Azoles

Clasificación

Los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles son un grupo de medicamentos antimicóticos ampliamente utilizados, que se pueden clasificar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum dos subgrupos:

• Imidazoles Imidazoles Compounds containing 1, 3-diazole, a five membered aromatic ring containing two nitrogen atoms separated by one of the carbons. Chemically reduced ones include imidazolines and imidazolidines. Distinguish from 1, 2-diazole (pyrazoles). Azoles:
  • Ketoconazol (rara vez se usa sistémicamente debido a su mayor toxicidad/menor eficacia que los LOS Neisseria triazoles)
  • Miconazol (solo tópico)
  • Clotrimazol (solo tópico)
• Triazoles:
  • Fluconazol
  • Itraconazol
  • Voriconazol
  • Posaconazol
  • Isavuconazol

Estructura Química y Farmacodinamia

Estructura química

• Todos los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles contienen un anillo de azol que contiene nitrógeno de 5 miembros.
• Los LOS Neisseria imidazoles Imidazoles Compounds containing 1, 3-diazole, a five membered aromatic ring containing two nitrogen atoms separated by one of the carbons. Chemically reduced ones include imidazolines and imidazolidines. Distinguish from 1, 2-diazole (pyrazoles). Azoles tienen 2 átomos de nitrógeno en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el anillo de azol.
• Los LOS Neisseria triazoles tienen 3 átomos de nitrógeno en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el anillo de azol.

Mecanismo de acción

Los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles causan el deterioro de la membrana celular fúngica al AL Amyloidosis inhibir la producción de ergosterol Ergosterol A steroid occurring in fungi. Irradiation with ultraviolet rays results in formation of ergocalciferol (vitamin d2). Azoles.

• Ergosterol Ergosterol A steroid occurring in fungi. Irradiation with ultraviolet rays results in formation of ergocalciferol (vitamin d2). Azoles:
  • Un componente crítico de las membranas celulares fúngicas (el equivalente al AL Amyloidosis colesterol en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las membranas celulares humanas)
  • Sintetizado por la lanosterol Lanosterol A triterpene that derives from the chair-boat-chair-boat folding of 2, 3-oxidosqualene. It is metabolized to cholesterol and cucurbitacins. Cholesterol Metabolism 14-α-desmetilasa , una enzima fúngica CYP450 que convierte el lanosterol Lanosterol A triterpene that derives from the chair-boat-chair-boat folding of 2, 3-oxidosqualene. It is metabolized to cholesterol and cucurbitacins. Cholesterol Metabolism en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ergosterol Ergosterol A steroid occurring in fungi. Irradiation with ultraviolet rays results in formation of ergocalciferol (vitamin d2). Azoles:
    • Los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles tienen una mayor afinidad por las enzimas fúngicas que las enzimas humanas.
    • Los LOS Neisseria triazoles tienen una mejor afinidad selectiva por las enzimas fúngicas que los LOS Neisseria imidazoles Imidazoles Compounds containing 1, 3-diazole, a five membered aromatic ring containing two nitrogen atoms separated by one of the carbons. Chemically reduced ones include imidazolines and imidazolidines. Distinguish from 1, 2-diazole (pyrazoles). Azoles.
• Los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles inhiben la lanosterol Lanosterol A triterpene that derives from the chair-boat-chair-boat folding of 2, 3-oxidosqualene. It is metabolized to cholesterol and cucurbitacins. Cholesterol Metabolism 14-α-desmetilasa → inhibe la producción de ergosterol Ergosterol A steroid occurring in fungi. Irradiation with ultraviolet rays results in formation of ergocalciferol (vitamin d2). Azoles
• Sin nueva producción de ergosterol Ergosterol A steroid occurring in fungi. Irradiation with ultraviolet rays results in formation of ergocalciferol (vitamin d2). Azoles:
  • Los LOS Neisseria hongos no pueden mantener la membrana celular ni crear nuevas membranas.
  • ↑ Permeabilidad de la membrana celular fúngica → lisis celular
• Los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles generalmente se consideran fungistáticos.

Farmacocinética

Los LOS Neisseria diferentes azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles tienen una farmacocinética variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables (y a veces compleja).

Absorción

• Buena absorción oral:
  • Fluconazol
  • Voriconazol
  • Posaconazol
• Absorción variable Variable Variables represent information about something that can change. The design of the measurement scales, or of the methods for obtaining information, will determine the data gathered and the characteristics of that data. As a result, a variable can be qualitative or quantitative, and may be further classified into subgroups. Types of Variables:
  • Itraconazol
  • Ketoconazol

Distribución

• Altos volúmenes de distribución → los LOS Neisseria medicamentos se acumulan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria tejidos de todo el cuerpo
• Todos están ampliamente distribuidos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria tejidos (con LCR y orina como excepciones notables).
• Medicamentos que se acumulan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la orina y el LCR:
  • Orina: fluconazol (debido a la excreción significativa como medicamento inalterado)
  • LCR: fluconazol, voriconazol
• Los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles son teratogénicos para el feto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum desarrollo y los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles sistémicos generalmente están contraindicados durante el embarazo.

Indicaciones

Los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles tienen una amplia variedad de usos e indicaciones únicas para cada medicamento.

Imidazoles Imidazoles Compounds containing 1, 3-diazole, a five membered aromatic ring containing two nitrogen atoms separated by one of the carbons. Chemically reduced ones include imidazolines and imidazolidines. Distinguish from 1, 2-diazole (pyrazoles). Azoles

• Clotrimazol (Lotrimin^®) (solo para uso tópico):
  • Candidiasis Candidiasis Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis (incluida la candidiasis Candidiasis Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis vaginal) debida a Cándida albicans
  • Tinea pedis Tinea pedis Dermatological pruritic lesion in the feet, caused by Trichophyton rubrum, T. mentagrophytes, or Epidermophyton floccosum. Dermatophytes/Tinea Infections (pie de atleta)
  • Tinea cruris Tinea cruris Fungal infection of the groin. The main causative fungus is Trichophyton. Dermatophytes/Tinea Infections (prurito inguinal): generalmente afecta la ingle
  • Tinea corporis Tinea corporis Dermatophytes/Tinea Infections (tiña): en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum cualquier parte del cuerpo
• Miconazol (Monistat^®) (solo uso tópico): candidiasis Candidiasis Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis vaginal
• Ketoconazol:
  • Usar solo cuando ambos:
    • No se dispone de/no se tolera otra terapia antimicótica eficaz.
    • Los LOS Neisseria beneficios del uso superan los LOS Neisseria riesgos.
  • Uso potencial en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum infecciones fúngicas sistémicas:
    • Blastomicosis
    • Histoplasmosis Histoplasmosis Histoplasmosis is an infection caused by Histoplasma capsulatum, a dimorphic fungus. Transmission is through inhalation, and exposure to soils containing bird or bat droppings increases the risk of infection. Most infections are asymptomatic; however, immunocompromised individuals generally develop acute pulmonary infection, chronic infection, or even disseminated disease. Histoplasma/Histoplasmosis
    • coccidioidomicosis

Triazoles

Además de las indicaciones específicas enumeradas a continuación, la mayoría de los LOS Neisseria triazoles también se pueden usar como profilaxis contra infecciones fúngicas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum personas inmunodeprimidas.

• Fluconazol: buena actividad contra levaduras (p.ej., Cándida), sin actividad significativa contra mohos (p.ej., Aspergillus):
  • Candidiasis Candidiasis Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis de organismos susceptibles como C. albicans (C. krusei y C. glabrata son típicamente resistentes al AL Amyloidosis fluconazol):
    • Infecciones mucocutáneas (agente de 1ra línea): esofágicas, orofaríngeas y vaginales
    • Peritoneal
    • Infecciones del tracto urinario
    • Neumonía
    • Infecciones sistémicas (p.ej., candidemia)
  • Infecciones por criptococos:
    • Meningitis Meningitis Meningitis is inflammation of the meninges, the protective membranes of the brain, and spinal cord. The causes of meningitis are varied, with the most common being bacterial or viral infection. The classic presentation of meningitis is a triad of fever, altered mental status, and nuchal rigidity. Meningitis
    • Neumonía
  • Coccidioidomicosis
• Itraconazol: buena actividad contra hongos dimórficos (hongos que existen tanto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de moho como de levadura):
  • Blastomicosis:
    • Agente de primera línea para casos leves-moderados
    • Se utiliza en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum casos graves como terapia de reducción después de un curso de anfotericina B
  • Histoplasmosis Histoplasmosis Histoplasmosis is an infection caused by Histoplasma capsulatum, a dimorphic fungus. Transmission is through inhalation, and exposure to soils containing bird or bat droppings increases the risk of infection. Most infections are asymptomatic; however, immunocompromised individuals generally develop acute pulmonary infection, chronic infection, or even disseminated disease. Histoplasma/Histoplasmosis (agente de primera línea para casos leves-moderados)
  • Infecciones por Esporothrix
  • Onicomicosis
  • Candidiasis Candidiasis Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis
• Voriconazol: eficacia similar a itraconazol frente a hongos dimórficos:
  • Aspergilosis (agente de primera línea)
  • Infecciones por Candida Candida Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis (incluyendo infecciones debidas a especies resistentes a fluconazol):
    • Candidiasis Candidiasis Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis mucocutánea
    • Candidemia
    • Infecciones diseminadas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el corazón, abdomen, riñón, vejiga y heridas
  • Infecciones graves causadas por:
    • Scedosporium spp.
    • Fusarium spp.
• Posaconazol e isavuconazol: espectro más amplio de azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles:
  • Candidiasis Candidiasis Candida is a genus of dimorphic, opportunistic fungi. Candida albicans is part of the normal human flora and is the most common cause of candidiasis. The clinical presentation varies and can include localized mucocutaneous infections (e.g., oropharyngeal, esophageal, intertriginous, and vulvovaginal candidiasis) and invasive disease (e.g., candidemia, intraabdominal abscess, pericarditis, and meningitis). Candida/Candidiasis (incluyendo cepas resistentes a fluconazol)
  • Aspergilosis (agente de segunda línea)
  • Mucormicosis

Efectos Secundarios y Contraindicaciones

Efectos secundarios

• Molestias gastrointestinales: náuseas, vómitos y/o diarrea.
• Síntomas dermatológicos:
  • Fotosensibilidad
  • Sarpullido
  • Alopecia Alopecia Alopecia is the loss of hair in areas anywhere on the body where hair normally grows. Alopecia may be defined as scarring or non-scarring, localized or diffuse, congenital or acquired, reversible or permanent, or confined to the scalp or universal; however, alopecia is usually classified using the 1st 3 factors. Alopecia
• Hepatotoxicidad:
  • Posible con todos los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles
  • Va VA Ventilation: Mechanics of Breathing desde leve ↑ en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum transaminasas (aproximadamente 5-10% de los LOS Neisseria individuos) hasta hepatitis/insuficiencia hepática fulminante
• Ketoconazol:
  • Insuficiencia suprarrenal: hipertensión, hipopotasemia y alcalosis
  • Los LOS Neisseria peores síntomas gastrointestinales y hepatotoxicidad de todos los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles
• Itraconazol:
  • Hipopotasemia
  • Insuficiencia cardíaca
• Voriconazol:
  • Cambios en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la visión:
    • Puede incluir visión anormal, destellos de luz, fotofobia y/o cambios de color
    • Por lo general, comienza dentro de los LOS Neisseria 30 minutos posteriores a la administración y dura de 30 a 60 minutos.
    • Visto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 20%–30% de los LOS Neisseria pacientes
  • Neurotoxicidad:
    • Alucinaciones visuales
    • Confusión y/o agitación
    • Movimientos mioclónicos
    • Neuropatía desmielinizante en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las extremidades inferiores (extremadamente rara, típicamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes que también toman tacrolimus Tacrolimus A macrolide isolated from the culture broth of a strain of streptomyces tsukubaensis that has strong immunosuppressive activity in vivo and prevents the activation of T-lymphocytes in response to antigenic or mitogenic stimulation in vitro. Immunosuppressants)
  • Prolongación del QT
  • Fotosensibilidad
  • Periostitis Periostitis Inflammation of the periosteum. The condition is generally chronic, and is marked by tenderness and swelling of the bone and an aching pain. Acute periostitis is due to infection, is characterized by diffuse suppuration, severe pain, and constitutional symptoms, and usually results in necrosis. Reactive Arthritis (inflamación del periostio (el tejido conectivo alrededor del hueso))
• Posaconazol e isavuconazol: generalmente menos efectos secundarios y mejor tolerados que voriconazol

Contraindicaciones

• Hipersensibilidad a los LOS Neisseria medicamentos azólicos
• Enfermedad hepática
• Administración conjunta de medicamentos que afectan las enzimas CYP relevantes:
  • Debido a que existen numerosas interacciones de medicamento a medicamento para los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles, evalúe cuidadosamente los LOS Neisseria medicamentos para evitar la toxicidad o la infra dosificación.
  • Un problema común para las personas inmunodeprimidas (a menudo con muchos medicamentos y con mayor riesgo de infecciones fúngicas)
• Insuficiencia cardíaca (itraconazol)
• Arritmias (voriconazol y ketoconazol)
• Insuficiencia suprarrenal (voriconazol y ketoconazol)
• Embarazo

Vigilancia

• Las concentraciones séricas de los LOS Neisseria azoles Azoles Azoles are a widely used class of antifungal medications inhibiting the production of ergosterol, a critical component in the fungal cell membrane. The 2 primary subclasses of azoles are the imidazoles, older agents typically only used for topical applications, and the triazoles, newer agents with a wide spectrum of uses. Azoles se controlan con frecuencia (recomendado para itraconazol, voriconazol y posaconazol)
• Transaminasas (especialmente voriconazol y ketoconazol)
• Función suprarrenal

Mecanismos de Resistencia

Los LOS Neisseria mecanismos comunes que contribuyen a la resistencia antifúngica incluyen:

• Mutación del sitio objetivo del medicamento → ↓ afinidad del medicamento por la lanosterol Lanosterol A triterpene that derives from the chair-boat-chair-boat folding of 2, 3-oxidosqualene. It is metabolized to cholesterol and cucurbitacins. Cholesterol Metabolism 14-α-desmetilasa → ↓ inhibición
• ↑ Bombas de eflujo → menos medicamento dentro de la célula fúngica
• Absorción reducida del medicamento → menos medicamento dentro de la célula fúngica
• La enzima objetivo está sobre producida.

Comparación de Medicamentos Antimicóticos