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Kultur Dokumente
ANTIFUNGAL
Systemic Antifungal Agents
1. Griseofulvin
2. Oral Azole Derivatives
3. Terbinafine
4. Hidroksistilbamidin
5. Flucytosin
6. Amphoterisin B
Fig. 1
Drugs
Absorp
tion
Distribution
Meta
bolism
Excretion
1.
Amphoterisin
B
Urine
Billier
2.
Fluconazole
Urine
3.
Fluciytosin
CNS fluid
Urine
4.
Ketoconazole
Urine
Billier
5.
Griseofulvin
Tissue
keratin
Urine
Faeces
6.
Nystatin
Fungal
Sterol
Faeces
7.
Salicylic Acid
Drugs
Indications
Side effects
Contraindications
Exp.
1.
Amphoterisin B
-Sinusitis
-Meningitis kronis
-Kandidiasis
-Menggigil
-Demam
-Muntah
-Sakit Kepala
-Hipotensi
-Muntah
-Diare
-Gangguan fungsi hati
2.
Fluconazole
-Kandidiasis oral
dan esophagus
-Kandidiasis
sistemik
-Meningitis
-Muntah
-Diare
-Gangguan
fungsi hati
3.
Flucytosine
-Kandidiasis
-Meningitis
kriptokokal
-Mual,Muntah
-Rash
-Depresi sumsum tulang
-Gagal Ginjal
-Kehamilan dan Laktasi
+ Amfoterisin B =
Aktifitasnya
4.
Ketoconazole
-Blastomikosis
-Histo
plasmosis
-Kandidiasis
-Dermato
mikosis
-Mual
-Ginekomastia
-Hepatitis
Kolestatik
-Hipersensitivitas
-Kehamilan dan Laktasi
-Penyakit hepar akut
Ketokonazol merupakan
obat pilihan untuk
Blastomikosis
Pharmacodynamic cont
No
Drugs
Indications
Side Effects
Contraindication
Explanation
5.
Griseofulvin
Infeksi
dermatofitosis
berat pd kulit,
rambut, kuku
disebabkan
Trycophyton
rubrum.
-Infections
-Serum
Sickness
-Leukopenia
Kehamilan
6.
Nystatin
-Skin Candidiasis
,selaput
Lendir, GIT
-Stomatitis
-Muntah
-Diarrhae
Hyper
sensitivitas
(-) Superinfeksi
pada wanita hamil
7.
Salisilyc acid
-Ptyriasis
versicolor
-Tinea Pedis
-Alergi
Hiper
sensitivitas
Asam salisilat
bekerja keratolitis,
yaitu dapat
melarutkan lapisan
tanduk
Disease
Therapy
1.
Oral Candidiasis
2.
Vaginal Candidiasis
3.
Aspergilosis
4.
Criptoccosis
5.
Blastomicocys
6.
Tinea Pedis
7.
Tinea Unguium
(Onicomycosis)
8.
Tinea capitis
9.
Ptyriasis versicolor
Precautions
Most topical antifungal agents are well tolerated.
The most common adverse effects are localized
irritation caused by the vehicle or its
components. This may include redness, itch,
and a burning sensation. Some direct allergic
reactions are possible.
Topical antifungal drugs should only be applied
in accordance with labeled uses. They are not
intended or ophthalmic (eye) or otic (ear) use.
Application to mucous membranes should be
limited to appropriate formulations.
ANTILEPROSY DRUGS
Mycobacterium leprae
Cutaneous leprosy
lesions on a patient's
thigh.
CLASSIFICATION
Paucibacillary (tuberculoid leprosy)
Multibacillary Hansen's disease
(lepromatous leprosy)
or borderline leprosy
PAUCIBACILLARY
Paucibacillary Hansen's disease is
characterized by one or more
hypopigmented skin macules and
anaesthetic patches, i.e., damaged
peripheral nerves that have been attacked
by the human host's immune cells.
MULTIBACILLARY
Multibacillary Hansen's disease is
associated with symmetric skin lesions,
nodules, plaques, thickened dermis, and
frequent involvement of the nasal mucosa
resulting in nasal congestion and epistaxis
(nose bleeds) but typically detectable
nerve damage is late.
BORDERLINE
Borderline leprosy (also termed multibacillary),
of intermediate severity, is the most common
form. Skin lesions resemble tuberculoid leprosy
but are more numerous and irregular; large
patches may affect a whole limb, and peripheral
nerve involvement with weakness and loss of
sensation is common. This type is unstable and
may become more like lepromatous leprosy or
may undergo a reversal reaction, becoming
more like the tuberculoid form.
Rifampicin
DDS
Acedapson
Etionamid
Protionamid
Clofazimin
MIC
Dosis
Rasio serum
Ug/ml
mg
puncak MIC
0.3
0.003
0.003
0.05
0.05
-
600
100
225
375
375
50/100
30
500
15
60
460
-
Lamanya konsentrasi
serum lampaui MIC (hari)
1
10
200
1
1
-
Aktivitas
bakterisidal
+++
+
++
++
+
TREATMENT of LEPROSY
Multidrug therapy (MDT) and combining all
three drugs was first recommended by a
WHO Expert Committee in 1981. These
three anti-leprosy drugs are still used in
the standard MDT regimens. None of
them are used alone because of the risk
of developing resistance.
THERAPY:
DAPSON
RIFAMPICIN
CLOFAZIMIN
WHO (1998)
MB (12-18 month)
PB with 2-5 lesion (6-9 month)
PB only 1 lesion :
Rifampicin 600 mg + Ofloxacin 400 mg + Minosiklin 100 mg
single dose
Or
MB resistance to Rifampicin and DDS CLOFAZIMIN:
Clofazimin 50 mg + Ofloxacin 400 mg + Minosiklin 100 mg
during 18 month (everyday).