![19
REFERENCE
FOYE’S principles of MEDICINAL CHEMISTRY 6th Edition
Pg. No.: 1112 – 1126.
Text book of MEDICINAL CHEMISTRY [Vol - 2] by
V. ALAGARSAMY Pg. No.:
A Text book of MEDICINAL CHEMISTRY (Synthesis &
biochemical Approach) [Vol - 1] by Surendra . N. Pandeya
Pg. No.:](https://image.slidesharecdn.com/anti-fungaldrugs-171026123313/85/Anti-fungal-drugs-19-320.jpg)
Anti fungal drugs
- 1. TEEGALA KRISHNA REDDY COLLEGE OF PHARMACY Subject :- MEDICINAL CHEMISTRY - II Topic :- ANTI – FUNGAL DRUGS Under the guidance of :- G. ASHWANI M.S Pharm
- 2. CONTENTS: 2 INTRODUCTION CLASSIFICATION MECHANISM OF ACTION SYNTHESIS ADVERSE EFFECTS THERAPEUTIC USES BRAND NAMES REFERENCES
- 3. INTRODUCTION 3 Chemotherapy of Fungal infections has lagged far behind chemotherapy of Bacterial infections. Most common fungal infections in humans have been relatively superficial infections of the skin and mucosal membranes and potentially lethal deep-seated infections have been quite rare. The number of effective anti-fungal agents available is quite small compared to those available to treat bacterial infections, but research in this area is quite active.
- 4. 4 The fungal kingdom includes Yeasts, Molds, Rusts & Mushrooms. Most Fungi are Saprophytic, which means that they live on dead organic matter in soil or on decaying leaves and wood. Yeasts such as Candida albicans, typically growing as single oval cells which reproduce by budding. Molds such as Trichophyton rubrum, one of the causative organism of ring worm, grow in clusters of hyphae called mycelium. CAUSITIVE ORGANISMS
- 5. 5 These are Mainly responsible for Superficial Mycosis Eg.: Dermatomycosis, Candidiasis, Onchomycosis Deep-seated (systemic) Mycosis Eg.: Coccidioidomycosis, Blastomycosis FUNGAL INFECTIONS
- 6. 6 CLASSIFICATION ANTI - FUNGAL AGENTS TOPICAL SYSTEMIC ALLYLAMINE IMIDAZOLE TRIAZOLE ECHINOCANDINS POLYENE MISC. TERBINAFINE KETOCONAZOLE AMPHOTERICIN - BCASPOFUNGIN ANIDULAFUNGIN MICAFUNGIN FLUCYTOSINE GRISEOFULVIN FLUCONAZOLE ITRACONAZOLE VORICONAZOLE ALLYLAMINE -TERBINAFINE, IMIDAZOLE – CLOTRIMAZOLE, TRIAZOLE – TERCONAZOLE, POLYENE – NYSTANIN, MISC. - CICLOPIROX
- 8. 8 AZOLES A Azole refers to any of the five-membered heterocyclic ring with nitrogen atoms. They are of 2 types: H IMIDAZOLE TRIAZOLE
- 9. 9 WHAT ARE IMIDAZOLES ? A Imidazole refers to any of the five-membered heterocyclic ring with three carbon atoms and two nitrogen atoms. CLOTRIMAZOLE KETOCONCONAZOLE
- 10. 10 WHAT ARE TRIAZOLES ? A triazole refers to any of the five-membered heterocyclic ring with two carbon atoms and three nitrogen atoms. FLUCONAZOLE ITRACONAZOLE
- 11. 11 The TRIAZOLES tend to have fewer side effects, better absorption, better drug distribution in body tissues, and fewer drug interactions. All azoles exert antifungal activity by inhibiting Cytochrome P450 enzymes responsible for the demethylation of Lanosterol to Ergosterol. Reduced fungal membrane Ergosterol concentrations result in damaged, leaky cell membranes.
- 12. 12 Fluconazole does not require an acidic environment, as does Ketoconazole, for GI absorption. About 80% of the drug is excreted unchanged in the urine. Dosage reductions are required in the presence of renal insufficiency. Fluconazole is very effective in the treatment of infections with most Candida species. AIDS patients with esophageal candidiasis also usually respond to fluconazole. A single dose has been shown to be an effective treatment for vaginal candidiasis. A 3-day course of oral fluconazole is an effective treatment for Candida urinary tract infection. FLUCONAZOLE
- 13. 13 ORAL thrush Candidiasis (HAND) Candidiasis (FEET)
- 14. 14 SYNTHESIS OF FLUCONAZOLE DIFLURO BENZENE Cl - CH2 - CH2 - C - Cl O + ETHYL ACETATE INTERMOLECULAR REARRANGEMENT TRIMETHYL SULFONIUM IODIDE FLUCONAZOLE H H
- 15. 15 ITRACONAZOLE Itraconazole is lipophilic and water insoluble and requires a low gastric pH for absorption. Itraconazole has replaced ketoconazole as the drug of choice in the treatment of paracoccidioidomycosis and chromomycosis or Blastomycosis. BLASTOMYCOSIS PARACOCCIDIOIDOMYCOSIS
- 16. 16 ADVERSE EFFECTS FLUCONAZOLE FEVER SKIN RASHES UPPER STOMACH PAIN DARK URINE LOSS OF APPETITE ITRACONAZOLE DIARRHOEA DIZZINESS MOOD CHANGES DECREASED URINE LOSS OF APPETITE
- 17. 17 THERAPEUTIC USES FLUCONAZOLE CANDIDA INFECTIONS OF VAGINA, MOUTH & ESOPHAGUS CRYPTOCOCCAL MENINGITIS PERITONITIS CRYPTOCOCCOSIS IN AIDS URINARY TRACT INFECTIONS ITRACONAZOLE FUNGAL INFECTIONS OF TOENAILS, THROAT, MOUTH & ESOPHAGUS PARACOCCIDIOIDOMYCOSIS ASPERGILLOSIS BLASTOMYCOSIS JOCK ITCH
- 18. 18 BRAND NAMES BRAND NAME DIFLUCAN CANDID DIFLU ITRABOND SYNTRON SPORANOX DOSAGE Capsule Tablet Suspension Tablet Capsule Vial (ORAL) DOSE Fluconazole 50mg Fluconazole 50mg - 150mg Fluconazole 50mg/5ml Itraconazole 100mg Itraconazole 200mg Itraconazole 10mg x 1ml
- 19. 19 REFERENCE FOYE’S principles of MEDICINAL CHEMISTRY 6th Edition Pg. No.: 1112 – 1126. Text book of MEDICINAL CHEMISTRY [Vol - 2] by V. ALAGARSAMY Pg. No.: A Text book of MEDICINAL CHEMISTRY (Synthesis & biochemical Approach) [Vol - 1] by Surendra . N. Pandeya Pg. No.:
- 20. THANK YOU