Tags: Voriconazole

Invasive Pulmonary Aspergillosis

Invasive pulmonary aspergillosis in the immunocompromised host is among the most serious manifestations of disease caused by Aspergillus spp. Key risk factors for invasive aspergillosis include neutropenia, especially profound neutropenia (< 100 neutrophils/mL) and prolonged neutropenia (> 12 days); prolonged high-dose corticosteroid therapy, graft-versus-host disease after bone marrow transplantation, acute rejection after solid-organ transplantation, cytomegalovirus disease after transplantation, advanced AIDS, and poorly controlled diabetes mellitus. On very rare occasions, invasive pulmonary aspergillosis may occur in previously healthy adults or in patients with alcoholic liver disease. Chronic necrotizing aspergillosis is an indolent form of invasive pulmonary aspergillosis that occurs in patients who are less profoundly immunosuppressed than those with the risk factors …

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Buy Diflucan (Fluconazole) No Prescription 50/100/150/200mg

Fluconazole [US: Diflucan 50mg, 100mg, 150mg, 200mg] (British Approved Name, US Adopted Name, rINN) Drug Nomenclature Synonyms: Fluconazol; Fluconazolum; Flukonatsoli; Flukonazol; UK-49858 BAN: Fluconazole USAN: Fluconazole INN: Fluconazole [rINN (en)] INN: Fluconazol [rINN (es)] INN: Fluconazole [rINN (fr)] INN: Fluconazolum [rINN (la)] INN: Флуконазол [rINN (ru)] Chemical name: 2-(2,4-Difluorophenyl)-1,3-bis(1H-1,2,4-triazol-1-yl)propan-2-ol Molecular formula: C13H12F2N6O =306.3 CAS: 86386-73-4 ATC code: D01AC15; J02AC01 Read code: y02Ug Pharmacopoeias. In China, Europe, and US. European Pharmacopoeia, 6th ed. (Fluconazole). A white or almost white, hygroscopic, crystalline powder. It exhibits polymorphism. Slightly soluble in water freely soluble in methyl alcohol soluble in acetone. Store in airtight containers. The United States Pharmacopeia 31, 2008, and Supplements 1 and 2 …

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Candidiasis

Description of Medical Condition Candida albicans and related species cause a variety of infections. Cutaneous candidiasis syndromes include erosio interdigitalis blastomycetica, folliculitis, balanitis, intertrigo paronychia, onychomycosis, diaper rash, perianal candidiasis, and the syndromes of chronic mucocutaneous candidiasis. Mucous membrane infections include oral candidiasis (thrush), esophagitis, and vaginitis. The most serious manifestation of candidiasis is hematogenously disseminated invasive candidiasis (sometimes referred to as acute systemic candidiasis). System(s) affected: Skin/Exocrine, Gastrointestinal, Reproductive, Pulmonary, Renal/Urologic Genetics: N/A Incidence/Prevalence in USA: Approximately 50/100,000. Hematogenously disseminated candidiasis affects at least 120,000 patients annually in the USA. Predominant age: All ages are susceptible to hematogenously disseminated candidiasis. Premature neonates are at particularly high risk. Predominant sex: Male …

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Aspergillosis

Description of Medical Condition Disease caused by a ubiquitous mold that primarily involves the lungs. Disease frequently lethal in neutropenic and bone marrow transplant (BMT) patients. Syndromes include: • Allergic aspergillosis – Extrinsic allergic alveolitis — hypersensitivity pneumonitis in individuals repeatedly exposed to the fungus – Allergic bronchopulmonary aspergillosis (ABPA) • pulmonary infiltrates, mucous plugging; secondary to allergic reaction to fungus • Aspergillomas: “fungus ball” saprophytic colonization within pre-existing pulmonary cavities • Invasive aspergillosis: most common and severe in BMT and neutropenic patients. Also occurs with increased frequency in other immunocompromised persons, such as those with AIDS, solid organ transplant or high dose corticosteroids; commonly fatal. System(s) affected: Pulmonary, Nervous, Gastrointestinal, …

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Intestinal Helminths

Potential Severity Infections are often asymptomatic. In the immuno-compromised host, Strongyloides can progress to a fatal hyperinfection syndrome. Helminths include the roundworms (nematodes), flukes (trematodes), and tapeworms (cestodes). These parasites are large, ranging in size from 1 cm to 10 m, and they often live in the human gastrointestinal tract without causing symptoms. Only when the infection is very heavy or the worm migrates to an extraintesti-nal site do patients seek medical attention. Transmission to humans results in most cases from contact with human waste. The diagnosis is generally made by examining the stool for eggs, larvae, or adult worms. Intestinal Nematodes (Roundworms) Nematodes can be classified into two groups. Those …

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Antifungal Agents

Fungi are eukaryotes, and they share many of the structural and metabolic characteristics of human cells. As a result, designing agents that affect fungi without harming human cells has proved difficult. One major difference between the two cell types is the primary sterol building block used to form the plasma membrane. The fungal plasma membrane consists of ergosterols; the major sterol component of the human plasma membrane is cholesterol. This difference has been exploited in the development of two classes of drugs. The polyenes act by binding to ergosterol and disrupting the fungal membrane. These agents are fungicidal. The azoles inhibit ergosterol synthesis, and lowered ergosterol levels results in fungal membrane …

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Fungal Infections, Invasive

Systemic mycoses, such as histoplasmosis, coccidioidomycosis, cryptococcosis, blastomycosis, paracoccidioidomycosis, and sporotrichosis, are caused by primary or «pathogenic» fungi that can cause disease in both healthy and immunocompromised individuals. In contrast, mycoses caused by opportunistic fungi such as Candida albicans, Aspergillus spp., Trichosporon, Torulopsis (Candida) glabrata, Fusarium, Alternaria, and Mucor are generally found only in the immunocompromised host. Advances in medical technology, including organ and bone marrow transplantation, cytotoxic chemotherapy, the widespread use of indwelling intravenous (intravenous) catheters, and the increased use of potent, broad-spectrum antimicrobial agents, have all contributed to the dramatic increase in the incidence of fungal infections worldwide. Specific fungal infections Candida infections Eight species of Candida are regarded …

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Antimicrobial Regimen Selection

Introduction A generally accepted systematic approach to the selection and evaluation of an antimicrobial regimen is shown in Table Systematic Approach for Selection of Antimicrobials. An «empiric» antimicrobial regimen is begun before the offending organism is identified, while a «definitive» regimen is instituted when the causative organism is known. Confirming the presence of infection Fever Fever is defined as a controlled elevation of body temperature above the normal range of 36.7 to 37.0В°C. Fever is a manifestation of many disease states other than infection. Many drugs have been identified as causes of fever. Drug-induced fever is defined as persistent fever in the absence of infection or other underlying condition. The fever …

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Voriconazole

C16H14F3N5O • Voriconazole is a synthetic triazole antifungal antibiotic. Uses • Aspergillosis Voriconazole is used for the treatment of invasive aspergillosis. Efficacy has been demonstrated in clinical studies in patients for primary therapy of invasive aspergillosis, for primary and salvage therapy of invasive aspergillosis, and for treatment of invasive aspergillosis in patients whose disease was refractory to, or who were intolerant of, other antifungal therapy. Aspergillus fumigatus was the most frequent isolate in patients with aspergillosis participating in clinical trials with the drug. Efficacy of voriconazole as primary or salvage therapy for invasive aspergillosis was evaluated in an open-label, noncomparative study in 116 patients 18-79 years of age with definite or …

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Voriconazole: Drug Interactions

• Drugs Affecting Hepatic Microsomal Enzymes Inhibitors or inducers of cytochrome P-450 (CYP) isoenzymes 2C19, 2C9, or 3A4 may increase or decrease plasma voriconazole concentrations, respectively. Voriconazole and its major metabolite inhibit the metabolic activity of CYP isoenzymes 2C19, 2C9, and 3A4 and may increase plasma concentrations of other drugs metabolized by these hepatic enzymes. • Rifampin and Rifabutin Potential pharmacokinetic interaction (decrease in plasma voriconazole concentrations and/or increase in plasma rifabutin concentrations). Concomitant use of rifampin or rifabutin with voriconazole is contraindicated. • Drugs that Prolong the QT Interval Potential pharmacokinetic interaction with CYP3A4 substrates that prolong the QT interval (e.g., terfenadine [no longer commercially available in the US], astemizole …

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