Fluconazole pharmacology

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    Fluconazole pharmacology


    Currently there are over 1,650 entries with more in the works, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM websites and free-to-access journal articles). The CCC was created, and is maintained, by Chris Nickson and originated from the FCICM exam study notes created by Jeremy Fernando in 2011. All of these pages have been updated, modified and added to since by a number of contributors (see below). As such will be particularly useful to those studying for the CICM Fellowship exam (though there are topics outside the scope of the exam as well). Increasingly, entries relevant to the FACEM exam are also being added. We have defined “critical care medicine” as the triad of 1) resuscitation, 2) emergency care for life-threatening conditions, and 3) intensive care; including all components of the emergency and critical care medicine delivery system, prehospital and hospital.” NOTE: Pages are continually added under these topic headings, to find a current list of pages for each topic just search for the topic heading in the searchable index table. Fluconazol (generisch geneesmiddel) is een geneesmiddel uit de triazolenfamilie, dat gebruikt wordt bij de behandeling van oppervlakkige en systemische infecties van gisten en schimmels. Fluconazol is ontwikkeld door Pfizer en kwam voor het eerst op de markt in 1990. Inmiddels is het verkrijgbaar als goedkoop generiek geneesmiddel. Het komt voor op de modellijst van essentiële geneesmiddelen van de Wereldgezondheidsorganisatie, waarop de belangrijkste geneesmiddelen staan die noodzakelijk zijn in een basisgezondheidssysteem. Het is verkrijgbaar als tablet en als suspensie voor oraal gebruik en ook als infusievloeistof. De stof is opgenomen in de lijst van essentiële geneesmiddelen van de WHO. Fluconazol is primair fungistatisch, maar kan fungicidaal zijn tegen sommige schimmels op een dosis-afhankelijke manier, bijvoorbeeld Cryptococcus.

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    Aug 7, 2018. The azoles that are available for systemic use can be classified into two groups the triazoles fluconazole, itraconazole, voriconazole. There is also a section devoted to the clinical and pharmacological profile of fluconazole, and any considerations concerning the future development of. Mg/kg/dose IV once daily after initial treatment with lipid amphotericin B or an echinocandin for patients who are unlikely to have a fluconazole-resistant.

    QT prolongation Torsades de pointes Alopecia Anaphylactic reactions Angioedema Cholestasis Dizziness Dyspnea Hepatic failure Hepatitis Hypertriglyceridemia Hypokalemia Increased alkaline phosphatase Increased ALT/AST Jaundice Leukopenia Pallor Seizures Stevens-Johnson syndrome Taste perversion Thrombocytopenia Toxic epidermal necrolysis Hypersensitivity to other azoles Use caution in proarrhythmic conditions and renal impairment Use extreme caution or avoid in congenital long-QT patients and patients with conditions that increase QT-prolongation risk Fluconazole inhibits CYP2C9, CYP2C19, and CYP3A4 isoenzymes; coadministration with drugs that are substrates if these isoenzymes may be contraindicated or warrant dosage modifications Capsules contain lactose and should not be given to patients with rare hereditary problems of galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption Powder for oral suspension contains sucrose and should not be used in patients with hereditary fructose, glucose/galactose malabsorption or sucrase-isomaltase deficiency Syrup contains glycerol; may cause headache, stomach upset, and diarrhea Hepatotoxicity reported with use; use with caution in patients with hepatic impairment Rare exfoliative skin disorders reported; monitor closely if rash develops and discontinue if it progresses When driving vehicles or operating machines, it should be taken into account that dizziness or seizures may occasionally occur Candida krusei is inherently resistant Convenience and efficacy of single dose oral tablet of fluconazole regimen for the treatment of vaginal yeast infections should be weighed against acceptability of higher incidence of drug related adverse events with fluconazole (26%) versus intravaginal agents (16%) If drug is used during pregnancy or if patient becomes pregnant while taking the drug, patient should be informed of potential hazard to fetus; effective contraceptive measures should be considered in women of child-bearing potential who are being treated with 400 to 800 mg/day and should continue throughout the treatment period and for approximately 1 week (5 to 6 half-lives) after the final dose Highly selective inhibitor of fungal cytochrome P-450-dependent enzyme lanosterol 14-alpha-demethylase Subsequent loss of normal sterols correlates with accumulation of 14 alpha-methyl sterols in fungi and may be responsible for the fungistatic activity of fluconazole Additive: TMP-SMX Y-site: Amphotericin B, amphotericin B cholesteryl sulfate, ampicillin, calcium gluconate, cefotaxime, ceftazidime(? ), ceftriaxone, cefuroxime, chloramphenicol, clindamycin, co-trimoxazole, diazepam, digoxin, erythromycin lactobionate, furosemide, haloperidol, hydroxyzine, imipenem/cilastatin, pentamidine, piperacillin, ticarcillin, TMP-SMX Solution: D5W, LR Additive: Acyclovir, amikacin, amphotericin B, cefazolin, ceftazidime, ciprofloxacin, clindamycin, gentamicin, heparin, meropenem, metronidazole, morphine, piperacillin, potassium chloride, ranitidine with ondansetron, theophylline Y-site: Acyclovir, aldesleukin, allopurinol, amifostine, amikacin, aminophylline, amiodarone, ampicillin-sulbactam, aztreonam, benztropine, bivalirudin, cefazolin, cefepime, cefotetan, cefoxitin, cefpirome, chlorpromazine, cimetidine, cisatracurium, dexamethasone sodium phosphate, dexmedetomidine, diltiazem, diphenhydramine, dobutamine, docetaxel, dopamine, doxorubicin liposomal, droperidol, etoposide PO4, famotidine, fenoldopam, filgrastim, fludarabine, foscarnet, ganciclovir, gatifloxacin, gemcitabine, gentamicin, granisetron, heparin, hetastarch, hydrocortisone, immune globulin, leucovorin, linezolid, lorazepam, melphalan, meperidine, meropenem, metoclopramide, metronidazole, midazolam, morphine, nafcillin, nitroglycerin, ondansetron, oxacillin, paclitaxel, pancuronium, penicillin G, phenytoin, piperacillin-tazobactam, prochlorperazine, promethazine, propofol, quinupristin-dalfopristin, ranitidine, remifentanil, sargramostim, tacrolimus, teniposide, theophylline, thiotepa, ticarcillin-clavulanate, tobramycin, vancomycin, vecuronium, vinorelbine, zidovudine Tablets: Store below 86° F (30° C) Dry powder: Store below 86° F (30° C); reconstituted suspension should be stored between 86° F (30° C) and 41° F (5° C), and unused portion should be discarded after 2 weeks; protect from freezing Injection (glass bottles): Store between 86° F (30° C) and 41° F (5° C); protect from freezing Injection (Viaflex Plus plastic containers): Store between 77° F (25° C) and 41° F (5° C); protect from freezing The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information. uses cookies to improve performance by remembering your session ID when you navigate from page to page. Please set your browser to accept cookies to continue. This cookie stores just a session ID; no other information is captured. Accepting the NEJM cookie is necessary to use the website.

    Fluconazole pharmacology

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    SPRING 2007 THE SOUTHERN AFRICAN JOURNAL OF HIV MEDICINE These guidelines do not provide guidance for the management Fluconazole is a white crystalline solid which is slightly soluble in water and saline. Fluconazole Injection, USP is an iso-osmotic, sterile, nonpyrogenic solution of fluconazole in The potential breakpoints for fluconazole against Cryptococcus neoformans. by an Medical Research Council MRC Fellowship in Clinical Pharmacology.

     
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    Adverse reactions experienced in higher than recommended doses were similar to those seen at normal doses. In the event of overdosage, general symptomatic and supportive measures are indicated as required. [see Microbiology] Azithromycin concentrates in phagocytes and fibroblasts as demonstrated by in vitro incubation techniques. Using such methodology, the ratio of intracellular to extracellular concentration was 30 after one hr of incubation. In vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues. The principal pharmacokinetic/pharmacodynamic parameter best associated with clinical and microbiological cure has not been elucidated in clinical trials with azithromycin. Based on animal models of infection, the antibacterial activity of azithromycin appears to correlate with the ratio of area under the concentration-time curve to minimum inhibitory concentration (AUC/MIC) for certain pathogens (S. Cardiac Electrophysiology QTc interval prolongation was studied in a randomized, placebo-controlled parallel trial in 116 healthy subjects who received either chloroquine (1000 mg) alone or in combination with oral azithromycin (500 mg, 1000 mg, and 1500 mg once daily). Coadministration of azithromycin increased the QTc interval in a dose- and concentration- dependent manner. In comparison to chloroquine alone, the maximum mean (95% upper confidence bound) increases in QTc F were 5 (10) ms, 7 (12) ms and 9 (14) ms with the co-administration of 500 mg, 1000 mg and 1500 mg azithromycin, respectively. Azithromycin 500mg Tablets - Summary of Product Azithromycin 3 Day Dose Pack, Azithromycin 5 Day Dose Azithromycin - Instruction, Prescriptions, Dosage, Side
     
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