ANTIFUNGAL MEANS (antimycotica) — the pharmaceuticals applied to treatment fungal a disease: dermatofitiya (epidermophitia, trichophytosis, favus), candidiases and deep (system) mycoses (coccidioidosis, histoplasmosis, zymonematoses, aspergillomycosis, chromomycosis, etc.).
Items of page of local action apply outwardly on the centers of defeat in a type of ointments, solutions, aerosols, powders. For this purpose widely use fungicidal and fungistatic drugs of various chemical nature: drugs of iodine (e.g., solution of iodine spirit, potassium iodide), phenols and their galoidozameshchenny, salicylic, the benzoic and acetic to - you, undecylenic acid (see), salts of heavy metals (copper, mercury, zinc), the quarternary ammonium and fosfoniyevy bases, derivatives of nitrofuran (see Nitrofurans), an imidazole, etc. P.'s efficiency of page at dermatomycoses in many respects depends on penetration of these substances into skin to the place of localization of a fungus that is reached by use of the corresponding ointment bases or ingredients which are «conductors» of active ingredients, e.g. a dimethyl sulfoxide (see).
In medical practice a number of ready dosage forms which part antifungal substances and their combinations are is used: ointment «Undecinum» containing undecylenic to - that, copper salt undecylenic to - you on 8% and para-chlorphenyl ether of glycerin of 4%; the Zincundanum ointment containing 10% undecylenic to - you, zinc salt undecylenic to - you and anilide salicylic to - you; 1% ointment and 1% spirit solution of octicyl; 5% ointment and 2 and 5% powder of Amicazolum (see); 3% ointment and powder of Octathionum (see); the sulfur-salicylic ointment containing 10% of the sulfur besieged and 3% salicylic to - you; the powder Dustundanum containing 5% undecylenic to - you, on 10% of zinc salt undecylenic to - you and anilide salicylic to - you and 75% of talc, etc. These drugs are used locally for treatment of fungal infections of smooth skin. Ointments rub in the centers of 1 — 2 time a day. Duration of treatment is established depending on character and the course of mycosis, and also results of microscopic examination. Usually the course of therapy proceeds 15 — 20 days.
For treatment of superficial forms of candidiasis as P. villages of local action use Dekaminum in the form of 0,5 — 1% of ointment, and at damages of a mucous membrane of an oral cavity — in the form of caramel (see. Dekaminum ); 1% emulsion ointment of an esulan; 1% the water and spirit solutions, ointments and pastes containing methylene blue, etc.
Treatment of fungal infections of a pilar part of the head often is at a loss the fact that P. of page of local action badly gets into hair bulbs. For increase in efficiency of treatment of such patients resort to shaving of hair, amotio of a corneous layer keratolytic drugs (salicylic, the benzoic or milk to - that), and carry sometimes out an epilation by means of 4% of an epilinovy plaster and it is extremely rare — by x-ray radiation but a special technique. At treatment of fungal infections of nails (onychomycoses) it is necessary to delete the struck nail plates by means of keratolytic drugs, napr, the plasters containing 20% of urea or 50% salicylic to - you (see. Keratolytic, keratoplastichesky means ), and then to carry out P.'s treatment by the village.
For treatment of patients with dermatofitiya use an antibiotic griseofulvin (see), appointing it inside or locally as a part of ointments, plasters and other dosage forms containing a dimethyl sulfoxide. At treatment griseofulvin of mycoses of a pilar part of the head of an epilation does not require.
Widely apply antifungal antibiotics to treatment of deep (system) mycoses and visceral forms of candidiasis (see) — the nystatin, levorinum, Amphotericinum of B, Mycoheptinum possessing the expressed fungistasis. Nystatin and levorinum in the form of tablets, ointments, candles apply to treatment and prevention of candidiasis of mucous membranes, skin and internals. Sodium salt of levorinum, well water soluble, use for inhalations, irrigations, washings, enemas. Amphotericinum of B is highly effective at a coccidioidosis, histoplasmosis, zymonematoses (see. Amphotericinums ). For parenteral administration (intravenously, in cerebrospinal liquid, intramusculary and an inhalation way) use a complex of this antibiotic with dezoksikholaty sodium and the phosphatic buffer in 5% solution of glucose. In the USSR the new dosage form of Amphotericinum of B — amfoglyukamin (mix of N-methylglucamine salt of Amphotericinum of B with M-metilglyukaminom) which is intended for intake at the same fungus diseases is offered, as Amphotericinum B. Mikogeptin on a chemical structure and action is close to Amphotericinum B. It is applied at visceral and skin mycoses. Appoint inside and outwardly (in the form of ointments).
Mechanisms of action of P. of page of a different chemical structure are not identical. E.g., griseofulvin oppresses synthesis nucleinic to - t, antibiotics of a half-yen structure (nystatin, levorinum, etc.) break permeability of a cytoplasmic membrane, and compounds of iodine oppress synthesis of protein in fungal cells.
Bibliography: Mashkovsky M. D. Pharmaceuticals, p. 2, M., 1977; Rudzit E. A. Modern antifungal means, Chemical - pharm. shurn., t. 12, X 7, page 39, 1978, bibliogr.; Drou-h e t E. Antifungal agents, Antibiot. apy Chemother., v. 25, p. 253, 1978; The pharmacological basis of therapeutics, ed. bv A. Gilman a. o., N. Y., 1980.
Century of M. Leshchenko, L. M. Polukhin.