主條目:化學療法
由於真菌和人類一樣是真核生物,所以比起原核生物的細菌較難找出有選擇性的藥品。
分類[]
影響細胞膜通透性[]
undecylenic acid十一烯酸[]
- undecylenic acid(十一烯酸): infection of dermatophytes, fungistatic
多烯類抗生素[]
- hexaene:nystatin:太毒以至於不全身性使用,但是由於口服吸收差所以可以治療口腔或是胃腸道黴菌
- heptaene
- Amphotericin B: fungicidal. treats candida 不通過BBB, 所以如果要治療中樞神經感染則必須intrathecal inj. 有liposome的劑型
- Candicidin
- hamycin
- trichomycin
- tetraene:natamycin: 5% suspension applied topically for eye infection
ergosterol biosynthesis inhibitors[]
azole類抗黴菌藥[]
- imidazole antifungal agents
- ketoconazole: candidiasis
- econazole
- miconazole
- clotrimazole→flutrimazole
- tioconazole
- butoconazole
- sulconazole
- fenticonazole
- isoconazole
- sertaconazole
- croconazole→neticonazole
- oxiconazole
- lanzoconazole
- omoconazole
- chlormidazole
- triazole antifungal agents
- itraconazole
- terconazole: treat vaginal candidiasis, local use only
- fluconazole: pass BBB and against Cryptococcus neoformans
- voriconazole: pass BBB and against Aspergillus, fluconazole-resistant Candida and Cryptococcus orally
- posaconazole: against Aspergillus and other increasingly common nosocomial infections resistant to other antifungal drugs
squalene epoxidase inhibitors[]
- allyl amines
- naftifine: treat tinea infection of the skin topically
- terbinafine: treat dermatophytoses, especially onychomycoses orally or topically
- others: 廣義的allyl amines
- butenafine:benzyl is bio-isosteric with allyl, treat tinea infection of the skin topically and superficial Candida albicans infection
- tolnaftate:thiocarbamate, treat tinea infection of the skin topically
morpholines[]
- amorolfine: topical treatment of dermatophytic infection
抑制細胞壁的生合成[]
- echinocandins :treat resistant Candida species, azole-resistant Aspergillus but Cryptococcus neoformans
- Caspofungin
- anidulafungin
- micafungin
擾亂核酸的代謝[]
- flucytosine:因fluconazole而被取代, treat Candida and Cryptococcus neoformans
- Griseofulvin(灰黴素): fungistatic, superficial fungal infection. oral or topical. 脂溶性,所以要做成水溶液必須做成O/W乳劑。也因為溶解度不好所以吸收時不好吸收,但是如果和油脂性食物一起食用則因為油脂刺激膽汁(界面活性劑的功能)的分泌所以可以使Griseofalvin濕潤而增加吸收 (但是減小吸收速率)。減小其顆粒大小也可以增加吸收。灰黴素Griseofulvin和phenytoin在玉米油懸浮液中口服也可以刺激膽汁分泌而增加吸收。
機轉不明[]
- haloprogin:topical use only
多價離子螯合劑[]
- ciclopirox: superficial dermatophytic infection, principally onychomycosis
其他[]
- Benzoic acid(苯甲酸)(安息香酸):和salicylic acid製成Whitfield's ointment治療香港腳 Tyler
- Methylparaban:對黴菌有很好的效果(8807國考考過了)
- Chlorobutanol(氯丁醇):對抗細菌和黴菌
- phenylmercuric salt(苯汞鹽)為有機汞化合物,包含兩種:phenylmercuric acetate(醋酸苯汞)和phenylmercuric nitrate(硝酸苯汞):對抗細菌和黴菌
- thimersal(硫柳汞):為有機汞化合物,對抗細菌和黴菌
- silver sulfadiazine治療燒傷也可以抗黴菌:Candida albicans(白色念珠菌
重點[]
疾病[]
甲黴菌病(onychomycosis),又稱甲癬(tinea unguium),俗稱灰指甲
systematic use[]
- imidazole antifungal agents
- triazole antifungal agents
- itraconazole
- fluconazole: pass BBB and against Cryptococcus neoformans
- voriconazole: pass BBB and against Aspergillus, fluconazole-resistant Candida and Cryptococcus
- posaconazole: against Aspergillus and other increasingly common nosocomial infections resistant to other antifungal drugs
local use[]
- imidazole antifungal agents
- ketoconazole
- econazole
- miconazole
- clotrimazole→
- tioconazole
- butoconazole
- sulconazole
- oxiconazole
- triazole antifungal agents
- terconazole: treat vaginal candidiasis, local use only
- imidazole antifungal agents
治療學[]
- 一般的藥可以治療 Candida species,強一些的藥可以治療Cryptococcus neoformans
,Aspergillus,像是azole類抗黴菌藥.但是echinocandins :treat resistant Candida species, azole-resistant Aspergillus but Cryptococcus neoformans
- allyl amines治療皮膚黴菌感染
- 2016NEJS臨床藥學 IDSA 2016最新版麴菌病治療指引 (IDSA PRACTICE GUIDELINES FOR THE DIAGNOSIS AND MANAGEMENT OF ASPERGILLOSIS 2016)
延伸學習[]
- Chemotherapy(化學療法
國考不會考(中文維基百科20151215)[]
黃葉病(又名萎蔫病、巴拿馬病)是出現在香蕉根部的植物病。黃葉病由Fusarium oxysporum f.sp. cubense尖孢鐮刀菌古巴專化型引起。尖孢鐮刀菌透過分泌毒素,引發香蕉出現細胞程序性死亡。此真菌對殺真菌劑有抵抗力,至今無藥可治。黃葉病又被稱為「香蕉癌症」,在2009年曾因此名稱在中國傳出香蕉致癌的傳言,各地的香蕉價格慘跌。
2019超級細菌耳念珠真菌[]
主條目:模板:抗藥性歷史
一些科學家認為,殺真菌劑在農業領域被濫用也是造成影響人類生命安全的抗藥真菌「蓬勃發展」的其中一個主因。此次的爆發通常對一至三種抗黴菌藥有抗藥性。(2019 年 04 月 08 日 13:30耳念珠菌全球蔓延,美國 587 病例近半 90 天內不治 )
2019-04-08致死數恐超越癌症 超級細菌耳念珠菌擴散:應該是超級細菌耳念珠真菌