资源描述：
《（表皮癣菌）课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、Chapter43AntifungalandAntiviralDrugsAntifungaldrugsFungalinfectionSuperficialinfectionSystemicinfectionAntifungaldrugsAntifungalantibioticsAzole:imidazoleandtriazoleOthers:terbinafineandflucytosineAntifungalantibioticsGriseofuvinAmphotericinBNystatinGr
2、iseofulvinAntifungalactivityinihibitthegrowthofdermatophytesincludeepidermophyton（表皮癣菌）,microsporum（小孢子菌）andtrichophyton（发癣菌属）noeffectonbacteriaandsystemicinfectionsoffungiMechanismofactioninterferewithfungalnucleicacidsynthesisGriseofulvinClinicalusei
3、tisonlyusedinthesystemictreatmentofdermatophotosisincludeskin,hairandnailsAdverseeffectsNausea,vomiting,headacheAllergicreaction:fever,skinrashandleukopeniaTeratogenesisAmphotericinBAntifungalactivityHasthebroadestspectrumofantifungalactionActiveagains
4、tcandidaalbicans,cryptococcusneoformans,histoplasmacapsulatumetcAmphotericinBMechanismofactionBindtoergosterolonfungalcellmembraneandalterthepermeabilityofthecellbyformingamphotericinB-associatedporesinthecellmembrane,allowtheleakageofintra-cellularion
5、s(K+)andmoleculesleadingtocelldeathAmphotericinBClinicalusesDrugofchoicefornearlyalllife-threateningmycoticinfectionsincludeseverefungalpneumonia,crypotoccalmeningitisorsepsissyndromeAmphotericinBAdversereactionsInfusion-relatedtoxicity:fever,chills,mu
6、sclespasm,headache,hypotensionRenaldamage:azotemia,K+,Mg2+wastingOthers:Liverdamage,arrthymia,anemiaNewpreparationLiposomalamphotericinB(两性霉素B脂质体）AmphotericinBlipidcomplex（两性霉素B脂质复合体）AmphotericinBcolloidaldispersion(两性霉素B胶质复合体）LowerrenaltoxicityNystati
7、nHasthesamemechanismwithamphotericinBOnlyusedtopicallyforsuppressionoflocalcandidalinfectionAzoleImidazoleClotrimazole,miconazole,ketoconazoleTriazoleFluconazole,itraconazoleAzoleMechanismofactionreductionofergosterolsynthesisbyinhibitionoffungalcytoch
8、romeP450-dependent14-α-demethylaseClinicalusesBroad-spectrum:candidaspecies,cryptococcusneoformans,anddermatophytesTopicalazoles:clotrimazoleandmiconazoleBroadspectrumPoorlyabsorbedTootoxicforsystemicusesTopicuseintreatmentofdermatophyt
