Fungal infections, drugs used systemic

Systemic fungal infections hypersensitivity to the drug IM use in ITP administration of live virus vaccines (eg, smallpox) in patients receiving immunosuppressive corticosteroid doses (see Warnings). 

The delivery of drugs to the RES (also referred to as the mononuclear phagocyte system) is an area where liposomes have a potential for success. They were successfully used in the delivery of antimonial drugs to treat experimental leishmaniasis infection [313], Very good results were obtained in the treatment of systemic fungal infections in cancer patients using liposomal amphotericin B [314, 315]. 

Agents used to treat common fungal infections are listed in Tables 35-1 and 35-2. As indicated in Table 35-1, certain drugs can be administered systemic ally to treat infections in various tissues. Other agents are more toxic their use is limited to local or topical application for fungal infections in the skin and mucous membranes (Table 35-2). The use of systemic and topical antifungal agents is addressed in more detail below. 

The antifungal agents that can be administered sys-temically by oral or intravenous routes are listed here. These agents are often used to treat invasive (deep) fungal infections in the body, or they can be administered systemically to treat more superficial infections that have disseminated over a large area of the skin or subcutaneous tissues. The clinical use, mechanism of action, and potential adverse effects of these drugs are addressed here. 

Clinical Use. Amphotericin B (Amphocin, Fungizone Intravenous) is one of the primary drugs used to treat severe systemic fungal infections.26,39 This drug is often chosen to treat systemic infections and meningitis caused by Candida, Cryptococcus, and several other... 

Clinical Use. Ketoconazole (Nizoral) is used to treat a variety of superficial and deep fungal infections.9,35,72 This drug can be administered orally to treat pulmonary and systemic infections in candidiasis, coccidioidomycosis, histoplasmosis, and several other types of deep fungal infections. Oral administration is... 

Amphotericin B is obtained from Streptomyces nodosus. It is fungistatic and administered intravenously as an infusion in the treatment of severe systemic fungal infections. It also is used for the local treatment of superficial candidiasis. Test-dose administration is advised to confirm adverse reactions. The amphotericin infusion should be slow to prevent the risk of irritation and infusion-related adverse effects. The drug is used in pregnancy without any adverse side effects.66... 

Which one of the following drugs is not used for the treatment of systemic fungal infections ... 

Fungal infections superficial dermatophyte or Candida infections purely involving the skin can be treated with a topical imidazole (e.g. clotrimazole, miconazole). Pityriasis versicolor, a yeast infection, primarily involves the trunk m young adults it responds poorly to imidazoles but topical terbinafine or selenium sulphide preparations are effective severe infection may require systemic itraconazole. Invasion of hair or nails by a dermatophyte or a deep mycosis requires systemic therapy terbinafine is the most effective drug. Terbinafine and griseo-fulvin are ineffective against yeasts, for which itraconazole is an alternative. Itraconazole can be used in weekly pulses each month for 3-4 months it is less effective against dermatophytes than terbinafine. 

The use of the polyenes for the treatment of systemic infections is limited by the toxicities of the drugs, their low water solubilities, and their poor chemical stabilities. Amphotericin B. the only polyene useful for the treatment of. serious systemic infections, must be solubilized with a detergent. The other polyenes are indicated only as topical agents for superficial fungal infections. 

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