Ch61 Antifungal Agents - 版本历史

Comcat：/* Systemic Antifungal Agents (全身性抗真菌药物) */

2024-11-08T09:13:29Z

‎Systemic Antifungal Agents (全身性抗真菌药物)

Comcat：/* Itraconazole (伊曲康唑) */

2024-11-08T06:57:22Z

‎Itraconazole (伊曲康唑)

Comcat：/* Itraconazole (伊曲康唑) */

2024-11-08T06:56:04Z

‎Itraconazole (伊曲康唑)

2024年11月8日 (五) 06:51 Comcat

2024-11-08T06:51:03Z

Comcat：/* Systemic Antifungal Agents (全身性抗真菌药物) */

2024-11-08T06:49:19Z

‎Systemic Antifungal Agents (全身性抗真菌药物)

Comcat：/* Systemic Antifungal Agents (全身性抗真菌药物) */

2024-11-08T06:48:50Z

‎Systemic Antifungal Agents (全身性抗真菌药物)

Comcat：/* Systemic Antifungal Agents (全身性抗真菌药物) */

2024-11-08T06:48:39Z

‎Systemic Antifungal Agents (全身性抗真菌药物)

Comcat：/* Systemic Antifungal Agents (全身性抗真菌药物) */

2024-11-08T06:48:32Z

‎Systemic Antifungal Agents (全身性抗真菌药物)

Comcat：/* Systemic Antifungal Agents (全身性抗真菌药物) */

2024-11-08T06:48:14Z

‎Systemic Antifungal Agents (全身性抗真菌药物)

2024年11月8日 (五) 06:46 Comcat

2024-11-08T06:46:06Z

@@ 第13行： / 第13行： @@
-* '''Amphotericin B''' (两性霉素 B)，抗生素类，结合麦角固醇，增加膜通透性（氨基酸、电解质等），致真菌生长停止。
+* '''Amphotericin B''' (两性霉素 B)，<b style=color:#0cf>【注】</b>抗生素类，结合麦角固醇，增加膜通透性（氨基酸、电解质等），致真菌生长停止。
 * '''Flucytosine''' (氟胞嘧啶)
 * '''Imidazoles and Triazoles''' (咪唑类和三唑类)，<b style=color:#0cf>【注】</b>皆使14 - 脱甲基酶系失活，导致<b style="color:#f80">麦角固醇</b>（真菌细胞膜重要成分）合成受阻

←上一版本		2024年11月8日 (五) 06:57的版本
第62行：		第62行：
	'''Adverse Effects''': Itraconazole carries an FDA boxed warning about possible serious adverse effects, including QT prolongation, heart failure, negative inotropic effects, and drug interactions. Serious hepatotoxicity has led, in rare cases, to hepatic failure and death. If symptoms of hepatotoxicity occur, the drug should be discontinued and liver function assessed. In the absence of interacting drugs, itraconazole capsules and suspension are well tolerated at 200 mg daily. Diarrhea, abdominal cramps, anorexia, and nausea are more common than with the capsules. Of patients receiving 50 to 400 mg of the capsules per day, nausea and vomiting, hypertriglyceridemia, hypokalemia, increased serum aminotransferase, and rash occurred in 2% to 10%. Occasionally, rash necessitates drug discontinuation, but most adverse effects can be handled with dose reduction. Profound hypokalemia has been seen in patients receiving 600 mg or more daily and in those who recently have received prolonged amphotericin B therapy. Doses of 300 mg twice daily have led to other side effects, including adrenal insufficiency, lower limb edema, hypertension, and in at least one case, rhabdomyolysis. Doses greater than 400 mg/day are not recommended for long-term use. Anaphylaxis has been observed rarely, as well as severe rash, including Stevens-Johnson syndrome. Itraconazole is contraindicated for the treatment of onychomycosis during pregnancy or for women contemplating pregnancy.		'''Adverse Effects''': Itraconazole carries an FDA boxed warning about possible serious adverse effects, including QT prolongation, heart failure, negative inotropic effects, and drug interactions. Serious hepatotoxicity has led, in rare cases, to hepatic failure and death. If symptoms of hepatotoxicity occur, the drug should be discontinued and liver function assessed. In the absence of interacting drugs, itraconazole capsules and suspension are well tolerated at 200 mg daily. Diarrhea, abdominal cramps, anorexia, and nausea are more common than with the capsules. Of patients receiving 50 to 400 mg of the capsules per day, nausea and vomiting, hypertriglyceridemia, hypokalemia, increased serum aminotransferase, and rash occurred in 2% to 10%. Occasionally, rash necessitates drug discontinuation, but most adverse effects can be handled with dose reduction. Profound hypokalemia has been seen in patients receiving 600 mg or more daily and in those who recently have received prolonged amphotericin B therapy. Doses of 300 mg twice daily have led to other side effects, including adrenal insufficiency, lower limb edema, hypertension, and in at least one case, rhabdomyolysis. Doses greater than 400 mg/day are not recommended for long-term use. Anaphylaxis has been observed rarely, as well as severe rash, including Stevens-Johnson syndrome. Itraconazole is contraindicated for the treatment of onychomycosis during pregnancy or for women contemplating pregnancy.

−	<b style="color:#f80">不良反应</b>：伊曲康唑带有 '''FDA 黑框警告'''，关于可能的严重不良反应，包括 QT 间期延长、<b style=color:#e00>心力衰竭</b>、'''负性肌力作用'''和药物相互作用。在极少数情况下，严重的肝毒性会导致肝功能衰竭和死亡。如果出现肝毒性症状，应停药并评估肝功能。在没有相互作用药物的情况下，伊曲康唑胶囊和混悬液每天 200 毫克的耐受性良好。腹泻、腹部绞痛、厌食和恶心比胶囊更常见。在每天接受 50 至 400mg ~~胶囊的患者中，恶心和呕吐、高甘油三酯血症、低钾血症、血清转氨酶升高和皮疹发生在~~ 2% 至 10% 的患者中。偶尔，皮疹需要停药，但<b style="color:#0c0">大多数不良反应可以通过减少剂量来处理</b>。在每天接受 600mg 或更多剂量的患者以及最近接受长期两性霉素 B 治疗的患者中，已观察到严重'''低钾血症'''。每天两次 300mg 的剂量导致了其他副作用，包括肾上腺皮质功能减退、下肢水肿、高血压，以及至少一例横纹肌溶解症。大于 400mg/d 的剂量不建议长期使用。很少观察到过敏反应，以及严重的皮疹，包括 Stevens-Johnson 综合征。伊曲康唑禁用于治疗妊娠期甲癣或考虑怀孕的妇女。	+	<b style="color:#f80">不良反应</b>：伊曲康唑带有 '''FDA 黑框警告'''，关于可能的严重不良反应，包括 QT 间期延长、<b style=color:#e00>心力衰竭</b>、'''负性肌力作用'''和药物相互作用。在极少数情况下，严重的肝毒性会导致肝功能衰竭和死亡。如果出现肝毒性症状，应停药并评估肝功能。在没有相互作用药物的情况下，伊曲康唑胶囊和混悬液每天 200 毫克的耐受性良好。腹泻、腹部绞痛、厌食和恶心比胶囊更常见。在每天接受 50 至 400mg 胶囊的患者中，'''恶心'''和'''呕吐'''、'''高甘油三酯血症'''、'''低钾血'''症、血清'''转氨酶升高'''和'''皮疹'''发生在 2% 至 10% 的患者中。偶尔，皮疹需要停药，但<b style="color:#0c0">大多数不良反应可以通过减少剂量来处理</b>。在每天接受 600mg 或更多剂量的患者以及最近接受长期两性霉素 B 治疗的患者中，已观察到严重'''低钾血症'''。每天两次 300mg 的剂量导致了其他副作用，包括肾上腺皮质功能减退、下肢水肿、高血压，以及至少一例横纹肌溶解症。大于 400mg/d 的剂量不建议长期使用。很少观察到过敏反应，以及严重的皮疹，包括 Stevens-Johnson 综合征。伊曲康唑禁用于治疗妊娠期甲癣或考虑怀孕的妇女。

←上一版本		2024年11月8日 (五) 06:56的版本
第62行：		第62行：
	'''Adverse Effects''': Itraconazole carries an FDA boxed warning about possible serious adverse effects, including QT prolongation, heart failure, negative inotropic effects, and drug interactions. Serious hepatotoxicity has led, in rare cases, to hepatic failure and death. If symptoms of hepatotoxicity occur, the drug should be discontinued and liver function assessed. In the absence of interacting drugs, itraconazole capsules and suspension are well tolerated at 200 mg daily. Diarrhea, abdominal cramps, anorexia, and nausea are more common than with the capsules. Of patients receiving 50 to 400 mg of the capsules per day, nausea and vomiting, hypertriglyceridemia, hypokalemia, increased serum aminotransferase, and rash occurred in 2% to 10%. Occasionally, rash necessitates drug discontinuation, but most adverse effects can be handled with dose reduction. Profound hypokalemia has been seen in patients receiving 600 mg or more daily and in those who recently have received prolonged amphotericin B therapy. Doses of 300 mg twice daily have led to other side effects, including adrenal insufficiency, lower limb edema, hypertension, and in at least one case, rhabdomyolysis. Doses greater than 400 mg/day are not recommended for long-term use. Anaphylaxis has been observed rarely, as well as severe rash, including Stevens-Johnson syndrome. Itraconazole is contraindicated for the treatment of onychomycosis during pregnancy or for women contemplating pregnancy.		'''Adverse Effects''': Itraconazole carries an FDA boxed warning about possible serious adverse effects, including QT prolongation, heart failure, negative inotropic effects, and drug interactions. Serious hepatotoxicity has led, in rare cases, to hepatic failure and death. If symptoms of hepatotoxicity occur, the drug should be discontinued and liver function assessed. In the absence of interacting drugs, itraconazole capsules and suspension are well tolerated at 200 mg daily. Diarrhea, abdominal cramps, anorexia, and nausea are more common than with the capsules. Of patients receiving 50 to 400 mg of the capsules per day, nausea and vomiting, hypertriglyceridemia, hypokalemia, increased serum aminotransferase, and rash occurred in 2% to 10%. Occasionally, rash necessitates drug discontinuation, but most adverse effects can be handled with dose reduction. Profound hypokalemia has been seen in patients receiving 600 mg or more daily and in those who recently have received prolonged amphotericin B therapy. Doses of 300 mg twice daily have led to other side effects, including adrenal insufficiency, lower limb edema, hypertension, and in at least one case, rhabdomyolysis. Doses greater than 400 mg/day are not recommended for long-term use. Anaphylaxis has been observed rarely, as well as severe rash, including Stevens-Johnson syndrome. Itraconazole is contraindicated for the treatment of onychomycosis during pregnancy or for women contemplating pregnancy.

−	<b style="color:#f80">不良反应</b>：伊曲康唑带有 '''FDA 黑框警告'''，关于可能的严重不良反应，包括 QT ~~间期延长、心力衰竭、~~'''负性肌力作用'''和药物相互作用。在极少数情况下，严重的肝毒性会导致肝功能衰竭和死亡。如果出现肝毒性症状，应停药并评估肝功能。在没有相互作用药物的情况下，伊曲康唑胶囊和混悬液每天 200 毫克的耐受性良好。腹泻、腹部绞痛、厌食和恶心比胶囊更常见。在每天接受 50 至 400mg 胶囊的患者中，恶心和呕吐、高甘油三酯血症、低钾血症、血清转氨酶升高和皮疹发生在 2% 至 10% 的患者中。偶尔，皮疹需要停药，但<b style="color:#0c0">大多数不良反应可以通过减少剂量来处理</b>。在每天接受 600mg 或更多剂量的患者以及最近接受长期两性霉素 B 治疗的患者中，已观察到严重'''低钾血症'''。每天两次 300mg 的剂量导致了其他副作用，包括肾上腺皮质功能减退、下肢水肿、高血压，以及至少一例横纹肌溶解症。大于 400mg/d 的剂量不建议长期使用。很少观察到过敏反应，以及严重的皮疹，包括 Stevens-Johnson 综合征。伊曲康唑禁用于治疗妊娠期甲癣或考虑怀孕的妇女。	+	<b style="color:#f80">不良反应</b>：伊曲康唑带有 '''FDA 黑框警告'''，关于可能的严重不良反应，包括 QT 间期延长、<b style=color:#e00>心力衰竭</b>、'''负性肌力作用'''和药物相互作用。在极少数情况下，严重的肝毒性会导致肝功能衰竭和死亡。如果出现肝毒性症状，应停药并评估肝功能。在没有相互作用药物的情况下，伊曲康唑胶囊和混悬液每天 200 毫克的耐受性良好。腹泻、腹部绞痛、厌食和恶心比胶囊更常见。在每天接受 50 至 400mg 胶囊的患者中，恶心和呕吐、高甘油三酯血症、低钾血症、血清转氨酶升高和皮疹发生在 2% 至 10% 的患者中。偶尔，皮疹需要停药，但<b style="color:#0c0">大多数不良反应可以通过减少剂量来处理</b>。在每天接受 600mg 或更多剂量的患者以及最近接受长期两性霉素 B 治疗的患者中，已观察到严重'''低钾血症'''。每天两次 300mg 的剂量导致了其他副作用，包括肾上腺皮质功能减退、下肢水肿、高血压，以及至少一例横纹肌溶解症。大于 400mg/d 的剂量不建议长期使用。很少观察到过敏反应，以及严重的皮疹，包括 Stevens-Johnson 综合征。伊曲康唑禁用于治疗妊娠期甲癣或考虑怀孕的妇女。

@@ 第5行： / 第5行： @@
 中文内容由 BH1RBH (Jack Tan) 粗糙翻译
-蓝色 <b style=color:#0cf>【注】</b> 后内容为 BH1RBH (Jack Tan) 所加之注释
+蓝色 <b style=color:#0cf>【注】</b> 后内容为 BH1RBH (Jack Tan) 所加之注释，便于理解记忆，内容大部来自于《药理学》人卫第十版
 == Systemic Antifungal Agents (全身性抗真菌药物) ==

@@ 第22行： / 第22行： @@
 ** Posaconazole (泊沙康唑)
 ** Isavuconazole (艾沙康唑)
-* '''Echinocandins''' (棘白菌素)，<b style=color:#0cf>【注】</b>抑制 β-1,3-D- 葡聚糖合成酶，造成细胞壁中 <b style="color:#0cf">β- 葡聚糖</b>含量减少，从而导致细胞壁结构破坏，最终致使菌体裂解、死亡。
+* '''Echinocandins''' (棘白菌素)，<b style=color:#0cf>【注】</b>抑制 β-1,3-D- 葡聚糖合成酶，造成细胞壁中 <b style="color:#f80">β- 葡聚糖</b>含量减少，从而导致细胞壁结构破坏，最终致使菌体裂解、死亡。
 ** Caspofungin (卡泊芬净)
 ** Micafungin (米卡芬净)

@@ 第18行： / 第18行： @@
 ** Ketoconazole (酮康唑)，口服酮康唑已被伊曲康唑取代。
 ** Itraconazole (伊曲康唑)，<b style=color:#0cf>【注】</b>肝毒性低于酮康唑。由于不抑制雄激素合成，亦可避免酮康唑所发生的内分泌异常。体内外抗真菌活性较酮康唑强 5～100 倍。
-** Fluconazole (氟康唑)，      <b style=color:#0cf>【注】</b>几乎不在肝代谢，主靠肾排泄，体内外抗真菌活性较酮康唑强 5～20 倍。
+** Fluconazole (氟康唑)，    <b style=color:#0cf>【注】</b>几乎不在肝代谢，主靠肾排泄，体内外抗真菌活性较酮康唑强 5～20 倍。
 ** Voriconazole (伏立康唑)
 ** Posaconazole (泊沙康唑)

@@ 第1行： / 第1行： @@
 <b style=font-size:16pt>抗真菌剂</b>
-本页内容摘取自：药理学蓝皮圣经第 14 版 (Goodman & Gilman’s: The Pharmacological Basis of Therapeutics, 14th Edition, published in 2022)
+本页英文内容取自：药理学蓝皮圣经第 14 版 (Goodman & Gilman’s: The Pharmacological Basis of Therapeutics, 14th Edition, published in 2022)
-蓝色 <b style=color:#0cf>【注】</b> 后内容为 BH1RBH (Jack Tan) 所加注释
+中文内容由 BH1RBH (Jack Tan) 粗糙翻译
 == Systemic Antifungal Agents (全身性抗真菌药物) ==