Tabel Obat Antifungal
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Amphoteric ine B Membentuk pores pada membrane jamur (yang mengandung ergosterol) Hilangnya konten intraselular melalui fungicidal pores Spectrum luas Lokal dan sistemik candidemia, Cryptococcus, histoplasma, blastomyces, coccidioides, aspergillus FK : IV u/ sistemik, intrathecal u/ meningitis, topical u/ infeksi mata dan VU. Tox : gangguan ginjal. Int : memperberat obat yang toksik terhadap ginjal juga. Flucytosin e Intervensi DNA dan RNA sintesis Sinergis dengan amphotericin Cryoptococcus dan chromoblastomycosis infection FK : Oral Tox : myelosuppression Ketokonazo le Blok fungal enzim P450 dan mengganggu sintesis ergosterol Poorly selective Spectrum luas, tetapi bersifat toksis FK : Oral, topical Tox & Int : menganggu sintesis hormone steroid dan metabolism obat fase I Itrakonazo le Sama dengan ketoconazole Lebih selektif daripada ketoconazole Spectrum luas : candida, Cryptococcus, blastomycosis, FK : oral dan IV, sulit ke CNS Tox & Int : low toxicity
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Transcript of Tabel Obat Antifungal
Amphotericine BMembentuk pores pada membrane jamur (yang mengandung ergosterol) Hilangnya konten intraselular melalui fungicidal poresSpectrum luasLokal dan sistemik candidemia, Cryptococcus, histoplasma, blastomyces, coccidioides, aspergillusFK : IV u/ sistemik, intrathecal u/ meningitis, topical u/ infeksi mata dan VU.Tox : gangguan ginjal.Int : memperberat obat yang toksik terhadap ginjal juga.
FlucytosineIntervensi DNA dan RNA sintesisSinergis dengan amphotericinCryoptococcus dan chromoblastomycosis infectionFK : OralTox : myelosuppression
KetokonazoleBlok fungal enzim P450 dan mengganggu sintesis ergosterolPoorly selectiveSpectrum luas, tetapi bersifat toksisFK : Oral, topicalTox & Int : menganggu sintesis hormone steroid dan metabolism obat fase I
ItrakonazoleSama dengan ketoconazoleLebih selektif daripada ketoconazoleSpectrum luas : candida, Cryptococcus, blastomycosis, coccidiodomycosis, histoplasmosisFK : oral dan IV, sulit ke CNSTox & Int : low toxicity
CaspofunginMemblok b-glucan sintaseMenghambat sintesis dinding sel jamurFungicidal candida sp, aspergillosisFK : IVTox : minor GI, flushingInt : meningkatkan level cyclosporine
TerbinafineMenghambat epoxidation dari squalene pada fungiMengurangi ergosterol, menghambat synthesis membrane sel jamurMucocutaneous fungal infectionsFK : oralTox : GI, headache, hepatotoxicity
Dose regime for itraconazoleVarious regimes for itraconazole have been found successful; typical doses are listed below. Courses can be repeated and the medication can be continued for months if necessary. Tinea corporis,tinea cruris: 200 mg daily for one week OR 100mg daily for 2 weeks Tinea pedis,tinea manuum: 200 mg twice daily for one week OR 100mg daily for 2-4 weeks Vulvovaginal candidiasis: 200 mg twice daily for one day OR 200 mg daily for 3 days Oral candidiasis: 100 mg daily for two weeks Tinea unguium: 200 mg/day for 6-8 weeks (fingernails) or 3-4 months (toenails), OR 200 mg twice daily for 7 days, repeated monthly for 2 months (fingernails) or 3-4 months (toenails) Pityriasis versicolor: 200 mg/day for 10 days, with a preventative dose of 200mg once monthly for 6 months.The dose of itraconazole in children is usually 5 mg per kg body weight per day to maximum 200 mg per day, but is reserved for exceptional circumstances.
