• 제목/요약/키워드: Itraconazole

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Oral Fluralaner Treatment in a Dog with Desperate Demodicosis: A Case Report

  • Nam, Hyeyeon;Yun, Taesik;Koo, Yunhoi;Chae, Yeon;Lee, Dohee;Park, Jooyoung;Choi, Yujin;Kim, Hakhyun;Yang, Mhan-Pyo;Kang, Byeong-Teck
    • 한국임상수의학회지
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    • 제38권4호
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    • pp.169-173
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    • 2021
  • A 10-year-old castrated male Shih-tzu dog presented with a history of generalized demodicosis, refractory to conventional therapy with ivermectin and amitraz for a year. The patient was also diagnosed with concurrent deep pyoderma, Malassezia dermatitis, and otitis externa. Treatment with amoxicillin-clavulanate, antifungal drugs (itraconazole, miconazole), and milbemycin oxime resulted in a good response for 90 days. Approximately 4 months later, the first relapse of demodicosis occurred and the miticidal therapy was changed to ivermectin. Additional diagnostic tests were performed to investigate an underlying cause for the recurrence of demodicosis, and endocrinopathies and allergic dermatitis were excluded based on the results. Although ivermectin therapy was sustained for 440 days, a second relapse occurred and amitraz baths were added to the therapy. Despite this therapy, the demodicosis persisted, and the miticidal therapy was changed to oral fluralaner, which led to rapid resolution. Demodicosis did not recur again before death approximately 920 days after administration of oral fluralaner. This case report describes the complete resolution of refractory demodicosis using oral fluralaner in a dog.

Production and Identification of Secondary Metabolite Gliotoxin-Like Substance Using Clinical Isolates of Candida spp.

  • Noorulhuda Ojaimi Mahdi, Al-Dahlaki;Safaa Al-Deen Ahmed Shanter, Al-Qaysi
    • 한국미생물·생명공학회지
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    • 제50권4호
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    • pp.488-500
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    • 2022
  • Most fungal infections by opportunistic yeast pathogens such as Candida spp. are the major causes of morbidity and mortality in patients with lowered immune. Previous studies have reported that some strains of Candida secret secondary metabolites play an important role in the decreasing of immunity in the infected patient. In this study, 110 Candida spp. were isolated from different clinical specimens from Baghdad hospitals. Candida isolates were identified by conventional methods, they were processed for Candida speciation on CHROMagar. The results of identification were confirmed by internal transcribed spacer (ITS) sequencing. Phylogenetic trees were analyzed with reference strains deposited in GenBank. Antifungal susceptibility testing was evaluated by the disc diffusion method and performed as recommended by the Clinical and Laboratory Standard Institute (CLSI) M44-A document. Candida isolates investigated produce secondary metabolites gliotoxin with HPLC technique and quantification. Out of 110 Candida isolates, C. albicans (66.36%) was the most frequent isolate, followed by the isolates of C. tropicalis (10.9%) and C. glabrata (6.36%) respectively. Concerning the antifungal susceptibility test, Candida isolates showed a high level of susceptibility to Miconazole (70.9%), Itraconazole (68.2%), and Nystatine (64.5%). The ability of obtained isolates of Candida spp. to produce gliotoxin on RPMI medium was investigated, only 28 isolates had the ability to secret this toxin in culture filtrates. The highest concentrations were detected in C. albicans (1.048 ㎍/ml). Gliotoxin productivity of other Candida species was significantly lower. The retention time for gliotoxin was approximately 5.08 min.

면역기능저하 환자에서 폐진균증에 대한 임상적 고찰 (Pulmonary Mycoses in Immunocompromised Hosts)

  • 서지영;박상준;강경우;고영민;김태성;정만표;김호중;한정호;최동철;송재훈;권오정;이종헌
    • Tuberculosis and Respiratory Diseases
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    • 제45권6호
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    • pp.1199-1213
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    • 1998
  • 연구배경 : 최근 면역기능저하 환자들이 급증하고 있으며 이들에 있어서 새로 발생된 설명이 불가능한 폐침윤은 매우 흔하면서도 환자의 생명을 위협할 수 있는 상황으로 발전할 수 있다. 폐진균증은 이런 임상상에서 폐침윤의 중요한 원인으로 대두되고 있으나 이에 대한 연구가 많지 않아 본 연구를 시행하였다. 방 법 : 1996년 10월부터 1998년 4월까지 삼성서울병원에서 면역기능저하 환자 중 새로운 폐침윤이 있었던 환자로 조직학적으로 폐에서 진균이 증명되었거나 정상적으로 균이 자리지 않는 부위(sterile)에서 시행한 배양검사장 진균이 배양된 환자들을 대상으로 임상적 특정, 방사선학적 소견, 진단적 검사, 치료 및 그 결과에 대해 후향적인 조사를 시행하였다. 결 과 : 총 13명의 환자 (M : F=8 : 5, 연령 중앙값 47세)에서 14예의 폐진균증이 진단되었다. 진단은 asperogillosis가 12예였고 mucormycosis가 2예였다. 혈액암 환자 9명에서 10예, 장기이식 환자에서 4예의 폐진균증이 진단되었다. 3예에서는 진단당시 경험적 amphotericin B를 중앙값 9일(8-21일)간 투여받고 있었다. 혈액암군 10예 중 9예에서 폐침윤 발견당시 백혈구 감소증이 중앙값 16일동안 지속되었으며 발열(9/10), 기침(6/10), 가래(5/10), 호흡곤란(4/10), 흉통 (5/10), 악설음(4/10) 등의 증상과 징후가 흔하게 관찰되었다. 반면에 장기이식환자군에서는 증상 및 징후가 뚜렸하지 않은 경우가 많았다(p<0.05). 단순 흉부촬영상으로 새로운 폐침윤은 단일 혹은 다발성의 결절(6/14)이나 경결(consolidation)(8/14)의 형태로 나타났으며 흉부 단층촬영상에서는 간유리음영(14/14), 흉수(5/14), 동공형성(7/14) 등의 소견이 관찰되었다. 확진한 방법으로는 개흉술이 10예, 비디오 흉강경술이 2예, 경피적침흡인술이 1예, 농양의 농 배양검사가 1예였다. 모든 환자는 amphotericin B(591-2806mg) 투여를 받았으며 1예에서 liposomal amphotericin B, 1예에서 경구 itraconazole로 치료를 부분적으로 시행하였다. Amphotericin B 투여 후 12/14예에서 폐병변의 호전이 관찰되었으며 14예중 4예에서 사망하거나 회복이 불가능한 상태로 퇴원하였다. 결 론 : 혈액암의 치료로 과립구감소증이 있는 환자나 장기이식 환자에서 새로운 폐침윤이 결절이나 경결의 형태로 발현하면, 증상이 미미하거나 경험적 amphotericin B를 투여하고 있더라도 폐진균증을 의심을 해야하며 적극적인 진단과 치료로써 예후를 호전시킬 수 있을 것으로 기대된다.

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Acinetobacter sp. SY-01로부터 Enantioselective Lipase의 생산 (Production of Enantioselective Lipase from Acinetobacter sp. SY-01)

  • 박대원;박호일;신평균
    • 한국미생물·생명공학회지
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    • 제31권2호
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    • pp.145-150
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    • 2003
  • Acinetobacter sp. SY-01가 생산하는 lipase는 소염진통제로 쓰이는 azolerP 의약품 중간체인 두 enantiomer를 가진 rcemate에 대해 enantioselectivity를 가지는 효소로써 chiral drug를 생산하는데 있어 중요한 역할을 수행한다. Acinetobacter sp. SY-01 lipase 효소의 다량 생산을 위한 여러 가지 최적 조건을 조사하였다. 탄소원으로는 여러 가지 천연 오일을 이용하여 실험한 결과 0.2% olive oil이 가장 좋았으며, 최적 온도와 pH는 30도와 pH 7이였다. EH한 금속이온과 유기용매 안정성에 있어서는 $Fe^{2+}$$Ca^{2+}$ DMSO가 좋은 효과를 나타냇었다. 특히 DMSO는 유기용매가 첨가되지 않았을 때보다 약 2.5배 높은 효소 활성을 나타내었다. 계면활성제 이용에 있어서는 tritom X-100을 이용했을 때 좋은 효과를 나타냈다. Acinetobacter sp. SY-01가 생산하는 lipase 효소의 최적 배지 조성은 0.8% yeast extract, 0.2% olive oil 0.4% triton X-100, 40% DMSO, 0.1 % $NH_4$Cl% 0.4%$K_2HPO_4$ 3.9% $NaH_2PO_4$ 0.03% $CaCl_22H_2O$ 0.01% $FeSO_4$$7H_2O$(pH 7.0)이다.

고분자가 흡착된 약물 나노결정입자의 분무 건조 (Spray Drying of Polymer-Adsorbed Drug Nanocrystal Particles)

  • 최지연;유지연;김환용;정상영;허윤석;홍성철;이종휘
    • 공업화학
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    • 제17권1호
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    • pp.106-110
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    • 2006
  • 약물입자들을 나노크기로 만들어 이용하면 기존 제형에 비해 효과적일 수 있다. 특히 생체 내 낮은 흡수율을 가진 난용성 약물들은 그 입자의 크기가 감소함에 따라 흡수율과 생체이용률이 높아질 수 있다. 본 연구에서는 난용성 약물인 이트라코나졸의 나노입자를 안정화시키기 위하여 폴리비닐피롤리돈(PVP)과 다양한 당을 안정화제로 사용하였다. 당으로 안정화된 이트라코나졸 나노입자는 5일 동안의 습식분쇄 공정으로 성공적으로 제조되었다. 그 후 얻어진 액상의 입자를 분무 건조하고 그 건조분말의 재분산성을 알아보았다. 분무 건조 시 가공 변수의 효과를 알아보기 위해 온도, 압력, 유속 등을 변화시켰다. 입자크기 분석을 통해 당을 함유한 나노입자 건조분산체가 그렇지 않은 경우보다 재분산도가 더 좋은 것을 알 수 있었다. 또한 주사전자현미경(SEM)과 원자현미경(AFM)을 이용하여 나노 결정입자들이 구형에 가까운 모양인 것을 확인하였다.

Variability in Drug Interaction According to Genetic Polymorphisms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • 한국환경성돌연변이발암원학회지
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    • 제24권1호
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    • pp.15-18
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    • 2004
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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Variability in Drug Interaction According to Genetic Polymorph isms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • 한국환경성돌연변이발암원학회지
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    • 제23권4호
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    • pp.131-134
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    • 2003
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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