ketoconazole

enUK

ketoconazole

[ke″to-kon´ah-zōl] a synthetic imidazole that is a broad-spectrum antifungal agent used for treatment of chronic mucocutaneous candidiasis and systemic fungal infections due to species of Candida, Epidermophyton, Microsporum, Trichophyton, and others.

ketoconazole

Apo-Ketoconazole (CA), Dactarin Gold (UK), Dandrazol (UK), Extina, Kryoxolr, Nizoral, Nizoral A-D, Novo-Ketoconazole (CA), Nu-Ketocon (CA), Nu-Ketoconazole (CA), Ratio-Ketoconazole (CA), Xolegel

Pharmacologic class: Imidazole

Therapeutic class: Antifungal

Pregnancy risk category C

FDA Box Warning

• Oral form has been linked to hepatic toxicity, including some deaths. Inform patient of this risk, and monitor closely.

• Concurrent use of astemizole, cisapride, or terfenadine with ketoconazole tablets is contraindicated, because serious cardiovascular adverse events (including death, ventricular tachycardia, and torsades de pointes) have occurred.

Action

Alters fungal cell membranes, resulting in increased permeability, growth inhibition, and ultimately, cell death

Availability

Cream: 2%

Shampoo: 1%, 2%

Tablets: 200 mg

Indications and dosages

➣ Blastomycosis; chronic mucocutaneous candidiasis; oral thrush; candiduria; coccidioidomycosis; histoplasmosis; chromomycosis; paracoccidioidomycosis; mucocutaneous or vaginal candidiasis

Adults: 200 to 400 mg P.O. daily

Children ages 2 and older: 3.3 to 6.6 mg/kg P.O. as a single daily dose. Duration depends on infection: for candidiasis, 1 to 2 weeks; other systemic mycoses, 6 months; recalcitrant dermatophyte infections involving glabrous skin, 4 weeks. Chronic mucocutaneous candidiasis requires maintenance therapy.

➣ Scaling caused by dandruff or seborrheic dermatitis

Adults: 2% shampoo applied topically twice weekly for 4 weeks, then as needed to control symptoms, with at least 3 days between applications; or 1% shampoo applied topically q 3 to 4 days for up to 8 weeks, then as needed to control dandruff

➣ Tinea corporis; tinea cruris; tinea versicolor; tinea pedis, cutaneous candidiasis

Adults: 2% cream applied topically to affected areas daily for 2 weeks (except for tinea pedis, which may require 6 weeks of therapy)

Contraindications

• Hypersensitivity to drug or its components

• Concurrent oral astemizole, cisapride, triazolam, or terfenadine therapy

Precautions

Use cautiously in:

• renal or hepatic disease, achlorhydria

• pregnant or breastfeeding patients

• children younger than age 2.

Administration

• Apply cream to damp skin of affected area and wide surrounding area.

• To use shampoo, wet hair, then apply shampoo and massage into scalp for 1 minute. Leave on for 5 minutes before rinsing. Rinse and repeat, this time leaving shampoo on scalp for 3 minutes before rinsing.

• Don't apply shampoo to broken or inflamed skin.

• In achlorhydria, dissolve 200-mg tablet in 4 ml of 0.2N hydrochloric acid solution.

• Withhold antacids for at least 2 hours after giving oral ketoconazole.

See Don't give concurrently with cisapride, available in U.S. for compassionate use only. (Astemizole and terfenadine are not available in U.S.)

Adverse reactions

CNS: headache, nervousness, dizziness, drowsiness, severe depression, suicidal ideation

EENT: photophobia

GI: nausea, vomiting, diarrhea, abdominal pain, anorexia

GU: erectile dysfunction, gynecomastia

Hematologic: purpura, hemolytic anemia, thrombocytopenia, leukopenia

Hepatic: hepatotoxicity

Metabolic: hyperlipidemia

Skin: pruritus, rash, dermatitis, urticaria, severe irritation, stinging, alopecia, abnormal hair texture, scalp pustules, oily skin, dry hair and scalp

Other: fever, chills, allergic reaction

Interactions

Drug-drug. Antacids, anticholinergics, histamine₂-receptor antagonists: decreased ketoconazole absorption

Cyclosporine: increased cyclosporine blood level

Isoniazid, rifampin: increased ketoconazole metabolism

Theophylline: decreased theophylline blood level

Topical corticosteroids: increased corticosteroid absorption

Triazolam (oral): increased triazolam effects

Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase: increased levels

Hemoglobin, platelets, white blood cells: decreased levels

Drug-herbs. Yew: inhibited ketoconazole metabolism

Patient monitoring

See Assess for suicidal ideation and signs and symptoms of depression.

See Monitor for evidence of hepatotoxicity, such as nausea, fatigue, jaundice, dark urine, and pale stools.

• With long-term therapy, stay alert for adrenal crisis.

Patient teaching

See Advise patient to watch for signs and symptoms of depression and to immediately report suicidal thoughts.

See Teach patient to recognize and immediately report signs and symptoms of hepatotoxicity, such as unusual tiredness or yellowing of skin or eyes.

• Advise patient not to take antacids for at least 2 hours after oral ketoconazole.

• Instruct patient to apply cream to damp skin of affected area and wide surrounding area.

• Tell patient to wet hair before applying shampoo and to massage into scalp for 1 minute; then leave on for 5 minutes before rinsing off. Tell him to shampoo again, leaving it on for 3 minutes this time before rinsing.

• Caution patient not to apply shampoo to broken or inflamed skin.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

ketoconazole

(kē′tō-kə-nā′zōl′)n. A broad-spectrum antifungal agent, C₂₆H₂₈Cl₂N₄O₄, administered as a topical treatment or as a second-line oral treatment for a variety of fungal infections.

ketoconazole

Nizoral Infectious disease An oral imidazole that inhibits fungal cytochrome P450-dependent steroid synthesis, which is effective against candidiasis, blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, paracoccidioidomycsis Adverse effects Liver problems, ↓ production of hormones–eg, testosterone

ketoconazole

An imidazole antifungal drug. Ketoconazole is absorbed into the blood from the intestine and can be used to treat internal (systemic) fungal infections as well as skin fungal infections. It can, however, damage the liver. Brand names are Daktarin Gold and Nizoral.

antifungal agent

Any substance which destroys or prevents the growth of fungi. It is one of the antibiotic groups. There are several classes of antifungal drugs: Polyenes, which cause an increase in fungal cell wall permeability leading to its death. Examples: amphotericin B, natamycin, nystatin. Azoles, which act either by inhibiting the synthesis of ergosterol, a component of fungal cell wall or by causing direct wall damage. Examples: clotrimazole, econazole, fluconazole, itraconazole, ketoconazole, miconazole. Pyrimidines, which interfere with the normal function of fungal cells. Example: flucytosine. Syn antimycotic agent.

单词	ketoconazole
释义	ketoconazole enUK ke·to·co·na·zole K0043450 (kē′tō-kə-nā′zōl′)n. A broad-spectrum antifungal agent, C₂₆H₂₈Cl₂N₄O₄, administered as a topical treatment or as a second-line oral treatment for a variety of fungal infections. [keto(ne) + (mi)conazole.] Translations EncyclopediaSeeantifungal agent ketoconazole enUK ketoconazole [ke″to-kon´ah-zōl] a synthetic imidazole that is a broad-spectrum antifungal agent used for treatment of chronic mucocutaneous candidiasis and systemic fungal infections due to species of Candida, Epidermophyton, Microsporum, Trichophyton, and others. ketoconazole Apo-Ketoconazole (CA), Dactarin Gold (UK), Dandrazol (UK), Extina, Kryoxolr, Nizoral, Nizoral A-D, Novo-Ketoconazole (CA), Nu-Ketocon (CA), Nu-Ketoconazole (CA), Ratio-Ketoconazole (CA), Xolegel *Pharmacologic class:* Imidazole *Therapeutic class:* Antifungal *Pregnancy risk category C* FDA Box Warning • Oral form has been linked to hepatic toxicity, including some deaths. Inform patient of this risk, and monitor closely. • Concurrent use of astemizole, cisapride, or terfenadine with ketoconazole tablets is contraindicated, because serious cardiovascular adverse events (including death, ventricular tachycardia, and torsades de pointes) have occurred. Action Alters fungal cell membranes, resulting in increased permeability, growth inhibition, and ultimately, cell death Availability Cream: 2% Shampoo: 1%, 2% Tablets: 200 mg Indications and dosages ➣ Blastomycosis; chronic mucocutaneous candidiasis; oral thrush; candiduria; coccidioidomycosis; histoplasmosis; chromomycosis; paracoccidioidomycosis; mucocutaneous or vaginal candidiasis Adults: 200 to 400 mg P.O. daily Children ages 2 and older: 3.3 to 6.6 mg/kg P.O. as a single daily dose. Duration depends on infection: for candidiasis, 1 to 2 weeks; other systemic mycoses, 6 months; recalcitrant dermatophyte infections involving glabrous skin, 4 weeks. Chronic mucocutaneous candidiasis requires maintenance therapy. ➣ Scaling caused by dandruff or seborrheic dermatitis Adults: 2% shampoo applied topically twice weekly for 4 weeks, then as needed to control symptoms, with at least 3 days between applications; or 1% shampoo applied topically q 3 to 4 days for up to 8 weeks, then as needed to control dandruff ➣ Tinea corporis; tinea cruris; tinea versicolor; tinea pedis, cutaneous candidiasis Adults: 2% cream applied topically to affected areas daily for 2 weeks (except for tinea pedis, which may require 6 weeks of therapy) Contraindications • Hypersensitivity to drug or its components • Concurrent oral astemizole, cisapride, triazolam, or terfenadine therapy Precautions Use cautiously in: • renal or hepatic disease, achlorhydria • pregnant or breastfeeding patients • children younger than age 2. Administration • Apply cream to damp skin of affected area and wide surrounding area. • To use shampoo, wet hair, then apply shampoo and massage into scalp for 1 minute. Leave on for 5 minutes before rinsing. Rinse and repeat, this time leaving shampoo on scalp for 3 minutes before rinsing. • Don't apply shampoo to broken or inflamed skin. • In achlorhydria, dissolve 200-mg tablet in 4 ml of 0.2N hydrochloric acid solution. • Withhold antacids for at least 2 hours after giving oral ketoconazole. See Don't give concurrently with cisapride, available in U.S. for compassionate use only. (Astemizole and terfenadine are not available in U.S.) Adverse reactions CNS: headache, nervousness, dizziness, drowsiness, severe depression, suicidal ideation EENT: photophobia GI: nausea, vomiting, diarrhea, abdominal pain, anorexia GU: erectile dysfunction, gynecomastia Hematologic: purpura, hemolytic anemia, thrombocytopenia, leukopenia Hepatic: hepatotoxicity Metabolic: hyperlipidemia Skin: pruritus, rash, dermatitis, urticaria, severe irritation, stinging, alopecia, abnormal hair texture, scalp pustules, oily skin, dry hair and scalp Other: fever, chills, allergic reaction Interactions Drug-drug. Antacids, anticholinergics, histamine₂-receptor antagonists: decreased ketoconazole absorption Cyclosporine: increased cyclosporine blood level Isoniazid, rifampin: increased ketoconazole metabolism Theophylline: decreased theophylline blood level Topical corticosteroids: increased corticosteroid absorption Triazolam (oral): increased triazolam effects Drug-diagnostic tests. Alanine aminotransferase, alkaline phosphatase, aspartate aminotransferase: increased levels Hemoglobin, platelets, white blood cells: decreased levels Drug-herbs. Yew: inhibited ketoconazole metabolism Patient monitoring See Assess for suicidal ideation and signs and symptoms of depression. See Monitor for evidence of hepatotoxicity, such as nausea, fatigue, jaundice, dark urine, and pale stools. • With long-term therapy, stay alert for adrenal crisis. Patient teaching See Advise patient to watch for signs and symptoms of depression and to immediately report suicidal thoughts. See Teach patient to recognize and immediately report signs and symptoms of hepatotoxicity, such as unusual tiredness or yellowing of skin or eyes. • Advise patient not to take antacids for at least 2 hours after oral ketoconazole. • Instruct patient to apply cream to damp skin of affected area and wide surrounding area. • Tell patient to wet hair before applying shampoo and to massage into scalp for 1 minute; then leave on for 5 minutes before rinsing off. Tell him to shampoo again, leaving it on for 3 minutes this time before rinsing. • Caution patient not to apply shampoo to broken or inflamed skin. • As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above. ketoconazole (kē′tō-kə-nā′zōl′)n. A broad-spectrum antifungal agent, C₂₆H₂₈Cl₂N₄O₄, administered as a topical treatment or as a second-line oral treatment for a variety of fungal infections. ketoconazole Nizoral Infectious disease An oral imidazole that inhibits fungal cytochrome P450-dependent steroid synthesis, which is effective against candidiasis, blastomycosis, coccidioidomycosis, histoplasmosis, chromomycosis, paracoccidioidomycsis Adverse effects Liver problems, ↓ production of hormones–eg, testosterone ketoconazole An imidazole antifungal drug. Ketoconazole is absorbed into the blood from the intestine and can be used to treat internal (systemic) fungal infections as well as skin fungal infections. It can, however, damage the liver. Brand names are Daktarin Gold and Nizoral. antifungal agent Any substance which destroys or prevents the growth of fungi. It is one of the antibiotic groups. There are several classes of antifungal drugs: Polyenes, which cause an increase in fungal cell wall permeability leading to its death. Examples: amphotericin B, natamycin, nystatin. Azoles, which act either by inhibiting the synthesis of ergosterol, a component of fungal cell wall or by causing direct wall damage. Examples: clotrimazole, econazole, fluconazole, itraconazole, ketoconazole, miconazole. Pyrimidines, which interfere with the normal function of fungal cells. Example: flucytosine. Syn antimycotic agent.
随便看	microscopic spontaneous platelet aggregation test microscopic state microscopic strain field analysis microscopic stress microscopic theory microscopic traffic demand model microscopic traffic simulator microscopies microscopist microscopists microscopist’s neck microscopium microscopium (constellation) microscopium constellation microscopy microscopy and cytometry resource facility microscopy and image analysis platform microscopy and imaging core facility microscopy and optical manipulation module microscopy, confocal microscopy, culture and sensitivity microscopy, electron microscopy, electron, scanning microscopy, phase-contrast microscopy, scanning tunneling

ketoconazole

ke·to·co·na·zole

ketoconazole

ketoconazole

ketoconazole

FDA Box Warning

Action

Availability

Indications and dosages

Contraindications

Precautions

Administration

Adverse reactions

Interactions

Patient monitoring

Patient teaching

ketoconazole

ketoconazole

ketoconazole

antifungal agent