Antifungals: Drug Class, Mechanisms of Action, Pharmacokinetics/Pharmacodynamics, Drug-Drug Interactions, Toxicity, and Clinical Use

摘要: Antifungal therapeutic outcomes have been historically suboptimal, in part, due to a relatively small number of safe and effective antifungal drugs. There are many important characteristics drugs consider treatment invasive fungal infection. Among these traits, spectrum activity, pharmacokinetics, pharmacodynamics, potential drug-drug interactions, toxicities the most critical. This chapter focuses on traits for available systemic agents Candida The main include renal damage, electrolyte abnormalities from toxicity, hepato-toxicity, infusion-related reactions. majority interactions related potentiation disturbances dysfunction typical amphotericin B. For example, risk toxicity is increased if B used concomitantly with organ transplant immuno-suppressants cyclosporine tacrolimus. In addition, lipid-based formulations preferred pregnant patients gestational triazole drug class. Studies found primary flucytosine, bone marrow be associated high peak concentrations. fact that pharmacodynamic drivers success different provides an opportunity design dosing strategies both optimize efficacy reduce toxicity. major flucytosine suppression hepato-toxicity. route elimination echinocandins non-enzymatic degradation inactive molecules which excreted primarily bile.