Transcript 9 Anti-Fungal & Anti-Vira

Chapter 9
Antifungal and Antiviral Agents
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Antifungal Agents
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Nystatin
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This antifungal drug binds to sterols in the
fungal cell membrane. The fungal cell
eventually dies off.
It is poorly absorbed from the gastrointestinal
tract when taken orally.
It has both fungicidal and fungistatic activity.
It is used for both the treatment and prevention
of oral candidiasis.
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Antifungal Agents
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Nystatin
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Dose forms include an aqueous suspension,
pastilles, and vaginal tablets.
The aqueous suspension and pastilles contain
sugar.
Oral dose forms should be dissolved slowly in
the mouth.
Good oral hygiene is essential because of the
high sugar content.
Adverse effects include gastrointestinal effects.
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Antifungal Agents
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Clotrimazole
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This is a synthetic antifungal drug that alters cell
membrane permeability.
 It is indicated for the treatment of oropharyngeal
candidiasis
 It is available as an oral lozenge and as a vaginal
cream.
 The lozenge contains sugar so good oral hygiene
is essential.
 Adverse effects include abdominal pain, diarrhea,
and nausea.
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Antifungal Agents
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Ketoconazole
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This is an imidazole that also alters cell membrane
permeability.
It requires an acidic environment for absorption.
Any medicine that increases stomach pH should not
be used with this drug.
It is effective against a wide number of fungal
infections.
The most common adverse reactions are nausea and
vomiting.
Ketoconazole is associated with hepatotoxicity. Liver
function is monitored while the patient receives this
drug.
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Antifungal Agents
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Acyclovir
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This drug exerts its antiviral action on herpes
viruses by interfering with DNA polymerase
and inhibiting DNA replication.
Only 15%-30% is absorbed when taken orally.
It is widely distributed throughout the body.
It is effective against herpes simplex types I
and II and varicella-zoster.
Topical adverse effects include burning,
stinging, and mild pain.
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Antifungal Agents
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Acyclovir
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Adverse effects with oral administration include
headache, vertigo, dizziness, insomnia, and
fatigue.
Gastrointestinal adverse effects include
nausea, vomiting, and diarrhea.
Adverse effects associated with parenteral
administration include irritation, pain, stinging,
and erythema at the injection site.
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Antifungal Agents
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Penciclovir
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It is indicated for oral herpes simplex.
 Penciclovir is available as a topical cream.
 It should be applied every 2 hours while
awake.
 Penciclovir decreases healing time by 1 day.
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Antifungal Agents
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Famciclovir
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It is used to treat herpes simplex.
 Famciclovir is converted to penciclovir after
oral administration.
 Adverse effects include headache, nausea,
and vomiting.
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Antifungal Agents
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Docosanol 10%
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Docosanol 10% is indicated for the treatment
of oral herpes simplex virus.
 This is the only antiviral drug that is available
without a prescription.
 It is a topical cream.
 Apply within 12 hours of prodromal symptoms.
 Decreases healing time by about 1 day.
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Acquired Immunodeficiency
Syndrome (AIDS)
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Those persons with AIDS receive a number of
medications from different chemical classes. This
combination is often referred to as a “cocktail.”
The adverse effects of these medications are
many.
Oral adverse effects are common with these
medications.
These persons are at high risk for opportunistic
infections. As a result, they are often treated for
tuberculosis, Pneumocystis carinii pneumonia,
herpes infections, and candidiasis.
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Other Antiviral Agents
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Some of these drugs are used to treat or
prevent the flu.
Other drugs are used to treat hepatitis or
multiple sclerosis.
Some drugs are used to treat certain types
of leukemia.
Several of these drugs have oral adverse
effects.
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