Voriconazole. Uses, Side Effects, Interactions, Mechanism of action.by-The Medicine Library

Voriconazole:

Taruf:

 Voriconazole ek tryazole anti-fungal agent hai jise 2002 mein American FDA ne nagawar aspergillosis aur ghizai naali candidiasis ke ilaj ke liye manzoor kiya tha. Yeh dusri nasl ka azole hai jo sakhti tor par fluconazole aur itraconazole se mutaliq hai. Woriconazole mein fungus ke khilaf sargarmi ka ek wasee daerah kaar hai aur lanosterol ke cytochrome P450 par munhasir 14-alpha demethylation ko rok kar fungus ergosterol biosynthesis ko rokta hai, jo fungus cell ki deewar ki tashkeel mein ek zaroori qadam hai.

Amal ka tareeqa kar:

 Woriconazole muntakhab tor par fungus cytochrome P450 par munhasir enzyme lanosterol 14-alpha-demethylation ko rokta hai, jo lanosterol ko ergosterol mein tabdeel karna ke liye zimmedar hai, jo fungus cell ki jhilli ka ek lazmi juz hai. Is rok tham ke natije mein 14-alpha-methylated sterols ki zehreela satah aur jhilliyon ki ghair mamooli sakht jamay hoti hai, jo fungus cell ki maut ka bai's ban'ti hai.

Dawasi:

 Voriconazole zubani tor par achi tarah jazb hota hai, jiski geoh dastiyabai 96% se 100% tak hoti hai. Ye cytochrome P450 system ke zariye metabolize hota hai, bunyadi tor par CYP2C19 aur CYP3A4, aur iski nisf zindagi taqreeban 6 ghantay hoti hai. Voriconazole ko bunyadi tor par jigar ke zariye kharij kia jata hai, jiski khurak ka 2% se bhi kam hissa peshab mein baghair kisi tabdeeli ke kharij hota hai. 

Sargarmi ka daerah: 

Voriconazole mein fungus ki aik wasee range ke khilaf sargarmi ka aik wasee daerah kar hai, bishmil Aspergillus species, Candida species, Fusarium species, Scedosporium species, aur degar.

 Tibi istemaal: 

Voriconazole nagawar Aspergillosis, ghair neutropenic mareezon mein candidemia, ghizai naali candidiasis, aur aise mareezon mein degar sangin fungal infection ke ilaj ke liye ishara kia jata hai jo degar anti-fungal agents se adam bardasht ya refractory hain. Ye hematopoietic stem cell transplantation se guzrne wale zyada khatra wale mareezon mein nagawar fungal infection ke prophylaxis ke liye bhi istemaal hota hai.

Burra asarath:

Voriconazole ke istemaal se aam tor par nuqsanat shamil hain jin mein barsee khallaq, jigar ke af'aal mein kharabiyaan, jild par daagh, aur maida ki kharabi shamil hain. Barsee khallaq mein dhundla pan, photo phobia, aur rangin beenai mein tabdeelian shamil ho sakti hain. Jigar ke function ki asamaniyat mein jigar ke khamron mein izafah, hepatitis aur jigar ki kharabi shamil ho sakti hai. Jild ke danay halkay se shadeed tak hosakte hain, beshumaar Stevens-Johnson Syndrome aur Zehreela Epidermal Necrolysis. Maida ki kharabi mein matli, qay, ishaal, aur pait mein dard shamil ho sakti hai.

Tazad: 

Voriconazole un mareezon mein mukhtalif hota hai jo voriconazole ya is ke kisi bhi ajza ke liye intehai hasasiat maloom hoti hain. QT toul ya ventricular arrhythmia ki tareekh wale mareezon mein bhi is se parhez karna chahiye.

Manshiyat ka ta'alluq: 

Voriconazole cytochrome P450 enzymes, khas tor par CYP3A4 aur CYP2C19 ka ek taaqatwar roknay wala hai. Lihazaa, is mein in enzymes ke zariye metabolize honay wali adviyat ki aik wasee range ke saath baat cheet karne ki salahiyat hai, beshumar dawaaon mein se jin mein cyclosporine, tacrolimus, ceruliamus, rifampin, aur degar shamil hain. Yeh aisi dawaaon ke saath ta'alluq ke liye bhi jana jata hai jo QT interval ko toul deti hain, jaise ki quinidine, dofetilide, aur amiodarone.

 Nateeja:

 Voriconazole aik taaqatwar antifungal agent hai jis mein phuphondi ki aik wasee range ke khilaaf wasee paimanay par sargarmi hoti hai. Yeh aise mareezon mein na-gawar aspergillosis, candidemia, aur degar shadeed fungal infections ke ilaj ke liye ishara kiya jata hai jo degar antifungal agents se adam bardasht ya refractory hain. Voriconazole aik achi tarah se qaim hifazati profile hai, lekin isay jigar ki kharabi ya tareekh ke saath mareezon mein ehtiyat ke saath istemaal kiya jana chahiye.