PHM2133: Tutorial 3Antifungal, Antiviral I, II &III

Abdul Razak Kasmuri

Anti-fungal• At the end of the lecture, the student should be able

to:1. Describe the chemistry and pharmacology of

antifungal agents namely;– Amphotericin B– Imidazoles (Ketonazole, Miconazole,

Clotrimazole) – Triazoles (Fluconazole, Itraconazole)– Flucytosine– Nystatin

2. Relates the pharmacology of the agents with their therapeutics uses and considerations.

Issues

• Ergosterol as a targeted structure in MOA. • Antagonism effect? Among which agents?• Choices among Imidazoles group in the

aspect of usages and mode of administration.

• Triazoles vs Imidazoles; advantages and disadvantages.

• Two brothers with different styles and way of life!

Anti-influenza• At the end of the lecture, the student should be

able to:1. Describe the antiviral agents for Influenza viruses

namely; amantadine, rimantadine, oseltamivir and zanamivir.• Structures, mechanism of actions, mechanism of

resistance, pharmacokinetics and therapeutics consideration

2. Relates the pharmacology of the agents with their therapeutics uses.

3. Describe three commonest diseases due to influenza A viruses.• Avian flu, seasonal flu and swine flu.

Issues

• Influenza as a disease! Viral infections that need antivirals?

• Amantadine and rimantadine are different in the aspect of metabolism, excretion, drug interaction etc.

• Mechanism of actions of A & R vs Oseltamivir and zanamivir.

• Oseltamivir vs zanamivir in therapeutics aspect.

Anti-retroviral• At the end of the lecture, the student should be able to:

1. Describe the chemistry and pharmacology of the antiretroviral agents for HIV viruses namely;

i. Nucleoside Analogue or Nucleoside Reverse Transcriptase Inhibitors (NRTIs)– Zidovudine, Didanosine, Lamivudine, Zalcitabine,

Stavudineii. Nonnucleoside analogues (NNRTIs)

– Nevirapine, Delavirdine, Loviride, Efavirenziii. Protease inhibitors

– Saquinavir, Ritonavir, Indinavir, Nelfinavir, Amprenaviriv. Nucleotides Reverse Transcriptase Inhibitors (NtRTI)

– Tenofovirv. Fusion inhibitors

– Fuzeon2. Relates the pharmacology of the agents with their

therapeutics uses and considerations.3. Describe the therapeutics principles in managing HIV

patients.

Issues

• When and how to start ART? Therapeutics goals, endpoints and stages of the disease.

• Nukes and Non-nukes as first line agents. 3rd, 4th and fifth line etc..

• Plus 3TC, d4T; don’t and do, combination, interaction, adverse effect, indications

• Pis and others; MOA, adverse effect, etc.

Anti-herpes and others• At the end of the lecture, the student should be

able to:1. Describe the chemistry and pharmacology

of antiviral agents namely;– Acyclovir, Penciclovir, Valaciclovir and

Famciclovir, Ganciclovir and Interferons. 2. Relates the pharmacology of the agents

with their therapeutics uses and considerations.

3. Explain how the interferons is used as an antiviral agent.

Issues

• Relationships of nukes antiherpetic.• MOA and P’kinetics.• Ganciclovir anti CMV, also herpes, why

and MOA, advantages.• Types of interferon, MOA.

My last two slides in this semester..

• Thanks for your attention.• I hope that I succeed to teach you with respect,

humble, passion and love; and treat you as an adult and as my future colleagues/boss.

• Please forgive me of all my shortcomings and any ill treatments/jokes that you can’t accept/bear it; – Kalau ada jarum yang patah– Jangan disimpan didalam peti– Kalau ada silap dan salah – Jangan disimpan didalam hati

Sememangnya aku pasti!• Andainya aku gagal menghiburmu…

sememangnya aku bukan penglipurmu• Andainya aku gagal menyayangimu …

sememangnya aku bukan kekasihmu• Andainya aku gagal menyantuni hatimu

sememangnya aku bukan ayah kandung mu….• Tapi……

– aku pasti segala usahaku sememangnya untuk mu!