Ketoconazole

Description overdue on 16.05.2012

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Antifungals   It affects yeasts, dermatophytes , Eumitsety, dimorphic fungi, as well as streptococci and staphylococci. The principle is based on the impact of violations of the permeability of the cell wall, inhibiting the process of synthesizing enzyme ergosterol   in the membrane of the fungus. The drug does not affect the Zygomycetes, the causative agent of aspergillosis. Under the influence of the drug ketoconazole reduces education androgens . Ketoconazole is available as tablets and capsules.

Indications:

Ketoconazole prescribed for fungal infections of the digestive system, reproductive organs, eyes, recurrent course vaginal candidiasis When ringworm, trihofitii, systemic fungal infections, thrush, onychomycosis, folliculitis, histoplasmosis, cryptococcosis, kotsidioidoze, paracoccidioidomycosis, candidiasis, blastomycosis, chromomycosis, fungal pneumonia , Fungal sepsis, paronychia, sporotrichosis, leishmaniasis, with pityriasis versicolor . The drug is prescribed for hirsutism , Kashin-Beck's syndrome, prostate cancer, for preventing fungal infections.

Contraindications:

Ketoconazole is not used during pregnancy, hypersensitivity, breastfeeding. When alcoholism, hypochlorhydria, achlorhydria, taking hepatotoxic drugs a drug used with caution.

Side effect:

Digestive system : Toxic hepatitis, diarrhea syndrome, constipation , Nausea, dyspepsia , Decreased appetite, vomiting, hypercreatininemia.   Nervous system:   paresthesia , Increased drowsiness, headache, dizziness. Urogenital:   impotence, oligospermia, gynecomastia, azoospermia, dysmenorrhea , Decreased libido in males. Bodies of blood:   hemolytic anemia, thrombocytopenia, leukopenia. Perhaps the development of allergic reactions in the form of photophobia, rash, skin rash, lihoralki, urticaria. Rarely observed alopecia.

Mode of application:

Capsules and tablets ketoconazole taken during meals, by mouth. Multicolored versicolor, ringworm: 1-8 weeks for daily 200-400mg. Onychomycosis: 3-12 months of 200-400mg daily to the normalization of laboratory data, a full recovery. Systemic mycoses: 2 weeks 200-40 mg per day, followed by 4-6 weeks of 200 mg. Vulvovaginal candidiasis: 3-5 days 200-400 mg daily. Paronychia: 200-400 mg per day. Fungal pneumonia, sepsis: 400-1000mg day. Kashin-Beck Syndrome: 600-1200 mg per day. In systemic mycosis duration of therapy is 6 months, in some cases longer.

Special instructions:

During antifungal therapy requires regular monitoring of the state of renal, hepatic systems, peripheral blood. If therapy is skin fungal disease begins with glucocorticoids, ketoconazole is used only two weeks after the cancellation of glucocorticoids. Patients with hypochlorhydria , Achlorhydria drug may be ineffective because of reduced absorption of the main substance. By drinking acidic drinks increases the absorption of the drug.

Drug Interactions:

Hepatotoxic drugs, ethanol increases the likelihood of damage to the liver parenchyma. Acceptance of alcoholic beverages can trigger the development of disulfiramopodobnyh reactions. Ketoconazole increases the likelihood of hypoglycemia It increases the level of sulfonylurea derivatives. Isoniazid . rifampicin   lower content of the drug in the blood. Ketoconazole weakens the effectiveness of amphotericin B. The drug increases the concentration of methylprednisolone, anticoagulants , Cyclosporine, triamzolama, midazolam, digoxin. Ketoconazole reduces the stimulating effect on the adrenal corticotropin, increases the bioavailability of the drug indinavir. In combination with astemizole, terdenadinom, cisapride increases the risk of severe Ventricular tachycardia   like "feast." In appointing oral contraceptives   increases the likelihood of bleeding "breakthrough". The drug increases the toxicity of phenytoin. Anticholinergic drugs, antacids, H2-blockers of histamine receptors reduce the acidity of gastric juice, which reduces the absorption of the ketoconazole.