AntiFungal drugs Polyene antifungal Amphotericin Nystatin Imidiazole antifungal Clotrimazole,econazol Not absorbed Not e,fenticonazole,isocon from the

gut. absorbed azole,ketoconazole,mi Can be given orally. conazole,sulconazole, parentrally but it ticonazole is toxic. Very toxic Indication; A formulation of parentrally. amphotricin Vaginal candidiasis & encapsulated in dermatophytes. Presentation liposome is less Example; Oral toxic. suspension Dacktarin by Janssen Amphotricin as a Tab. Miconazole complex with Na Pestilles cholesteryl SO4 is Presentation; also available. pessaries Scored tab 250 mg Indication; Indication; Oral gel SF 25 Intestinal candidiasis 1. Intestinal mg/ml(retain near lesions Caution candidiasis
1. Toxic; so hepatic, renal, blood counts, plasma electrolyte monitoring. 2. Cautious with other nephrotoxic drugs as corticosteroids & antineoplastic. 3. Pregnancy & breast feeding. S.E 1.When given parentrally; Anorexia, nausea, dizziness,headache 2.Epigastric pain. 3.Renovascular & cardiovascular Page 1

Triazide antifungal Not concomitantly administered with imidiazole & triazole Fluconazole Diflucan by Pfizer Itraconazole Sporanox by Janssen. 7 caps 50mg/pack. Indication 1 pack caps 200 mg 1. for oropharangeal Indication; & vulvo vaginal Oral for local & candidiasis, systemic pityriasis. candidiasis. 2. Tenia corporis & Cryptococcal pedis. infections.
In AIDS In neonates. In Tinea

others
Flucytosin e Griseofulvi n
Terbinafine

Alcoban by Roche

Grisovin by Glaxo 125 mg tab

Indication;
Dermatophyte

Lamisil by Sandoz 250 mg scored tab

Indication; Dermatophyte infections of nails, ring worms infections (tinea)

Indication; In long standing infection. Adjunct to amphotricin. In meningitis. In candidiasis

infections of skin,scalp, hair & nails

2. Infections
by candida albicans of skin & mucous membrane

S.E.
nausea, vomiting, Diarrhea.

Indication; Oral & intestinal fungal infection Caution; Pregnancy CI.With astimazole(Hismanal). Terfenadine(triludan), & cisapride(prepulsid) S.E nausea,vomiting,rashes, prurities
Example 2; Nizoral by Janssen Ketoconazole Indication

before swallowing)

SE; 1. Nausea, diarrhea. 2. Flatulence 3. Abdominal discomfort. 4. Anaphylaxis.

5. Allergic reactions

SE. 1. Nausea, constipation. 2. Dyspepsia 3. Abdominal pain. 4. Headache. 5. dizziness

Scored tab 200mg & shampoo

High dose

Dr.Abeer Hekal

toxicity. 4.Blood & neurological disorders.

causes oral irritation, rashes.

1. GI mycosis. 2. Resistant candidiasis. 3. Chronic resistant vaginal candidiasis 4. Resistant dermatophyte infection of skin & nails. 5. Prophylaxis in mycosis in immunosuppressive patients Caution; Avoid concomitant use of astimazole, terfenadine or cisapride. monitor liver functions CI hepatic impairment Terratogenic in pregnancy. S.E. 1. Nausea, vomiting, abdominal pain. 2. Headache 3. Fatal liver damage.
4. Rashes, urticaria, pruritis.

5. If given for more than

14 days, & increase risk of hepatitis.

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Dr.Abeer Hekal

3- Antiviral drugs. Different types of viral infections; 1234Herpes simplex & Varicella zoster. Human immunodeficiency virus. Cytomegalovirus (CMV); drugs used 1- ganciclovir, 2- Foscarnet Na. Respiratory Syncytial virus; drugs used; tribavirin(Ribavirin) inhibit DNA, RNA virus, given by inhalation in bronchiolitis.

1- Drugs used in Herpes simplex & Vorticella zoster. Acyclovir Zovirax by welcome Presentation; 1- Dispersible tab. 2- Suspension. 3- IV infusion. 4- Cream. 5- Eye ointment Caution; Renal impairment. Pregnancy & breast feeding. SE; Rashes. GI disturbance. Fatigue. Confusion. Convulsions. coma Idoxuridine Amantadine HCl Also antiparkinsonism Symmetrel by geigy Caps, & syrup Valaciclovir Valtrex tab by welcome Pro-drug of acyclovir Indication; Herpes zoster Inosine pranoloex Imunovir by leo Famciclovir Famvir by SK tab

Caution; SE; 1- Hepatic, renal Nausea. impairment. Headache. 2- Pregnancy & breast As acyclovir. feeding. 3- Congestive heart failure SE; 1- Nausea, Anorexia. 2- Insomnia,dizziness. 3- Confusions. 4- Convulsions 5- hallucinations

Indications; 1- Mucocutaneous herpes simplex 2- Adjunctive treatment in genital warts. SE reversal increase in serum & urinary uric acid

SE. Nausea. Headache.

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Dr.Abeer Hekal

2- Human immunodeficiency virus (HIV) Used for treatment of AIDS (acquired immune deficiency syndrome)

Zidovudine(AZT) (Azidothymidine) Retrovir by welcome. CI; anaemia. SE; anaemia. nausea. vomiting. anorexia. dyspepsia. headache. rashes. 3- Antiprotozoal drugs a- Antimalarial drugs. b- Amoebicides.trichomonocides. c- Antigiardial drugs. d- Leishmaniacides. e- Trypanocides. f- Drugs for toxoplasmosis. g- Drugs for pneumocystis pneumonia

Didanosine Videx by BMS tab with Al & Mg antacids. additive; Aspartam given when Zidovudine is inappropriate. caution; history of pancreatitis

Zacitabine(DDC) Hivid tab by Roche

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Dr.Abeer Hekal

a- Antimalarial drugs. Falciparum malaria (treatment of malignant malaria) Resistant to chloroquine Drugs used a- Quinine diHCl SO4 followed by tetracyclines. b- Mefloquine HCl. c- Halofantrine HCl. d- Quinine is given orally, but if patient is very ill, it can be given by IV infusion SE. of Halofantrine HCl a- Diahrea. b- Nausea. c- Vomiting. d- Abdominal pain. e- Rashes. SE of mefloquine HCl As before + a- Dizzness, loss of balance. b- Weakness, loss of apetite. c- Visual disturbance. Pl.vivax, Pl.malaria (treatment of benign malaria) Chloroquine is the drug of choice. N.B. used for radical cure (destruction of parasite in liver to prevent relapse). Prophylaxis against malaria

For 1 week before going to endemic area & for 4 weeks after leaving. Chloroquine 300 mg once weekly Proguanil HCl 200 mg once daily Give chloroquine then primaquine for 14-21 days. Mefloquine 250 mg once weekly Chloroquine can be given in pregnancy, but Doxycycline primaquine is not till pregnancy is over. Proguanil SE; Diarrhea, mouth ulcers.

Chloroquine(PO4 or SO4) initial dose; 600 mg then single dose 300 mg after 6-8 hours then single dose daily for 2 days

Dapsone Indication; Prophylaxis against Pl.Falciparum.

SE; GI disturbance. Headache. Visual disturbance Primaquine PO4 SE; Nausea, vomiting. Abdominal pain.

Irreversible retinal Damage. Skin reactions.

Haemolytic anaemia

Pyrimethamine+sulfadoxine Indication; Adjunct to quinine in treatment of Pl.Falciparum.

Page 5 Dr.Abeer Hekal

Amoebicides, & Trichomonocides.

Amoebicides

Trichomonocides

Metronidazole

indication;
1- intestinal amaebiasis. 2- extraintestinal amaebiasis (in liver) 3- urogenital trichomoniasis. 4- Giardiasis

Tinidazol e

Diloxanide Furoate indication; chronic amaebiasis. SE; - Flatulance. - vomiting. - Urticaria - prurities Example Furamide by Knoll scored tab

Metronidazole. Tinidazole

c- Antigiardial drugs;

Metroinidazole.

Tinidazole.

Mepacrine HCl

dLeishmaniacides Leishmaniasis either cutenous; heal spontonously. Or Visceral(Kala-Azar): need therapy. Na stibagluconate Pentamidine isethionate Na stibagluconate Dose : 20 mg/kg daily, for 20 days IM or IV injection. CI in renal impairment. In breast feeding. SE anorexia- nausea- vomiting- abdominal pain.

Paramomycin.

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Dr.Abeer Hekal

e- Trypanocides. f- Drugs for toxoplasmosis. Combination of pyrimethamine & sulfdiazine. NB.; toxoplasmosis in pregnancy lead to severe diseases in fetus. g- Drugs for Pneumocystis pneumonia Co-trimoxazole. Pentamidine isethionate. Atovaquone 4- Anthelmintics

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Dr.Abeer Hekal

Ascaricides drugs for thread worms Mebendazole tab & suspension Vermox by Janssen against thread worm, round worm,whip worm, hook worm infections caution; schisotosomicides(bilharziasis) praziquantel: Biltricide for all types cause loss of intercellular Ca+2 of the worm. Metriphonate Bilarcil for S.haematobium infection only against round worm levamisole drug of choice. piperazine.

mebendazole.
pyrantel (indication : round, hook, & thread worm)

toxic in pregnancy & breast feeding

SE abdominal pain diahrea. hypersensetivity reactions. example 2 piperazine (PO4 & citrate) indication; thread & round worms caution; renal & hepatic impairment. for tape worm Niclosamide. Praziquantel filaricides

diethyl carbamazine citrate Hetrazan By lederle. Suramin. both are toxic Ivermectin Mectizan by MSD drug of choice

for strongyloidiosis. worm live in gut. albendazole. thiobendazole (tiabendazole)

epilepsy & pregnancy

SE. nausea, vomiting, colic, diahrea. allergic reaction. bronchospasm

for hook worm Mebendazole. pyrantel

for Guniea worms(dracontiasis) Metronidazole mebendazole

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Dr.Abeer Hekal

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Dr.Abeer Hekal