine, Naftifine, Terbinafine)
    systemic: (Terbinafine)
    β-glucan synthase
    inhibitors
    echinocandins (Anidulafungin, Caspofungin, Micafungin)
    Intracellular
    Pyrimidine analogues/
    Thymidylate synthase inhibitors
    Flucytosine#
    Mitotic inhibitors
    Griseofulvin#
    Others
    Bromochlorosalicylanilide · Methylrosaniline · Tribromometacresol · Undecylenic acid · Polynoxylin · Chlorophetanol · Chlorphenesin · Ticlatone · Sulbentine · Ethyl hydroxybenzoate · Haloprogin · Salicylic acid · Selenium sulfide# · Ciclopirox · Amorolfine · Dimazole · Tolnaftate · Tolciclate · Sodium thiosulfate# · Whitfield's ointment# · Potassium iodide#
    Tea tree oil • citronella oil • lemon grass • orange oil • patchouli • lemon myrtle
    PCP: Pentamidine • Dapsone • Atovaquone
    #WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
    see also diseases
    Antiparasitics – antiprotozoal agents – Excavata antiparasitics (P01)
    Discicristata
    Trypanosomiasis
    African trypanosomiasis: Eflornithine# · Melarsoprol# · Pentamidine# · Suramin#
    Chagas disease: Benznidazole# · Nifurtimox#
    Leishmaniasis
    Amphotericin B# · Pentavalent antimonials (Meglumine antimoniate#, Sodium stibogluconate) · Pentamidine# · Miltefosine · Paromomycin
    PAM
    Amphotericin B
    Trichozoa
    Giardiasis
    nitrofuran (Furazolidone) · azole (Metronidazole#, Albendazole, Tinidazole) · thiazole (Nitazoxanide) · aminoacridine (Quinacrine)
    Trichomoniasis
    azole (Metronidazole#, Tinidazole)
    Dientamoebiasis
    oxyquinoline (Iodoquinol) · tetracycline (Doxycycline) · neomycin (Paromomycin) · azole (Metronidazole, Secnidazole)
    #WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
    see also diseases
    Gynecological anti-infectives and antiseptics (G01)
    Antibiotics
    polyene antimycotic (Nystatin, Natamycin, Amphotericin B) · Candicidin · Chloramphenicol · Hachimycin · Oxytetracycline · Carfecillin · Mepartricin · Clindamycin · Pentamycin
    Arsenic compounds
    Acetarsol
    Quinoline derivatives
    Diiodohydroxyquinoline · Clioquinol · Chlorquinaldol · Dequalinium · Broxyquinoline · Oxyquinoline
    Organic acids
    Lactic acid · Acetic acid · Ascorbic acid
    Sulfonamides
    Sulfatolamide
    Imidazole derivatives
    Metronidazole · Clotrimazole · Miconazole · Econazole · Ornidazole · Isoconazole · Tioconazole · Ketoconazole · Fenticonazole · Azanidazole · Propenidazole · Butoconazole · Omoconazole · Oxiconazole · Flutrimazole
    Triazole derivatives
    Terconazole
    Other
    Clodantoin · Inosine · Policresulen · Nifuratel · Furazolidone · Methylrosaniline · Povidone-iodine · Ciclopirox · Protiofate · Lactobacillus fermentum · Copper usnate
    Tinea cruris
    From Wikipedia, the free encyclopedia
    Tinea cruris, also known informally as crotch itch, crotch rot or jock itch in American English[1]:303 and dhobi itch or scrot rot in British English,[citation needed] is a dermatophyte fungal infection of the groin region in either sex[2], though more often seen in males.
    Contents
    [hide]* 1 Symptoms and signs
    2 Causes
    3 Treatment
    4 See also
    5 References
    6 External links
    Symptoms and signs
    As the common name for this condition implies, it causes itching or a burning sensation in the groin area, thigh skin folds, or anus. It may involve the inner thighs and genital areas, as well as extending back to the perineum and perianal areas.
    Affected areas may appear red, tan, or brown, with flaking, rippling, peeling, or cracking skin.[3][4]
    The acute infection begins with an area in the groin fold about a half-inch across, usually on both sides. The area may enlarge, and other sores may develop in no particular pattern. The rash appears as raised red plaques (platelike areas) and scaly patches with sharply defined borders that may blister and ooze.[5]
    If the rash advances, it usually advances down the inner thigh. The advancing edge is redder and more raised than areas that have been infected longer. The advancing edge is usually scaly, and very easily distinguished or well demarcated.
    The skin within the border turns a reddish-brown and loses much of its scale. The border may exhibit tiny pimples or even pustules, with central areas that are reddish and dry with small scales.[6][7]
    If infected with candidal organisms, the rash tends to be redder and wetter. The skin of the penis may be involved, whereas other organisms spare the penis.
    Causes
    Opportunistic infections (infections that are caused by a diminished immune system) are frequent. Fungus from other parts of the body (commonly tinea pedis or 'athlete's foot') can contribute to jock itch. A warm, damp environment allowing the fungus to cultivate greatly contributes; especially with tight, sweaty or rubbing clothing such as a jockstrap.
    The type of fungus that most commonly causes tinea cruris is called Trichophyton rubrum. Some other contributing fungi are Candida albicans, Trichophyton mentagrophytes and Epidermophyton floccosum.
    Treatment
    Tinea cruris is often treated with antifungal drugs applied topically. Traditionally creams containing tolnaftate, terbinafine, econazole nitrate, clotrimazole or miconazole have been used, although newer agents such as butenafine are also used. These anti-fungal agents work by stopping the fungi from producing a substance called ergosterol, which is an essential component of fungal cell membranes. If ergosterol synthesis is completely or partially inhibited, the cell is no longer able to construct an intact cell membrane. This leads to death of the fungus.
    If the skin inflammation causes discomfort and itching, glucocorticoid steroids may be combined with the anti-fungal drug to help prevent further irritation due to the patient scratching the area. Apart from the quicker relief of symptoms, this also helps minimise the risk of secondary bacterial infection caused by the scratching. However, steroids may exacerbate the condition if used alone for fungal infections.
    Since fungi tend to thrive in warm, dark, damp conditions, minimizing these conditions can help treat and prevent symptoms. Examples of optimal environmental conditions and behaviors are: losing weight, wearing boxer underwear or no underwear, increasing air-flow by sleeping near a fan, wearing loose sleepwear or no sleepwear, exposing the area to wind and sun, minimizing the use of lap-top computers, and thoroughly cleaning the area with a hand-held shower head and soap.
    See also
    Antifungal drugs
    Pruritus ani
    Ringworm
    Tinea
    Tinea corporis gladiatorum
    List of cutaneous conditions
    References
    ^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
    ^ reproduction from //U.S. Pharmacist//, "Tinea Cruris in Men: Bothersome but Treatable", 2005, vol. 30, no. 8, pp. 13-17
    ^ http://www.cnn.com/HEALTH/library/DS/00490.html
    ^ http://www.med.nyu.edu/patientcare/library/article.html?ChunkIID=11736
    ^ http://www.nlm.nih.gov/medlineplus/ency/article/000876.htm#Symptoms
    ^ http://www.emedicinehealth.com/jock_itch/page3_em.htm
    ^ http://dermatology.about.com/cs/fungalinfections/a/jockitch.htm
    External links
    eMedicine Health
    MayoClinic - jock itch
    Links to jock itch pictures (Hardin MD/Univ of Iowa)
    How to Prevent Jock Itch with Rubbing Alcohol
    v • d • eDiseases of the skin and appendages by morphology
    Growths
    Epidermal
    wart · callus · seborrheic keratosis · acrochordon · molluscum contagiosum · actinic keratosis · squamous cell carcinoma · basal cell carcinoma · merkel cell carcinoma · nevus sebaceous · trichoepithelioma
    Pigmented
    Freckles · lentigo · melasma · nevus · melanoma
    Dermal and
    subcutaneous
    epidermal inclusion cyst · hemangioma · dermatofibroma · keloid · lipoma · neurofibroma · xanthoma · Kaposi's sarcoma · infantile digital fibromatosis · granular cell tumor · leiomyoma · lymphangioma circumscriptum · myxoid cyst
    Rashes
    With
    epidermal
    involvement
    Eczematous
    contact dermatitis · atopic dermatitis · seborrheic dermatitis · stasis dermatitis · lichen simplex chronicus · Darier's disease · glucagonoma syndrome · langerhans cell histiocytosis · lichen sclerosus · pemphigus foliaceus · Wiskott-Aldrich syndrome · Zinc deficiency
    Scaling
    psoriasis · tinea (corporis · cruris · pedis · manuum · faciei) · pityriasis rosea · secondary syphillis · mycosis fungoides · systemic lupus erythematosus · pityriasis rubra pilaris · parapsoriasis · ichthyosis
    Blistering
    herpes simplex · herpes zoster · varicella · bullous impetigo · acute contact dermatitis · pemphigus vulgaris · bullous pemphigoid · dermatitis herpetiformis · porphyria cutanea tarda · epidermolysis bullosa simplex
    Papular
    scabies · insect bite reactions · lichen planus · miliaria · keratosis pilaris · lichen spinulosus · transient acantholytic dermatosis · lichen nitidus · pityriasis lichenoides et varioliformis acuta
    Pustular
    acne vulgaris · acne rosacea · folliculitis · impetigo · candidiasis · gonococcemia · dermatophyte · coccidioidomycosis · subcorneal pustular dermatosis
    Hypopigmented
    tinea versicolor · vitiligo · pityriasis alba · postinflammatory hyperpigmentation · tuberous sclerosis · idiopathic guttate hypomelanosis · leprosy · hypopigmented mycosis fungoides
    Without
    epidermal
    involvement
    Red
    Blanchable
    Erythema
    Generalized
    drug eruptions · viral exanthems · toxic erythema · systemic lupus erythematosus
    Localized
    cellulitis · abscess · boil · erythema nodosum · carcinoid syndrome · fixed drug eruption
    Specialized
    urticaria · erythema (multiforme · migrans · gyratum repens · annulare centrifugum · ab igne)
    Nonblanchable
    Purpura
    Macular
    thrombocytopenic purpura · actinic purpura
    Papular
    disseminated intravascular coagulation · vasculitis
    Indurated
    scleroderma/morphea · granuloma annulare · lichen sclerosis et atrophicus · necrobiosis lipoidica
    Miscellaneous
    disorders
    Ulcers
    Hair
    telogen effluvium · androgenic alopecia · trichotillomania · alopecia areata · systemic lupus erythematosus · tinea capitis · loose anagen syndrome · lichen planopilaris · folliculitis decalvans · acne keloidalis nuchae
    Nail
    onychomycosis · psoriasis · paronychia · ingrown nail
    Mucousmembrane
    aphthous stomatitis · oral candidiasis · lichen planus · leukoplakia · pemphigus vulgaris · mucous membrane pemphigoid · cicatricial pemphigoid · herpesvirus · coxsackievirus · syphilis · systemic histoplasmosis · squamous cell carcinoma
    v • d • eInfectious diseases · Mycoses and Mesomycetozoea (B35-B49, 110-118)
    Superficial and
    cutaneous
    (dermatomycosis):
    Tinea=skin;
    Piedra (exothrix/endothrix)=hair
    Ascomycota
    Dermatophyte
    (Dermatophytosis)
    By location
    Tinea barbae/Tinea capitis (Kerion) · Tinea corporis (Ringworm) · Tinea cruris · Tinea manuum · Tinea pedis (Athlete's foot) · Tinea unguium/Onychomycosis
    By organism
    Epidermophyton floccosum · Microsporum canis · Microsporum audouinii · Trichophyton interdigitale/mentagrophytes · Trichophyton tonsurans · Trichophyton schoenleini · Trichophyton rubrum
    Other
    Hortaea werneckii (Tinea nigra) · Piedraia hortae (Black piedra)
    Basidiomycota
    Malassezia furfur (Tinea versicolor) · Trichosporon beigelii (White piedra)
    Subcutaneous,
    systemic,
    and opportunistic
    Ascomycota
    Dimorphic
    (yeast+mold)
    Onygenales
    Coccidioides immitis/Coccidioides posadasii (Coccidioidomycosis) · Histoplasma capsulatum (Histoplasmosis) · Lacazia loboi (Lobo's disease) · Paracoccidioides brasiliensis (Paracoccidioidomycosis)
    Other
    Blastomyces dermatitidis (Blastomycosis) · Sporothrix schenckii (Sporotrichosis) · Penicillium marneffei (Penicilliosis)
    Yeast-like
    Candida albicans (Candidiasis, Oral, Esophageal, Chronic mucocutaneous) · C. glabrata · C. tropicalis · C. lusitaniae · Pneumocystis jirovecii (Pneumocystosis, Pneumocystis pneumonia)
    Mold-like
    Aspergillus (Aspergillosis, Aspergilloma, Allergic bronchopulmonary aspergillosis) · Exophiala jeanselmei (Eumycetoma) · Fonsecaea pedrosoi/Fonsecaea compacta/Phialophora verrucosa (Chromoblastomycosis) · Geotrichum candidum (Geotrichosis) · Pseudallescheria boydii (Allescheriasis)
    Basidiomycota
    Cryptococcus neoformans (Cryptococcosis)
    Zygomycota
    (Zygomycosis)
    Mucorales
    (Mucormycosis)
    Rhizopus oryzae · Mucor indicus · Absidia corymbifera · Syncephalastrum racemosum
    Entomophthorales
    (Entomophthoramycosis)
    Basidiobolus ranarum (Basidiobolomycosis) · Conidiobolus coronatus/Conidiobolus incongruus (Conidiobolomycosis)
    Microsporidia
    (Microsporidiosis)
    Enterocytozoon bieneusi/Encephalitozoon intestinalis
    Mesomycetozoea
    Rhinosporidium seeberi (Rhinosporidiosis)
    Posaconazole
    From Wikipedia, the free encyclopedia
    Jump to: navigation, search
    {http://upload.wikimedia.org/wikipedia/commons/thumb/1/11/Posaconazole.svg/280px-Posaconazole.svg.png}
    {http://upload.wikimedia.org/wikipedia/commons/thumb/6/61/Posaconazole3d.png/280px-Posaconazole3d.png}
    Posaconazole
    Systematic (IUPAC) name
    4-(4-(4-(4-(((3r,5r)-5-(2,4-difluorophenyl)-5-(1,2,4-triazol-1-ylmethyl)oxolan-3-yl)methoxy)phenyl)piperazin-1-yl)phenyl)-2-((2s,3s)-2-hydroxypentan-3-yl)-1,2,4-triazol-3-one
    Identifiers
    CAS number
    171228-49-2
    ATC code
    J02AC04
    PubChem
    147912
    Chemical data
    Formula
    **C**37**H**42**F**2**N**8**O**4
    Mol. mass
    700.778 g/mol
    Synonyms
    4-{4-[4-(4-{[(5R)-5-(2,4-difluorophenyl)-5-(1H-1,2,4-triazol-1-ylmethyl)oxolan-3-yl]methoxy}phenyl)piperazin-1-yl]phenyl}-1-[(2S,3S)-2-hydroxypentan-3-yl]-4,5-dihydro-1H-1,2,4-triazol-5-one
    Pharmacokinetic data
    Bioavailability
    High
    Protein binding
    98 to 99%
    Metabolism
    Hepatic glucuronidation
    Half life
    16 to 31 hours
    Excretion
    Fecal (77%) and renal (14%)
    Therapeutic considerations
    Licence data
    EU EMEA:link, US FDA:link
    Pregnancy cat.
    B3(AU) C(US)
    Legal status
    ℞[[http://en.wikipedia.org/wiki/Prescription_drug|-only]](US)
    Routes
    Oral
    Posaconazole is a triazole antifungal drug.[1][2]
    Posaconazole is marketed in the United States, the European Union, and in other countries by Schering-Plough under the trade name Noxafil.
    Uses
    It is used to treat invasive infections by Candida species[3], Mucor, and Aspergillus species[4] in severely immunocompromised patients.
    There is also limited clinical evidence for its utility in treatment of invasive disease caused by Fusarium species (fusariosis).[5]
    Two studies published in the January 25, 2007 issue of the New England Journal of Medicine suggest posaconazole may be superior to other triazoles, such as fluconazole or itraconazole, in the prevention of invasive fungal infections, although it may cause more serious side effects.[6][7]
    References
    ^ Schiller DS, Fung HB (September 2007). "Posaconazole: an extended-spectrum triazole antifungal agent". Clin Ther 29 (9): 1862–86. doi:10.1016/j.clinthera.2007.09.015. PMID 18035188. http://linkinghub.elsevier.com/retrieve/pii/S0149-2918(07)00296-2.
    ^ Rachwalski EJ, Wieczorkiewicz JT, Scheetz MH (October 2008). "Posaconazole: an oral triazole with an extended spectrum of activity". Ann Pharmacother 42 (10): 1429–38. doi:10.1345/aph.1L005. PMID 18713852. http://www.theannals.com/cgi/pmidlookup?view=long&pmid=18713852.
    ^ Li X, Brown N, Chau AS, et al. (January 2004). "Changes in susceptibility to posaconazole in clinical isolates of Candida albicans". J. Antimicrob. Chemother. 53 (1): 74–80. doi:10.1093/jac/dkh027. PMID 14657086. http://jac.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=14657086.
    ^ Walsh TJ, Raad I, Patterson TF, et al. (January 2007). "Treatment of invasive aspergillosis with posaconazole in patients who are refractory to or intolerant of conventional therapy: an externally controlled trial". Clin. Infect. Dis. 44 (1): 2–12. doi:10.1086/508774. PMID 17143808. http://www.journals.uchicago.edu/doi/abs/10.1086/508774?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%3dncbi.nlm.nih.gov.
    ^ Raad I, Hachem R, Herbrecht R, et al. (2006). "Posaconazole as salvage treatment for invasive fusariosis in patients with underlying hematologic malignancy and other conditions" ([dead link]). Clin Infect Dis 42 (10): 1398–1403. http://www.journals.uchicago.edu/CID/journal/issues/v42n10/38411/brief/38411.abstract.html.
    ^ Cornely O, Maertens J, Winston D, Perfect J, Ullmann A, Walsh T, Helfgott D, Holowiecki J, Stockelberg D, Goh Y, Petrini M, Hardalo C, Suresh R, Angulo-Gonzalez D (2007). "Posaconazole vs. fluconazole or itraconazole prophylaxis in patients with neutropenia". N Engl J Med 356 (4): 348–59. doi:10.1056/NEJMoa061094. PMID 17251531.
    ^ Ullmann A, Lipton J, Vesole D, Chandrasekar P, Langston A, Tarantolo S, Greinix H, Morais de Azevedo W, Reddy V, Boparai N, Pedicone L, Patino H, Durrant S (2007). "Posaconazole or fluconazole for prophylaxis in severe graft-versus-host disease". N Engl J Med 356 (4): 335–47. doi:10.1056/NEJMoa061098. PMID 17251530.
    Antifungals (D01 and J02)
    Wall/
    membrane
    Ergosterol
    inhibitors
    Azoles
    (lanosterol 14alpha-demethylase inhibitors)
    Imidazoles
    topical: Bifonazole, Clomidazole, Clotrimazole#, Croconazole, Econazole, Fenticonazole, Ketoconazole, Isoconazole, Miconazole#, Neticonazole, Oxiconazole, Sertaconazole, Sulconazole, Tioconazole
    Triazoles
    topical: (Fluconazole#, Fosfluconazole)
    systemic: (Fluconazole, Itraconazole, Posaconazole, Voriconazole)
    Benzimidazoles
    topical: Thiabendazole
    Polyene antimycotics
    (ergosterol binding)
    topical: (Natamycin, Nystatin#)
    systemic: (Amphotericin B#)
    Allylamines
    (squalene monooxygenase
    inhibitors)
    topical: (Amorolfine, Butenafine, Naftifine, Terbinafine)
    systemic: (Terbinafine)
    β-glucan synthase
    inhibitors
    echinocandins (Anidulafungin, Caspofungin, Micafungin)
    Intracellular
    Pyrimidine analogues/
    Thymidylate synthase inhibitors
    Flucytosine#
    Mitotic inhibitors
    Griseofulvin#
    Others
    Bromochlorosalicylanilide · Methylrosaniline · Tribromometacresol · Undecylenic acid · Polynoxylin · Chlorophetanol · Chlorphenesin · Ticlatone · Sulbentine · Ethyl hydroxybenzoate · Haloprogin · Salicylic acid · Selenium sulfide# · Ciclopirox · Amorolfine · Dimazole · Tolnaftate · Tolciclate · Sodium thiosulfate# · Whitfield's ointment# · Potassium iodide#
    Tea tree oil • citronella oil • lemon grass • orange oil • patchouli • lemon myrtle
    PCP: Pentamidine • Dapsone • Atovaquone
    #WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
    see also diseases
    [hide]v • d • ePiperazines
    1-Cyclohexylpiperazine • 2C-B-BZP • Acaprazine • Almitrine • Alnespirone • Aminoethylpiperazine • Amoxapine • Antrafenine • Aripiprazole • Atevirdine • Azaperone • Azimilide • Befuraline • Bifeprunox • Binospirone • BRL-15572 • Buclizine • Buspirone • BZP • Chlorbenzoxamine • Chlorcyclizine • Cinepazet • Cinnarizine • Ciprofloxacin • Clocinizine • Clopenthixol • Clozapine • CPPene • Cyclizine • Dasatinib • DBL-583 • DBZP • Dibenzylpiperazine • Diethylcarbamazine • Dimethylphenylpiperazinium • Dotarizine • DPI-3290 • Dropropizine • EGIS-12233 • Eltoprazine • Ensaculin • Etoperidone • Fipexide • Flesinoxan • Flibanserin • Flupentixol • Fluphenazine • Fluprazine • GBR-12935 • Gepirone • HEPPS • Hexocyclium • Hydroxyzine • Imatinib • Indinavir • Ipsapirone • Itraconazole • JNJ-7777120 • Ketoconazole • Levodropropizine • Lidoflazine • Loxapine • Lurasidone • Manidipine • MBZP • mCPP • MDBZP • Meclizine • MeOPP • Nefazodone • Niaprazine • Olanzapine • Oxatomide • Oxypertine • PB28 • Perazine • Perospirone • Perphenazine • pFPP • Piberaline • Piperazine • PIPES • Pirenzepine • Piribedil • Posaconazole • Prochlorperazine • PRX-00023 • Quipazine • Ranolazine • S-15535 • SA 4503 • SB-258,585 • SB-271,046 • SB-357,134 • SB-399,885 • Sildenafil • Tandospirone • TFMPP • Thiethylperazine • Thiothixene • Tirilazad • Trazodone • Trelibet • Trifluoperazine • Trimazosin • Trimetazidine • Vanoxerine • Vardenafil • Vesnarinone • Vilazodone • VUF-6002 • WAY-100,135 • WAY-100,635 • Zalospirone • Zipeprol • Ziprasidone • Zuclopenthixol
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    Ketoconazole
    From Wikipedia, the free encyclopedia
    Jump to: navigation, search
    {http://upload.wikimedia.org/wikipedia/commons/thumb/5/5b/Ketoconazole2.png/200px-Ketoconazole2.png}
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    Ketoconazole
    Systematic (IUPAC) name
    1-[4-(4-{[(2R,4S)-2-(2,4-dichlorophenyl)-
    2-(1H-imidazol-1-ylmethyl)-1,3-dioxolan-
    4-yl]methoxy}phenyl)piperazin-1-yl]ethan-1-one
    Identifiers
    CAS number
    65277-42-1
    ATC code
    J02AB02 D01AC08 G01AF11
    PubChem
    47576
    DrugBank
    APRD00401
    ChemSpider
    401695
    Chemical data
    Formula
    **C**26**H**28**Cl**2**N**4**O**4
    Mol. mass
    531.43 g/mol
    Pharmacokinetic data
    Bioavailability
    Variable
    Protein binding
    84 to 99%
    Metabolism
    Hepatic
    Half life
    Biphasic: * Initial phase: 2 hours
    Terminal phase: 8 hours
    Excretion
    Biliary and renal
    Therapeutic considerations
    Pregnancy cat.
    B3 (Au), C (U.S.)
    Legal status
    POM (UK, oral formulation)
    Routes
    Oral, topical
    {http://upload.wikimedia.org/wikipedia/commons/thumb/f/fb/Yes_check.svg/14px-Yes_check.svg.png} Yes check.svgY(what is this?) (verify)
    Ketoconazole (pronounced /ˌkiːtəʊˈkoʊnəzol/) is a synthetic antifungal drug used to prevent and treat skin and fungal infections, especially in immunocompromised patients such as those with AIDS. Ketoconazole is sold commercially as an anti-dandruff shampoo, under brand names Perkhotal by Gepach International, and Nizoral, by Johnson & Johnson.
    Ketoconazole is very lipophilic, which leads to accumulation in fatty tissues. The less toxic and more effective triazole compounds fluconazole and itraconazole have largely replaced ketoconazole for internal use. Ketoconazole is best absorbed at highly acidic levels, so antacids or other causes of decreased stomach acid levels will lower the drug's absorption when taken orally.
    Contents
    [hide]* 1 History
    2 Usage
    3 Mechanism of action
    4 Sensitive fungi
    5 Hair loss benefits
    6 References
    7 External links
    History
    Ketoconazole was discovered in 1976 and released in 1981[1]. It followed griseofulvin as one of the first available oral treatments for fungal infections.
    Usage
    Ketoconazole is usually prescribed for topical infections such as athlete's foot, ringworm, candidiasis (yeast infection or thrush), and jock itch. The over-the-counter shampoo version can also be used as a body wash for the treatment of tinea versicolor[2][3].
    Ketoconazole is used to treat eumycetoma, the fungal form of mycetoma.
    The side-effects of ketoconazole are sometimes used to treat non-fungal problems. The decrease in testosterone caused by the drug makes it useful for treating prostate cancer and for preventing post-operative erections[4] following penile surgery. Another use is the suppression of glucocorticoid synthesis, where it is used in the treatment of Cushing's disease.[5] These side effects have also been studied for use in reducing depressive symptoms[6] and drug addiction;[7] however, it has not succeeded in either of these roles.[8][9]
    Ketoconazole can be prescribed as a 200-mg pill, a 2% cream, a 2% gel,a 2% foam,or 2% shampoo for the treatment of dandruff or seborrhoeic dermatitis, or as a 1% over-the-counter shampoo (Perkhotal)& (Nizoral). However, 2% shampoo is sold over-the-counter in many countries as well.
    Ketoconazole is also available as a topical mousse, using patented Versafoam technology, marketed under the brand name Ketomousse. In clinical studies, the Versafoam proved to be a superior mechanism of delivery to the shampoo. Currently it is only available in Europe.
    The anti-dandruff shampoo is designed for people who have a more serious case of dandruff where symptoms include, but are not limited to constant non-stop flaking, and severe itchiness.
    It is a pregnancy category C drug because animal testing has shown it to cause teratogenesis in high dosages. Until recently, there were two human test cases on record (both during the treatment of Cushing's syndrome)[10][11] and no adverse effects were reported, but this is not a broad enough data sample to draw any meaningful conclusions. A subsequent trial in Europe failed to show a risk to infants of mothers receiving ketoconazole.[12]
    This medication is also sometimes prescribed by veterinarians for use on pets, often as 200 mg unflavored tablets that may need to be cut to smaller size for correct dosage.[13]
    Mechanism of action
    Ketoconazole is structurally similar to imidazole, and interferes with the fungal synthesis of ergosterol, a constituent of cell membranes, as well as certain enzymes. It is specific for fungi, as the equivalent mammalian pathway, leading to the biosynthesis of cholesterol, is not sensitive to ketoconazole. However, other mammalian cytochrome P450 enzymes can be sensitive to ketoconazole, and inhibition of steroid hormone synthesis is a possible side effect of ketoconazole treatment.
    As with all azole antifungal agents, ketoconazole works principally by inhibition of an enzyme, cytochrome P450 14-alpha-demethylase (P45014DM). This enzyme is in the sterol biosynthesis pathway that leads from lanosterol to ergosterol. Fluconazole and itraconazole have been found to have a greater affinity for fungal cell membrane than ketoconazole, and thus lower doses of these azoles are required to kill fungi.
    Sensitive fungi
    Ketoconazole inhibits growth of dermatophytes and yeast species such as Candida albicans. The rise in the number of HIV/AIDS immune compromised patients has led to an increase in the frequency and significance of opportunistic fungal infections. Resistance to ketoconazole has been observed in a number of clinical fungal isolates, including C. albicans. Experimentally resistance usually arises as a result of mutations in the sterol biosynthesis pathway. Defects in the sterol 5-6 desaturase enzyme reduce the toxic effects of azole inhibition of the 14-alpha demethylation step. MDR or multidrug resistance genes can also play a role in reducing cellular levels of the drug. As azole antifungals all act at the same point in the sterol pathway, resistant isolates are normally cross-resistant to all members of the azole family.
    Hair loss benefits
    A study in mice indicated that ketoconazole may have a stimulatory effect on hair growth.[14] Nizoral shampoo has shown to be beneficial in men suffering from androgenic alopecia. One 1998 study showed that Nizoral 2% worked just as well as minoxidil 2% (brand name Rogaine) in men with androgenic alopecia. Both medicines increased hair thickness and increased the number of anagen-phase hair follicles on the scalp. Researchers were guarded about the meaning of these results, saying that more rigorous studies on larger groups of men should be done to confirm the findings, both to evaluate the ideal dosage and formulation, and to assess the desirability of routine treatment in this condition. Nizoral Shampoo only has U.S. Food and Drug Administration (FDA) approval for the treatment of dandruff and seborrheic dermatitis of the scalp, so although Nizoral may be useful as a hair loss remedy, it cannot be endorsed or marketed as one to the general public.[15] Nevertheless, pharmacies and drug stores often stock Nizoral with other hairloss remedies, rather than other shampoos.[citation needed]
    Results so far indicate that both the 1% and 2% dosages have positive hair loss benefits; however the more potent 2% formulation could have better results. Optimal usage is speculated at every third day, leaving the shampoo on the scalp for 3–5 minutes before rinsing. It has been stated that medications capable of maintaining the existing hair population should be regarded as effective treatments for androgenic alopecia. The present data suggest that ketoconazole should enter this group of drugs.[16]
    References
    ^ http://www.medicinenet.com/ketoconazole/article.htm
    ^ MedlinePlus Medical Encyclopedia: //Tinea versicolor//
    ^ //Tinea Versicolor//
    ^ Evans, K. C.; A. C. Peterson, H. E. Ruiz and R. A. Costabile (August 2004). "Use of oral ketoconazole to prevent postoperative erections following penile surgery". International Journal of Impotence Research 16 (4): 346–349. doi:10.1038/sj.ijir.3901160. PMID 14973533. http://www.nature.com/ijir/journal/v16/n4/full/3901160a.html.
    ^ Loli, Paola; Maria Elisa Berselli and Mariantonella Tagliaferri (1986). "Use of ketoconazole in the treatment of Cushing's syndrome". Journal of Clinical Endocrinology & Metabolism 63 (6): 1365–71. PMID 3023421.
    ^ Wolkowitz, Owen M.; Victor I. Reus (01 Sep 1999). "Treatment of Depression With Antiglucocorticoid Drugs". Psychosomatic Medicine 61 (5): 698–711. PMID 10511017. http://www.psychosomaticmedicine.org/cgi/content/full/61/5/698.
    ^ Goeders, Nick E.; Rachel L. Peltiera and Glenn F. Guerin (December 1998). "Ketoconazole reduces low dose cocaine self-administration in rats". Drug and Alcohol Dependence 53 (1): 67–77. doi:10.1016/S0376-8716(98)00108-2. PMID 10933341. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&list_uids=10933341&dopt=ExternalLink.
    ^ Malison, Robert T.; Amit Anand, Gregory H. Pelton, Paul Kirwin, Linda Carpenter, Christopher J. McDougle, George R. Heninger and Lawrence H. Price (October 1999). "Limited Efficacy of Ketoconazole in Treatment-Refractory Major Depression". Journal of Clinical Psychopharmacology 19 (5): 466–470. doi:10.1097/00004714-199910000-00011. PMID 10505589.
    ^ Ward, Amie S.; Eric D. Collins, Margaret Haney, Richard W. Foltin and Marian W Fischman (November 1998). "Ketoconazole attenuates the cortisol response but not the subjective effects of smoked cocaine in humans". Behavioural Pharmacology 9 (7): 577–86. doi:10.1097/00008877-199811000-00013. PMID 9862083.
    ^ Amado, José Antonio; Carlos Pesquera, Eva M. Gonzalez, Macarena Otero, Julio Freijanes, and Angel Alvarez (March 1990). "Successful treatment with ketoconazole of Cushing's syndrome in pregnancy". Postgraduate Medical Journal 66 (773): 221–3. doi:10.1136/pgmj.66.773.221. PMID 2362890.
    ^ Berwaerts, Joris; Johan Verhelst, Charles Mahler and Roger Abs (June 1999). "Cushing's syndrome in pregnancy treated by ketoconazole: case report and review of the literature". Gynecological Endocrinology 13 (3): 175–82. PMID 10451809. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&list_uids=10451809&dopt=ExternalLink.
    ^ Kazy, Zoltán; Erzsébet Puhó and Andrew E. Czeizel (March 2005). "Population-based case–control study of oral ketoconazole treatment for birth outcomes". Congenital Anomalies 45 (1): 5–8. doi:10.1111/j.1741-4520.2005.00053.x. PMID 15737124. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&list_uids=15737124&dopt=ExternalLink.
    ^ Ketoconazole for Your Pet at Petscriptions
    ^ Jiang J, Tsuboi R, Kojima Y, Ogawa H (April 2005). "Topical application of ketoconazole stimulates hair growth in C3H/HeN mice". J. Dermatol. 32 (4): 243–7. PMID 15863844. http://www.dermatol.or.jp/Journal/JD/2005/032040243.html.
    ^ Nizoral Shampoo as a Hair Loss Remedy? http://www.dermadoctor.com/pages/newsletter198.asp
    ^ http://www.hairlosstalk.com/download/nizoral.pdf
    External links
    PubPK - Ketoconazole Pharmacokinetics
    Janssen Pharmaceutica fungal infections page
    Doctor Fungus ketoconazole page
    Nizoral (manufacturer's website)
    Ketoconazole (patient information)
    Ketoconazole (Up to date product information)
    Piérard-Franchimont C, Goffin V, Decroix J, Piérard GE (2002). "A multicenter randomized trial of ketoconazole 2% and zinc pyrithione 1% shampoos in severe dandruff and seborrheic dermatitis". Skin Pharmacol. Appl. Skin Physiol. 15 (6): 434–41. PMID 12476017. http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=sph15434. – ketoconazole (Nizoral) versus zinc pyrithione (Head & Shoulders)
    v • d • eAntifungals (D01 and J02)
    Wall/
    membrane
    Ergosterol
    inhibitors
    Azoles
    (lanosterol 14alpha-demethylase inhibitors)
    Imidazoles
    topical: Bifonazole, Clomidazole, Clotrimazole#, Croconazole, Econazole, Fenticonazole, Ketoconazole, Isoconazole, Miconazole#, Neticonazole, Oxiconazole, Sertaconazole, Sulconazole, Tioconazole
    Triazoles
    topical: (Fluconazole#, Fosfluconazole)
    systemic: (Fluconazole, Itraconazole, Posaconazole, Voriconazole)
    Benzimidazoles
    topical: Thiabendazole
    Polyene antimycotics
    (ergosterol binding)
    topical: (Natamycin, Nystatin#)
    systemic: (Amphotericin B#)
    Allylamines
    (squalene monooxygenase
    inhibitors)
    topical: (Amorolfine, Butenafine, Naftifine, Terbinafine)
    systemic: (Terbinafine)
    β-glucan synthase
    inhibitors
    echinocandins (Anidulafungin, Caspofungin, Micafungin)
    Intracellular
    Pyrimidine analogues/
    Thymidylate synthase inhibitors
    Flucytosine#
    Mitotic inhibitors
    Griseofulvin#
    Others
    Bromochlorosalicylanilide · Methylrosaniline · Tribromometacresol · Undecylenic acid · Polynoxylin · Chlorophetanol · Chlorphenesin · Ticlatone · Sulbentine · Ethyl hydroxybenzoate · Haloprogin · Salicylic acid · Selenium sulfide# · Ciclopirox · Amorolfine · Dimazole · Tolnaftate · Tolciclate · Sodium thiosulfate# · Whitfield's ointment# · Potassium iodide#
    Tea tree oil • citronella oil • lemon grass • orange oil • patchouli • lemon myrtle
    PCP: Pentamidine • Dapsone • Atovaquone
    #WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
    see also diseases
    v • d • eGynecological anti-infectives and antiseptics (G01)
    Antibiotics
    polyene antimycotic (Nystatin, Natamycin, Amphotericin B) · Candicidin · Chloramphenicol · Hachimycin · Oxytetracycline · Carfecillin · Mepartricin · Clindamycin · Pentamycin
    Arsenic compounds
    Acetarsol
    Quinoline derivatives
    Diiodohydroxyquinoline · Clioquinol · Chlorquinaldol · Dequalinium · Broxyquinoline · Oxyquinoline
    Organic acids
    Lactic acid · Acetic acid · Ascorbic acid
    Sulfonamides
    Sulfatolamide
    Imidazole derivatives
    Metronidazole · Clotrimazole · Miconazole · Econazole · Ornidazole · Isoconazole · Tioconazole · Ketoconazole · Fenticonazole · Azanidazole · Propenidazole · Butoconazole · Omoconazole · Oxiconazole · Flutrimazole
    Triazole derivatives
    Terconazole
    Other
    Clodantoin · Inosine · Policresulen · Nifuratel · Furazolidone · Methylrosaniline · Povidone-iodine · Ciclopirox · Protiofate · Lactobacillus fermentum · Copper usnate
    v • d • ePiperazines
    1-Cyclohexylpiperazine • 2C-B-BZP • Acaprazine • Almitrine • Alnespirone • Aminoethylpiperazine • Amoxapine • Antrafenine • Aripiprazole • Atevirdine • Azaperone • Azimilide • Befuraline • Bifeprunox • Binospirone • BRL-15572 • Buclizine • Buspirone • BZP • Chlorbenzoxamine • Chlorcyclizine • Cinepazet • Cinnarizine • Ciprofloxacin • Clocinizine • Clopenthixol • Clozapine • CPPene • Cyclizine • Dasatinib • DBL-583 • DBZP • Dibenzylpiperazine • Diethylcarbamazine • Dimethylphenylpiperazinium • Dotarizine • DPI-3290 • Dropropizine • EGIS-12233 • Eltoprazine • Ensaculin • Etoperidone • Fipexide • Flesinoxan • Flibanserin • Flupentixol • Fluphenazine • Fluprazine • GBR-12935 • Gepirone • HEPPS • Hexocyclium • Hydroxyzine • Imatinib • Indinavir • Ipsapirone • Itraconazole • JNJ-7777120 • Ketoconazole • Levodropropizine • Lidoflazine • Loxapine • Lurasidone • Manidipine • MBZP • mCPP • MDBZP • Meclizine • MeOPP • Nefazodone • Niaprazine • Olanzapine • Oxatomide • Oxypertine • PB28 • Perazine • Perospirone • Perphenazine • pFPP • Piberaline • Piperazine • PIPES • Pirenzepine • Piribedil • Posaconazole • Prochlorperazine • PRX-00023 • Quipazine • Ranolazine • S-15535 • SA 4503 • SB-258,585 • SB-271,046 • SB-357,134 • SB-399,885 • Sildenafil • Tandospirone • TFMPP • Thiethylperazine • Thiothixene • Tirilazad • Trazodone • Trelibet • Trifluoperazine • Trimazosin • Trimetazidine • Vanoxerine • Vardenafil • Vesnarinone • Vilazodone • VUF-6002 • WAY-100,135 • WAY-100,635 • Zalospirone • Zipeprol • Ziprasidone • Zuclopenthixol
    Micafungin
    From Wikipedia, the free encyclopedia
    Jump to: navigation, search
    {http://upload.wikimedia.org/wikipedia/commons/thumb/7/7e/Micafungin.svg/250px-Micafungin.svg.png}
    Micafungin
    Systematic (IUPAC) name
    {5-[(1S,2S)-2-[(3S,6S,9S,11R,15S,18S,20R,21R,24S,25S,26S)-3-[(1R)-2-carbamoyl-1-hydroxyethyl]-11,20,21,25-tetrahydroxy-15-[(1R)-1-hydroxyethyl]-26-methyl-2,5,8,14,17,23-hexaoxo-18-[(4-{5-[4-(pentyloxy)phenyl]-1,2-oxazol-3-yl}benzene)amido]-1,4,7,13,16,22-hexaazatricyclo[22.3.0.09,13]heptacosan-6-yl]-1,2-dihydroxyethyl]-2-hydroxyphenyl}oxidanesulfonic acid
    Identifiers
    CAS number
    235114-32-6
    ATC code
    J02AX05
    PubChem
    477468
    Chemical data
    Formula
    **C**56**H**71**N**9**O**23**S**
    Mol. mass
    1270.28 g/mol
    Pharmacokinetic data
    Bioavailability
    ?
    Protein binding
    99.8%
    Metabolism
    Via catechol-O-methyltransferase pathway
    Half life
    11–17 hours
    Excretion
    40% feces, <15% urine
    Therapeutic considerations
    Licence data
    EU EMEA:link, US FDA:link
    Pregnancy cat.
    C
    Legal status
    ℞ Prescription only
    Routes
    Intravenous
    Micafungin (trade name Mycamine) is an echinocandin antifungal drug developed by Astellas Pharma. It inhibits the production of beta-1,3-glucan, an essential component of fungal cell walls. Micafungin is administered intravenously. It received final approval from the United States Food and Drug Administration on March 16, 2005, and gained approval in the European Union on April 25, 2008.
    Contents
    [hide]* 1 Indications
    2 Contraindications
    3 Dosage
    4 Dosage forms
    5 External links
    Indications
    Micafungin is indicated for the treatment of candidemia, acute disseminated candidiasis, candida peritonitis, abscesses and esophageal candidiasis. Since January 23, 2008, micafungin has been approved for the prophylaxis of candida infections in patients undergoing hematopoietic stem cell transplantation.
    Contraindications
    Known hypersensitivity to micafungin or any other ingredient contained in the formulation.
    Dosage
    For the treatment of candidemia, acute disseminated candidiasis, candida peritonitis and abscesses, the dosage of micafungin is 100 mg once daily. For the treatment of esophageal candidiasis, the dosage is 150 mg once daily. For prophylaxis of candida infections in HSCT recipients, the dosage is 50 mg once daily.
    Dosage forms
    Mycamine 50mg for i.v.-infusion (manufacturer Astellas)
    Mycamine 100mg for i.v.-infusion (manufacturer Astellas)
    Brand names in countries other than the US may vary.
    External links
    Mycamine website, run by Astellas Pharma US
    Mycamine Prescribing Information
    Gregory Eschenauer, Daryl D DePestel, and Peggy L Carver: Comparison of echinocandin antifungals. Ther Clin Risk Manag 2007, 3(1): 71–97.
    [hide]v • d • eAntifungals (D01 and J02)
    Wall/
    membrane
    Ergosterol
    inhibitors
    Azoles
    (lanosterol 14alpha-demethylase inhibitors)
    Imidazoles
    topical: Bifonazole, Clomidazole, Clotrimazole#, Croconazole, Econazole, Fenticonazole, Ketoconazole, Isoconazole, Miconazole#, Neticonazole, Oxiconazole, Sertaconazole, Sulconazole, Tioconazole
    Triazoles
    topical: (Fluconazole#, Fosfluconazole)
    systemic: (Fluconazole, Itraconazole, Posaconazole, Voriconazole)
    Benzimidazoles
    topical: Thiabendazole
    Polyene antimycotics
    (ergosterol binding)
    topical: (Natamycin, Nystatin#)
    systemic: (Amphotericin B#)
    Allylamines
    (squalene monooxygenase
    inhibitors)
    topical: (Amorolfine, Butenafine, Naftifine, Terbinafine)
    systemic: (Terbinafine)
    β-glucan synthase
    inhibitors
    echinocandins (Anidulafungin, Caspofungin, Micafungin)
    Intracellular
    Pyrimidine analogues/
    Thymidylate synthase inhibitors
    Flucytosine#
    Mitotic inhibitors
    Griseofulvin#
    Others
    Bromochlorosalicylanilide · Methylrosaniline · Tribromometacresol · Undecylenic acid · Polynoxylin · Chlorophetanol · Chlorphenesin · Ticlatone · Sulbentine · Ethyl hydroxybenzoate · Haloprogin · Salicylic acid · Selenium sulfide# · Ciclopirox · Amorolfine · Dimazole · Tolnaftate · Tolciclate · Sodium thiosulfate# · Whitfield's ointment# · Potassium iodide#
    Tea tree oil • citronella oil • lemon grass • orange oil • patchouli • lemon myrtle
    PCP: Pentamidine • Dapsone • Atovaquone
    #WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
    see also diseases
    received the email of your complete work= 90/100**

    (view changes)
    5:30 am

Tuesday, October 20

  1. page home edited TO MY PHARMACY INFORMATICS STUDENTS: Thanks for the sem. It was nice getting to know all of you…

    TO MY PHARMACY INFORMATICS STUDENTS:
    Thanks for the sem. It was nice getting to know all of you a little bit more.
    Hope to see you all around next semester. =)
    Remember not to quit despite all the hardships.
    God Bless and enjoy your sembreak!!
    -Mam Lianne =)
    ***

    Welcome to the Pharmacy Informatics Wiki!
    This was created for the following purposes:
    (view changes)
    6:24 pm
  2. page anti- ulcer edited ... NOBLE, Rita 9:30- 10:30; MWF; A206 89/100 = lack brand names
    ...
    NOBLE, Rita
    9:30- 10:30; MWF; A206
    89/100 = lack brand names
    (view changes)
    6:13 pm
  3. page ANTIFUNGALS edited ... #WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III see also di…
    ...
    #WHO-EM. ‡Withdrawn from market. CLINICAL TRIALS: †Phase III. §Never to phase III
    see also diseases
    68/100 - please makereceived the email of your work neat and complete!!!**complete work= 90/100**
    (view changes)
    6:12 pm
  4. page Antiviral Drugs edited ... Cruz Dela Cruz 80/100
    ...
    Cruz
    Dela Cruz
    80/100
    (view changes)
    6:06 pm
  5. page Antihistamines edited ... Tamondong MWF 9:30-10:30 A-206 95/100 = VERY GOOD!
    ...
    Tamondong
    MWF 9:30-10:30 A-206
    95/100 = VERY GOOD!
    (view changes)
    5:13 pm
  6. page NSAIDs edited ... Cabanes, Audrey Dizon, Charmaine 95/100 = VERY GOOD! =)
    ...
    Cabanes, Audrey
    Dizon, Charmaine
    95/100 = VERY GOOD! =)
    (view changes)
    5:08 pm
  7. page Antitussives, Expectorants and Mucolytics edited ... Gumangan, Lea Pangonilo, Mae Regine ... 10:30 MWF 84/100 = nice and very colorful, bu…
    ...
    Gumangan, Lea
    Pangonilo, Mae Regine
    ...
    10:30 MWF
    84/100 = nice and very colorful, but some lack brand names and some medications included are not under the category.
    Good work anyway! =)

    (view changes)
    5:06 pm
  8. page Antibiotics edited ... *Tendinopathies, tendinitis, tendon ruptures. *C 95/100 = VERY GOOD! =)
    ...
    *Tendinopathies, tendinitis, tendon ruptures.
    *C
    95/100 = VERY GOOD! =)
    (view changes)
    5:02 pm

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