Anti viral,Anti fungal, Anti helmintics drug.The latest classification

Anti viral, Anti fungal, Anti helmintics
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Anti viral, Anti fungal, Anti helmintics drug. Antiviral drugs are a class of medication used specifically for treating viral infections rather than bacterial ones. Most antivirals are used for specific viral infections, while a broad-spectrum antiviral is effective against a wide range of viruses. Unlike most antibiotics, antiviral drugs do not destroy their target pathogen; instead they inhibit their development.

Antiviral drugs are one class of antimicrobials, a larger group which also includes antibiotic (also termed antibacterial), antifungal and antiparasitic drugs, or antiviral drugs based on monoclonal antibodies. Most antivirals are considered relatively harmless to the host, and therefore can be used to treat infections. They should be distinguished from viricides, which are not medication but deactivate or destroy virus particles, either inside or outside the body. Natural antivirals are produced by some plants such as eucalyptus.

Anti-herpetic agents

Generic Brand Name
Acyclovir Zovirax, Sitavig
Brivudine Helpin
Docosanol Abreva
Famciclovir Famvir
Foscarnet Foscavir
Idoxuridine Herplex, Dendrid
Penciclovir Denavir
Trifluridine Viroptic
Valacyclovir Valtrex
Pritelivir Inhibitor of the viral helicase-primase enzyme complex, currently under investigation

Anti-influenza agents
Generic Brand Name
Adamantane Derivatives
Amantadine Symmetrel
Rimantadine Flumadine
Neuraminidase Inhibitors
Oseltamivir Tamiflu
Peramivir Rapivab
Zanamivir Relenza

Allylamines

Generic name Brand name
Amorolfin Locery® (nail lacquer)
Butenafine Lotrimin® Ultra (cream, spray), Mentax® (cream)
Naftifine Naftin® (cream, gel)
Terbinafine Lamisil® (cream, gel, spray, solution, oral granules, tablets)

Allylamines are synthetic antifungals with activity against a wide range of dermatophytes. Allylamines act via inhibition of the squalene epoxidase formation, which blocks the synthesis of ergosterol.

Allylamines (with the exception of terbinafine) are used as topical treatments. Oral terbinafine is extensively used for the treatment of onychomycosis (fungal infection of the nail). It acts at an earlier stage by inhibiting the formation of squalene epoxide, a precursor of lanosterol. Oral terbinafine is the first choice for treating infections of fingernails and toenails

Azoles

Generic name Brand name
Imidazoles
Bifonazole Canespor® (cream)
Butoconazole Femstat® 3 (vaginal cream), Gynazole® 1 (vaginal cream)
Clotrimazole Canesten ® (cream, solution), Clocreme® (cream), Cruex® (spray powder), Desenex® (cream) , Femcare® (vaginal), Fungoid® (solution), Gyne-Lotrimin® (cream), Gynix® (vaginal tablets), Lotrimin (cream), Mycelex® (solution, troches), Pedesil® (ointment), Trivagizole® (cream)
Econazole Ecoza® (foam), Spectazole® (cream)
Fenticonazole * Lomexin®, Gynoxin®
Ketoconazole Nizoral® (oral tablets, cream, shampoo), Extina® (foam), Ketodan (foam), Kuric® (cream), Xolegel® (gel)
Isoconazole* Icaden®, Travogen®
Luliconazole Luzu® (cream)
Miconazole Cavilon® (antifungal cream), Cruex® (spray), Desenex® (topical powder), Fungoid® (cream, tincture), Lotrimin® AF Athlete’s Foot Spray (deodorant powder, powder, liquid), Lotrimin® AF Athlete’s Foot powder, Lotrimin® AF Jock Itch spray powder, Micatin® (cream), Monistat® 1, Monistat® 3, Monistat® 7, Ting® (antifungal spray powder, spray liquid), Vagistat® 3, Zeasorb® AF (powder, lotion)
Omoconazole* Fongamil®
Oxiconazole Oxistat® (cream, lotion)
Sertaconazole Ertaczo® (cream)
Sulconazole Exelderm® (cream, solution)
Tioconazole Monistat® 1 Simple Therapy, Vagistat® 1
Terconazole Terazol® 3 (vaginal cream, vaginal suppositories), Terazol® 7 (vaginal cream), Terconazole® (vaginal cream, vaginal suppositories), Zazole® (vaginal cream, vaginal suppositories)
Triazoles
Albaconazole Under® investigation
Efinaconazole Jublia® (topical gel, solution)
Fluconazole Diflucan® (tablets, capsules, injection)
Isavuconazole Cresemba® (capsules, injection)
Itraconazole Sporanox® (capsules, oral solution, injection), Onmel® (tablets)
Posaconazole Noxafil® (tablets, oral suspension, injection)
Ravuconazole Under investigation
Terconazole Terazol® 3, Terazol® 7 (vaginal cream, vaginal suppositories)
Voriconazole Vfend® (oral suspension, injection)
Arylguanidines (Thiazoles)
Abafungin* Abasol® (cream, gel)
* Not available in U.S.
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Azoles (imidazole and triazole derivatives) are a large group of synthetic antifungal agents. Azoles are essentially fungistatic, and have a relatively broad antifungal spectrum. The azole antifungals have many drug-drug interactions because of their interference with cytochrome P-450 enzymes.

Imidazoles are considered first-line agents for most dermatophyte infections. Topical formulations are widely used for the treatment of superficial fungal infections and vaginal candidiasis. Imidazoles are very toxic when taken orally, so they are available only as topical formulations.

Triazoles are generally used for prophylaxis and treatment of invasive fungal infections and systemic mycosis.

Arylguanidines are a novel class of synthetic antifungal drugs.

Summary of the use of topical antifungals used in the treatment of tinea corporis, cruris and pedis

Polyenes

Generic name Brand name
Amphotericin B Fungilin® (lozenges, oral suspension)
Nystatin Nilstat® (oral drops, capsules, powder, tablets)
Natamycin (pimaricin)
Trichomycin (hachimycin)

The polyenes are naturally occurring compounds with a very broad antifungal spectrum. Polyenes act by binding to sterols in the fungal cell membrane, thereby interfering with membrane integrity and causing leakage of essential metabolites. Most polyenes are used topically, but intravenous amphotericin remains an important agent for the treatment of systemic fungal infections. The risk of nephrotoxicity limits the use of amphotericin B.

Echinocandins

Generic name Brand name
Anidulafungin Eraxisin® injection
Caspofungin Cancidas® injection
Micafungin Mycamine® injection

Echinocandins are the most recently developed class of antifungals. Echinocandins are used mainly for the treatment of severe, invasive Candida infections. Echinocandins are safer than other classes of antifungals and have a broad spectrum, and synergistic effect in combination therapy.

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Miscellaneous Antifungal Drugs

Generic name Brand name
Thiocarbamates
Tolnaftate Tinactin®, Aftate®, Breezee®, Ting®
Antimetabolites
Flucytosine
Benzylamines
Butenafine Mentax® (cream), Lotrimin® (cream)
Other antifungals
Griseofulvin Gris-PEG® (tablets), Grifulvin® V (tablets), Grisactin®
Ciclopirox Ciclodan® (cream, solution, topical suspension), Loprox® (cream), Penlac® (solution, nail lacquer), Loprox® (topical suspension, gel, shampoo)
Selenium sulfide Selsun®, Exsel®
Tavaborole Kerydin®

Anthelmintics

Anthelmintics are agents that destroy or expel parasitic worms (helminths). Interestingly, most anthelmintics were developed for use in veterinary medicine.

Generic Brand Name
Bephenium
Diethylcarbamazine
Ivermectin Sklice, Stromectol, Ivomec, Mectizan
Niclosamide Niclocide
Piperazine
Praziquantel Biltricide
Pyrantel Antiminth, Aut, Cobantril, Helmex, Lombriareu, Trilombrin
Pyrvinium Vanuin, Viprynium
Benzimidazoles
Albendazole Albenza
Flubendazole Fluvermal
Mebendazole Mebendacin, Mebutar, Nemazole, Vermox
Thiabendazole Foldan, Mintezol, Minzolum, Triasox

Scabicides & Pediculicides

Scabicides are agents that kill scabies mites and mite eggs.
Pediculicides are agents used to kill head lice.

Generic Brand Name
Benzyl benzoate Ascabiol
Benzyl benzoate/disulfiram Tenutex
Lindane GBH, G-Well, Kwellada, Kwildane, PMS Lindane
Malathion Derbac, Ovide
Permethrin Acticin, Elimite
Pediculicides (only for lice infestations)
Benzyl alcohol Ulesfia
Piperonyl butoxide/pyrethrins Pronto Lice Kill System
Spinosad Natroba
Scabicides (only for scabies infestations)
Crotamiton Eurax

References

  1. “A global view of hepatitis C: Physician knowledge, opinions, and perceived barriers to care”Hepatology57 (4): 1325–1332. doi:10.1002/hep.26246PMC 3683983Freely accessiblePMID 23315914.
  2.  “New Hepatitis C Drugs Are Very Costly And Unavailable To Many State Prisoners”Health Affairs35 (10): 1893–1901. doi:10.1377/hlthaff.2016.0296ISSN 0278-2715.
  3. Summary of Recommendations for Patients Who are Initiating Therapy for HCV Infection by HCV Genotype | Recommendations for Testing, Managing, and Treating Hepatitis C”www.hcvguidelines.org.
  4. Sofosbuvir and Velpatasvir (Lexi-Drugs)”online.lexi.com.
  5. “Ledipasvir and Sofosbuvir (Lexi-Drugs)”online.lexi.com.
  6. Hill, A.; Khoo, S.; Fortunak, J.; Simmons, B.; Ford, N. (6 January 2014). “Minimum Costs for Producing Hepatitis C Direct-Acting Antivirals for Use in Large-Scale Treatment Access Programs in Developing Countries”Clinical Infectious Diseases58 (7): 928–936. doi:10.1093/cid/ciu012PMC 3952605Freely accessiblePMID 24399087.
  7. Times, Los Angeles. “The FDA can single-handedly reduce drug price-gouging. Why is it waiting?”latimes.com.
  8. “21 USC CHAPTER 9, SUBCHAPTER VIII: IMPORTS AND EXPORTS . §381”uscode.house.gov.
  9. NIH-Industry Partnerships Frequently Asked Questions | National Center for Advancing Translational Sciences”National Center for Advancing Translational Sciences.
  10. Center for Disease Control. Understanding How Vaccines Work. https://www.cdc.gov/vaccines/hcp/conversations/downloads/vacsafe-understand-color-office.pdf Reviewed February 2013. Accessed 20 October 2016.

Anti viral, Anti fungal, Anti helmintics

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