Thesis (Ph. D.)--Oregon State University, 2009. / Printout. Includes bibliographical references (leaves 312-323). Also available on the World Wide Web.

Master of Science in Biomedical Sciences / Department of Clinical Sciences / Elizabeth G. Davis / The primary study objective was to compare the pharmacokinetics of p.o. terbinafine alone to p.o. terbinafine administered with p.o. cimetidine in healthy adult horses. The second objective was to assess the pharmacokinetics of terbinafine when administered per rectum in two different suspensions at 30 mg/kg to adult horses. Six healthy adult horses were included in this crossover study. Plasma terbinafine concentrations were quantified with liquid chromatography and mass spectrometry. The half-life (geometric mean) was 8.38 and 10.76 h, for p.o. alone and p.o. with cimetidine, respectively. The mean maximum plasma concentrations were 0.291 lg/mL at 1.54 h and 0.418 lg/mL at 1.28 h for p.o. alone and p.o. with cimetidine, respectively. Terbinafine with cimetidine had an average CMAX 44% higher and the relative F was 153% compared p.o. terbinafine alone but was not statistically different (P > 0.05). Terbinafine was infrequently detected when administered per rectum in two different suspensions (water or olive oil). Minor adverse effects included oral irritation, fever, and colic. All resolved spontaneously. More pharmacokinetic studies are indicated assessing drug–drug interactions and using multiple dosing intervals to improve our knowledge of effective oral dosing, the potential for drug accumulation, and systemic adverse effect of terbinafine in horses.

A 72 year-old-patient without known past medical history presented to the hospital with worsening cough, dyspnea on exertion, decreased appetite, weight loss for two months. Prior to admission, he was treated with a 10- day course of levofloxacin and prednisone as a case of bronchitis with minimal improvement. Then he started to develop red urine with marked changes in mental status. On physical examination, the patient had notifiable scleral icterus, confusion and abdominal tenderness in the right upper quadrant. On admission his labs were significant for alkaline phosphatase 541, aspartate transaminase 557, alanine transaminase 94, total bilirubin 8.6, lactate 11.7. CT scan of abdomen showed hepatosplenomegaly, mild ascites and trace bilateral pleural effusion. Work up with Viral hepatitis serology, cryptococcal antigen, histoplasma antigen, respiratory virus panel, Epstein Barr virus tests were negative. Anti-nuclear antibodies (ANA) and anti-mitochondrial antibody were also negative. Blood level of amylase, lipase, acetaminophen and alcohol were negative at admission too. The patient was started initially on broad spectrum antibiotics, N-acetyl cysteine empirically and aggressive intravenous fluid hydration. Patient condition rapidly worsened and he developed profound shock requiring mechanical ventilation and started on stress dose steroid and pressor support. Upon further investigation, patient was noted to take terbinafine for toe onychomycosis (day 112). Ferritin level was elevated to 1596 with 93% iron saturation. Ceruloplasmin level was normal. Patient was not a transplant candidate due to multiple organ failure. As per family request, patient was palliatively extubated and died. Terbinafine is a fungicidal drug with activity against dermatophytes including Epidermophyton flccosum and trichophyton rubrum. It works by inhibition of squalene epoxidase with a resultant accumulation of squalene in the fungal cell and killing it as a result. Commonly used orally to treat onychomycosis and other fingernails and toenails infections. Shortly after its introduction to the market, DILI had been reported with elevation with serum aminotransferases elevation that was usually self-limited. Usually presents within first 6 weeks of therapy with either hepatocellular or cholestatic initially with sings of hypersensitivity. Mechanism of injury entails hypersensitivity reaction, though the full pathogenesis was not elucidated yet, but genetic polymorphism is implicated in the variable presentation especially among HLA-A 33:01 allele carriers. Terbinafine DILI resolves usually within 6 months of stopping the medication but can lead to death or need liver transplantation in some cases.

A dermatofitose é micose superficial desencadeada, principalmente, pelo Microsporum canis e de ocorrência comum nos felinos da raça Persa. Objetivou-se no presente estudo avaliar e comparar a melhora clínica e negativação micológica nos animais tratados com a terbinafina em pulsoterapia em relação a terapia contínua; evidenciar o acúmulo de terbinafina no pelame e o tempo em que o fármaco permanece em doses terapêuticas após a suspensão de sua administração; correlacionar a melhora clínica com a quantificação do fármaco no pelame; comparar a ocorrência de efeitos colaterais em pulsoterapia em relação a terapia contínua.. Foram incluídos nesse estudo, 27 gatos da raça Persa, 17 portadores assintomáticos e 10 sintomáticos do M. canis, o Grupo I foi composto por 13 fêmeas tratadas em pulsoterapia. Durante os primeiros sete dias a terbinafina foi administrada na dose de 20 mg/kg a cada 24 horas por via oral, seguidos por um período de suspensão da medicação pelos 21 dias subseqüentes, posteriormente foi realizado um segundo ciclo de sete dias, na dose de 40 mg/kg a cada 24 horas, novamente seguidos por um período de suspensão do fármaco nos 21 dias posteriores. O Grupo 11 foi constituído por 14 machos, que receberam terapia contínua, durante 56 dias. Nos primeiros 28 dias foi administrada a dose de 20 mg/kg a cada 24 horas por via oral e nos 28 dias subseqüentes a dose foi aumentada para 40 mg/kg diários. Os animais foram submetidos à duas colheitas de pelame pela Técnica do carpete com intervalo de 15 dias, anteriormente e posteriormente à terapia. Também eram realizadas colheitas de pelame nos dias zero, sete, 28, 35 e 56 dias para realização da quantificação das concentrações de terbinafina no pelame dos animais tratados, pela cromatografia líquida de alta performance (HPLC). Quinzenalmente, colhia-se sangue para realização de função hepática. Houve cura clínica e micológica em 100% dos animais tratados, as concentrações de terbinafina no pelame dos gatos se mantiveram acima daquelas consideradas terapêuticas por 21 dias após a pulsoterapia de sete dias, tanto na dose de 20, quanto na dose de 40 mg/kg diários, mas ocorreu maior acúmulo do fármaco na dose mais alta em terapia contínua, todavia esses animais apresentaram episódios eméticos na primeira semana de terapia, além de aumento da atividade sérica das transferases e da fosfatase alcalina. Já no grupo da pulsoterapia, não houve aumento da atividade sérica das enzimas hepáticas. A terbinafina foi eficaz e segura no tratamento de portadores sintomáticos e assintomáticos de M. canis. / Dermatophytosis is a superficial mycosis caused mainly by Microsporum canis and is very common in Persian cats. The goals of this study were: to evaluate the clinical and mycological cure in the animais treated with terbinafine in pulse therapy compared with continuous therapy; the accumulation of terbinafine in cats hair and the time that it is maintained in therapeutical concentrations after its suspension; correlates the clinical cure with the quantity of the drug in the hair and compare the side effects in pulse therapy in relation to continuous therapy. In this study were included 27 Persian cats, 17 healthy carriers of M. canis and 10 cats with dermatophytosis. The group I was composed of 13 females treated with pulse therapy, during the first seven days in the dosis of 20 mg/kg, daily, followed by a period of suspension of the medication for 21 days, subsequently, it was realized a new cycle of therapy, more seven days of terbinafine in the dosis of 40 mg/kg daily, repeating a period of suspension for another 21 days . The group 11 was composed of 14 males, that received continuous therapy, during 56 days, in the first 28 days they received the oral dosis of 20 mg/kg daily and 40 mg/kg daily for the next 28 days. The animais were submitted to two mycological cultures collected by the carpet square method with 15 days of interval, before and after the therapy. It was realized also manual avulsion of the cats hair for the quantification of terbinafine by high performance liquid chromatography (HPLC) in the days zero, seven, 28, 35 and 56. Every 15 days, blood samples were taken for hepatic function evaluation. There were clinical and mycological cure in 100% of treated animais; the concentrations of terbinafine in cats hair were maintained above therapeutical concentrations in pulse therapy in the dosis of 20, and also in 40 daily oral administration, but there was a higher accumulation of the drug when it was used in the higher dosis in continuous therapy. Although were seen emesis in the first week of therapy, and also higher serical activities of hepatic enzymes. There were no alterations in the values of AL T and FA in the pulse therapy group. Terbinafine had good efficacy and was secure for the treatment of healthy carriers of M. canis and also in animais with dermatophytosis.

Considerando a importância do felino doméstico nos relatos zoonóticos da esporotricose, assim como os problemas relacionados a terapêutica da micose nessa espécie, o estudo objetiva avaliar a atividade in vitro da terbinafina e itraconazol frente ao S. schenckii; estudar a ação desses fármacos no tratamento da esporotricose sistêmica experimental; analisar as enzimas hepáticas e hemograma dos animais submetidos ao tratamento antifúngico; estudar as possíveis alterações macroscópicas nos animais inoculados com S. schenckii assim como realizar o retroisolamento do agente. Para o teste in vitro, foram utilizados 10 isolados de S. schenckii (seis felinos, três humanos e um de cão), os quais foram avaliados quanto a suscetibilidade frente aos fármacos através da técnica de microdiluição em caldo de acordo com o CLSI para as fases leveduriforme e filamentosa do agente. A leitura da CIM foi visual, correspondendo à menor concentração do antifúngico em que não houve crescimento visível do S. schenckii quando comparado ao controle positivo. O teste in vivo, foi realizado através da inoculação pelas vias intraperitonial e veia lateral da cauda de células fúngicas (2x103 cél/mL) de dois isolados de S. schenckii (felino e canino) em 120 ratos norvergicus, divididos em quatro grupos: tratado terbinafina (250mg/kg) e itraconazol (100mg/kg); diluente terbinafina (250mg/kg de solução de água destilada com 5% de DMSO e 1% de Tween 20) e itraconazol (100mg/kg de água destilada estéril), sendo administrados através de sondagem oral uma vez ao dia, durante 30 dias. Paralelamente foram realizados hemogramas e avaliação das enzimas hepáticas (ALT e FA), assim como o acompanhamento da evolução clínica e análise histopatológica de todos animais experimentais. No final do período experimental os animais foram necropsiados e realizado análise macroscópica com a coleta dos órgãos para a obtenção do retroisolamento do S. schenckii. A CIM para a terbinafina obtida entre todos os isolados na fase leveduriforme de esporotricose felina variaram de 0,055μg/mL a 0,109μg/mL, enquanto que para os isolados humanos e de cão foi de 0,055μg/ml. Para o itraconazol, a CIM frente aos isolados de esporotricose felina foi de 0,875μg/mL a 1,75μg/mL, já para os casos humanos foi de 0,219μg/mL e para o isolado de cão de 1,75μg/mL. Para a fase filamentosa do agente foi observada uma CIM para a terbinafina entre os isolados de felinos de 0,875 μg/mL, enquanto que os isolados humanos e de cão a CIM foi de 0,219μg/mL. Para o itraconazol os isolados felinos resultaram numa CIM de 3,5μg/mL, já nos isolados de esporotricose humana e em cão a CIM foi de 1,75μg/mL. Quanto ao estudo in vivo, os animais tratados com terbinafina e itraconazol resultaram em menor freqüência de alterações macroscópicas assim como na obtenção do retroisolamento do agente em relação aos grupos controle. Não foi detectada alterações nas enzimas hepáticas, hemograma e nas avaliações macro e histopatológicas dos animais submetidos ao tratamento antifúngico. Com esses resultados conclui-se que a terbinafina e itraconazol possuem atividade in vitro frente ao S. schenckii e que as doses estudadas dos fármacos são eficazes no tratamento da esporotricose experimental sistêmica, assim como não produzem alterações das enzimas hepáticas avaliadas e do hemograma. / Considering the importance of the domestic feline in the zoonotic reports of the esporotrichosis, as well as the related problems the therapeutics of the mycosis in that species, the study objective was evaluate the activity in vitro of terbinafine and itraconazole against to S. schenckii; study the activity of those drugs in the treatment of the experimental systemic esporotrichosis; analyze the hepatic enzymes and blood count of the animals submitted to the antifungal treatment; study the possible macroscopic alterations in the animals inoculated with S. schenckii as well as realized the agent retroisolament. For the test in vitro, 10 isolated of S. schenckii were used (six felines, three humans and one canine), which were performed as the susceptibility against to the drugs through the microdiluição technique in broth in accordance with the CLSI for the phases yeast and mycelial of the agent. The reading of CIM was visual, corresponding to smallest concentration of the antifungal in that there was not visible growth of S. schenckii when compared to the positive control. The test in vivo, was performed through the of the inoculation intraperitonial and lateral vein of the tail of fungal cells (2x103 cél/mL) of two isolated of S. schenckii (feline and canine) in 120 mice norvergicus, divided in four groups: treaty terbinafine (250mg/kg) and itraconazole (100mg/kg); diluent terbinafine (250mg/kg of solution of water distilled with 5% of DMSO and 1% of Tween 20) and itraconazol (100mg/kg of water distilled sterile), being administered by gavage once a day, for 30 days. Parallel blood counts and evaluation of the hepatic enzymes were accomplished (ALT and F.A), as well as the accompaniment of the clinical evolution and analysis histopathologic of all animal experimental. In the end of the experimental period the animals were autopsied and performed macroscopic analysis with the collection of the organs for the obtaining of the detected S. schenckii growth. CIM for the terbinafine obtained among all the isolated in the phase yeast of feline esporotrichosis oscillated between 0,055μg/mL the 0,109μg/mL, while for the isolated humans and canine was of 0,055μg/ml. For the itraconazole, the CIM against of the isolated of feline esporotrichosis was from 0,875μg/mL to 1,75μg/mL, for the human cases it went of 0,219μg/mL and for the isolated canine of 1,75μg/mL. For the mycelial phase a CIM was observed for the terbinafine among the isolated of felines of 0,875 μg/mL, while the isolated humans and canine CIM was of 0,219μg/mL. For the itraconazole the isolated felines resulted in a CIM 3,5μg/mL, in the isolated of human esporotrichosis and canine CIM was of 1,75μg/mL. As for the study in vivo, the animals treaties with terbinafine and itraconazole resulted in smaller frequency of macroscopic alterations as well as in the obtaining of the detected agent growth in relation to the groups control. It was not detected alterations in the hepatic enzymes, blood count and in the evaluations macro and histopathologic of the animals submitted to the antifungal treatment. With those results we are to report that the terbinafine and itraconazol apresent activity in vitro against to S. schenckii and that the studied doses of the drugs are effective in the treatment of the systemic experimental esporotrichosis, as well as they don't produce alterations of the appraised hepatic enzymes and blood count.

Considerando a importância do felino doméstico nos relatos zoonóticos da esporotricose, assim como os problemas relacionados a terapêutica da micose nessa espécie, o estudo objetiva avaliar a atividade in vitro da terbinafina e itraconazol frente ao S. schenckii; estudar a ação desses fármacos no tratamento da esporotricose sistêmica experimental; analisar as enzimas hepáticas e hemograma dos animais submetidos ao tratamento antifúngico; estudar as possíveis alterações macroscópicas nos animais inoculados com S. schenckii assim como realizar o retroisolamento do agente. Para o teste in vitro, foram utilizados 10 isolados de S. schenckii (seis felinos, três humanos e um de cão), os quais foram avaliados quanto a suscetibilidade frente aos fármacos através da técnica de microdiluição em caldo de acordo com o CLSI para as fases leveduriforme e filamentosa do agente. A leitura da CIM foi visual, correspondendo à menor concentração do antifúngico em que não houve crescimento visível do S. schenckii quando comparado ao controle positivo. O teste in vivo, foi realizado através da inoculação pelas vias intraperitonial e veia lateral da cauda de células fúngicas (2x103 cél/mL) de dois isolados de S. schenckii (felino e canino) em 120 ratos norvergicus, divididos em quatro grupos: tratado terbinafina (250mg/kg) e itraconazol (100mg/kg); diluente terbinafina (250mg/kg de solução de água destilada com 5% de DMSO e 1% de Tween 20) e itraconazol (100mg/kg de água destilada estéril), sendo administrados através de sondagem oral uma vez ao dia, durante 30 dias. Paralelamente foram realizados hemogramas e avaliação das enzimas hepáticas (ALT e FA), assim como o acompanhamento da evolução clínica e análise histopatológica de todos animais experimentais. No final do período experimental os animais foram necropsiados e realizado análise macroscópica com a coleta dos órgãos para a obtenção do retroisolamento do S. schenckii. A CIM para a terbinafina obtida entre todos os isolados na fase leveduriforme de esporotricose felina variaram de 0,055μg/mL a 0,109μg/mL, enquanto que para os isolados humanos e de cão foi de 0,055μg/ml. Para o itraconazol, a CIM frente aos isolados de esporotricose felina foi de 0,875μg/mL a 1,75μg/mL, já para os casos humanos foi de 0,219μg/mL e para o isolado de cão de 1,75μg/mL. Para a fase filamentosa do agente foi observada uma CIM para a terbinafina entre os isolados de felinos de 0,875 μg/mL, enquanto que os isolados humanos e de cão a CIM foi de 0,219μg/mL. Para o itraconazol os isolados felinos resultaram numa CIM de 3,5μg/mL, já nos isolados de esporotricose humana e em cão a CIM foi de 1,75μg/mL. Quanto ao estudo in vivo, os animais tratados com terbinafina e itraconazol resultaram em menor freqüência de alterações macroscópicas assim como na obtenção do retroisolamento do agente em relação aos grupos controle. Não foi detectada alterações nas enzimas hepáticas, hemograma e nas avaliações macro e histopatológicas dos animais submetidos ao tratamento antifúngico. Com esses resultados conclui-se que a terbinafina e itraconazol possuem atividade in vitro frente ao S. schenckii e que as doses estudadas dos fármacos são eficazes no tratamento da esporotricose experimental sistêmica, assim como não produzem alterações das enzimas hepáticas avaliadas e do hemograma. / Considering the importance of the domestic feline in the zoonotic reports of the esporotrichosis, as well as the related problems the therapeutics of the mycosis in that species, the study objective was evaluate the activity in vitro of terbinafine and itraconazole against to S. schenckii; study the activity of those drugs in the treatment of the experimental systemic esporotrichosis; analyze the hepatic enzymes and blood count of the animals submitted to the antifungal treatment; study the possible macroscopic alterations in the animals inoculated with S. schenckii as well as realized the agent retroisolament. For the test in vitro, 10 isolated of S. schenckii were used (six felines, three humans and one canine), which were performed as the susceptibility against to the drugs through the microdiluição technique in broth in accordance with the CLSI for the phases yeast and mycelial of the agent. The reading of CIM was visual, corresponding to smallest concentration of the antifungal in that there was not visible growth of S. schenckii when compared to the positive control. The test in vivo, was performed through the of the inoculation intraperitonial and lateral vein of the tail of fungal cells (2x103 cél/mL) of two isolated of S. schenckii (feline and canine) in 120 mice norvergicus, divided in four groups: treaty terbinafine (250mg/kg) and itraconazole (100mg/kg); diluent terbinafine (250mg/kg of solution of water distilled with 5% of DMSO and 1% of Tween 20) and itraconazol (100mg/kg of water distilled sterile), being administered by gavage once a day, for 30 days. Parallel blood counts and evaluation of the hepatic enzymes were accomplished (ALT and F.A), as well as the accompaniment of the clinical evolution and analysis histopathologic of all animal experimental. In the end of the experimental period the animals were autopsied and performed macroscopic analysis with the collection of the organs for the obtaining of the detected S. schenckii growth. CIM for the terbinafine obtained among all the isolated in the phase yeast of feline esporotrichosis oscillated between 0,055μg/mL the 0,109μg/mL, while for the isolated humans and canine was of 0,055μg/ml. For the itraconazole, the CIM against of the isolated of feline esporotrichosis was from 0,875μg/mL to 1,75μg/mL, for the human cases it went of 0,219μg/mL and for the isolated canine of 1,75μg/mL. For the mycelial phase a CIM was observed for the terbinafine among the isolated of felines of 0,875 μg/mL, while the isolated humans and canine CIM was of 0,219μg/mL. For the itraconazole the isolated felines resulted in a CIM 3,5μg/mL, in the isolated of human esporotrichosis and canine CIM was of 1,75μg/mL. As for the study in vivo, the animals treaties with terbinafine and itraconazole resulted in smaller frequency of macroscopic alterations as well as in the obtaining of the detected agent growth in relation to the groups control. It was not detected alterations in the hepatic enzymes, blood count and in the evaluations macro and histopathologic of the animals submitted to the antifungal treatment. With those results we are to report that the terbinafine and itraconazol apresent activity in vitro against to S. schenckii and that the studied doses of the drugs are effective in the treatment of the systemic experimental esporotrichosis, as well as they don't produce alterations of the appraised hepatic enzymes and blood count.

Considerando a importância do felino doméstico nos relatos zoonóticos da esporotricose, assim como os problemas relacionados a terapêutica da micose nessa espécie, o estudo objetiva avaliar a atividade in vitro da terbinafina e itraconazol frente ao S. schenckii; estudar a ação desses fármacos no tratamento da esporotricose sistêmica experimental; analisar as enzimas hepáticas e hemograma dos animais submetidos ao tratamento antifúngico; estudar as possíveis alterações macroscópicas nos animais inoculados com S. schenckii assim como realizar o retroisolamento do agente. Para o teste in vitro, foram utilizados 10 isolados de S. schenckii (seis felinos, três humanos e um de cão), os quais foram avaliados quanto a suscetibilidade frente aos fármacos através da técnica de microdiluição em caldo de acordo com o CLSI para as fases leveduriforme e filamentosa do agente. A leitura da CIM foi visual, correspondendo à menor concentração do antifúngico em que não houve crescimento visível do S. schenckii quando comparado ao controle positivo. O teste in vivo, foi realizado através da inoculação pelas vias intraperitonial e veia lateral da cauda de células fúngicas (2x103 cél/mL) de dois isolados de S. schenckii (felino e canino) em 120 ratos norvergicus, divididos em quatro grupos: tratado terbinafina (250mg/kg) e itraconazol (100mg/kg); diluente terbinafina (250mg/kg de solução de água destilada com 5% de DMSO e 1% de Tween 20) e itraconazol (100mg/kg de água destilada estéril), sendo administrados através de sondagem oral uma vez ao dia, durante 30 dias. Paralelamente foram realizados hemogramas e avaliação das enzimas hepáticas (ALT e FA), assim como o acompanhamento da evolução clínica e análise histopatológica de todos animais experimentais. No final do período experimental os animais foram necropsiados e realizado análise macroscópica com a coleta dos órgãos para a obtenção do retroisolamento do S. schenckii. A CIM para a terbinafina obtida entre todos os isolados na fase leveduriforme de esporotricose felina variaram de 0,055μg/mL a 0,109μg/mL, enquanto que para os isolados humanos e de cão foi de 0,055μg/ml. Para o itraconazol, a CIM frente aos isolados de esporotricose felina foi de 0,875μg/mL a 1,75μg/mL, já para os casos humanos foi de 0,219μg/mL e para o isolado de cão de 1,75μg/mL. Para a fase filamentosa do agente foi observada uma CIM para a terbinafina entre os isolados de felinos de 0,875 μg/mL, enquanto que os isolados humanos e de cão a CIM foi de 0,219μg/mL. Para o itraconazol os isolados felinos resultaram numa CIM de 3,5μg/mL, já nos isolados de esporotricose humana e em cão a CIM foi de 1,75μg/mL. Quanto ao estudo in vivo, os animais tratados com terbinafina e itraconazol resultaram em menor freqüência de alterações macroscópicas assim como na obtenção do retroisolamento do agente em relação aos grupos controle. Não foi detectada alterações nas enzimas hepáticas, hemograma e nas avaliações macro e histopatológicas dos animais submetidos ao tratamento antifúngico. Com esses resultados conclui-se que a terbinafina e itraconazol possuem atividade in vitro frente ao S. schenckii e que as doses estudadas dos fármacos são eficazes no tratamento da esporotricose experimental sistêmica, assim como não produzem alterações das enzimas hepáticas avaliadas e do hemograma. / Considering the importance of the domestic feline in the zoonotic reports of the esporotrichosis, as well as the related problems the therapeutics of the mycosis in that species, the study objective was evaluate the activity in vitro of terbinafine and itraconazole against to S. schenckii; study the activity of those drugs in the treatment of the experimental systemic esporotrichosis; analyze the hepatic enzymes and blood count of the animals submitted to the antifungal treatment; study the possible macroscopic alterations in the animals inoculated with S. schenckii as well as realized the agent retroisolament. For the test in vitro, 10 isolated of S. schenckii were used (six felines, three humans and one canine), which were performed as the susceptibility against to the drugs through the microdiluição technique in broth in accordance with the CLSI for the phases yeast and mycelial of the agent. The reading of CIM was visual, corresponding to smallest concentration of the antifungal in that there was not visible growth of S. schenckii when compared to the positive control. The test in vivo, was performed through the of the inoculation intraperitonial and lateral vein of the tail of fungal cells (2x103 cél/mL) of two isolated of S. schenckii (feline and canine) in 120 mice norvergicus, divided in four groups: treaty terbinafine (250mg/kg) and itraconazole (100mg/kg); diluent terbinafine (250mg/kg of solution of water distilled with 5% of DMSO and 1% of Tween 20) and itraconazol (100mg/kg of water distilled sterile), being administered by gavage once a day, for 30 days. Parallel blood counts and evaluation of the hepatic enzymes were accomplished (ALT and F.A), as well as the accompaniment of the clinical evolution and analysis histopathologic of all animal experimental. In the end of the experimental period the animals were autopsied and performed macroscopic analysis with the collection of the organs for the obtaining of the detected S. schenckii growth. CIM for the terbinafine obtained among all the isolated in the phase yeast of feline esporotrichosis oscillated between 0,055μg/mL the 0,109μg/mL, while for the isolated humans and canine was of 0,055μg/ml. For the itraconazole, the CIM against of the isolated of feline esporotrichosis was from 0,875μg/mL to 1,75μg/mL, for the human cases it went of 0,219μg/mL and for the isolated canine of 1,75μg/mL. For the mycelial phase a CIM was observed for the terbinafine among the isolated of felines of 0,875 μg/mL, while the isolated humans and canine CIM was of 0,219μg/mL. For the itraconazole the isolated felines resulted in a CIM 3,5μg/mL, in the isolated of human esporotrichosis and canine CIM was of 1,75μg/mL. As for the study in vivo, the animals treaties with terbinafine and itraconazole resulted in smaller frequency of macroscopic alterations as well as in the obtaining of the detected agent growth in relation to the groups control. It was not detected alterations in the hepatic enzymes, blood count and in the evaluations macro and histopathologic of the animals submitted to the antifungal treatment. With those results we are to report that the terbinafine and itraconazol apresent activity in vitro against to S. schenckii and that the studied doses of the drugs are effective in the treatment of the systemic experimental esporotrichosis, as well as they don't produce alterations of the appraised hepatic enzymes and blood count.

A dermatofitose é micose superficial desencadeada, principalmente, pelo Microsporum canis e de ocorrência comum nos felinos da raça Persa. Objetivou-se no presente estudo avaliar e comparar a melhora clínica e negativação micológica nos animais tratados com a terbinafina em pulsoterapia em relação a terapia contínua; evidenciar o acúmulo de terbinafina no pelame e o tempo em que o fármaco permanece em doses terapêuticas após a suspensão de sua administração; correlacionar a melhora clínica com a quantificação do fármaco no pelame; comparar a ocorrência de efeitos colaterais em pulsoterapia em relação a terapia contínua.. Foram incluídos nesse estudo, 27 gatos da raça Persa, 17 portadores assintomáticos e 10 sintomáticos do M. canis, o Grupo I foi composto por 13 fêmeas tratadas em pulsoterapia. Durante os primeiros sete dias a terbinafina foi administrada na dose de 20 mg/kg a cada 24 horas por via oral, seguidos por um período de suspensão da medicação pelos 21 dias subseqüentes, posteriormente foi realizado um segundo ciclo de sete dias, na dose de 40 mg/kg a cada 24 horas, novamente seguidos por um período de suspensão do fármaco nos 21 dias posteriores. O Grupo 11 foi constituído por 14 machos, que receberam terapia contínua, durante 56 dias. Nos primeiros 28 dias foi administrada a dose de 20 mg/kg a cada 24 horas por via oral e nos 28 dias subseqüentes a dose foi aumentada para 40 mg/kg diários. Os animais foram submetidos à duas colheitas de pelame pela Técnica do carpete com intervalo de 15 dias, anteriormente e posteriormente à terapia. Também eram realizadas colheitas de pelame nos dias zero, sete, 28, 35 e 56 dias para realização da quantificação das concentrações de terbinafina no pelame dos animais tratados, pela cromatografia líquida de alta performance (HPLC). Quinzenalmente, colhia-se sangue para realização de função hepática. Houve cura clínica e micológica em 100% dos animais tratados, as concentrações de terbinafina no pelame dos gatos se mantiveram acima daquelas consideradas terapêuticas por 21 dias após a pulsoterapia de sete dias, tanto na dose de 20, quanto na dose de 40 mg/kg diários, mas ocorreu maior acúmulo do fármaco na dose mais alta em terapia contínua, todavia esses animais apresentaram episódios eméticos na primeira semana de terapia, além de aumento da atividade sérica das transferases e da fosfatase alcalina. Já no grupo da pulsoterapia, não houve aumento da atividade sérica das enzimas hepáticas. A terbinafina foi eficaz e segura no tratamento de portadores sintomáticos e assintomáticos de M. canis. / Dermatophytosis is a superficial mycosis caused mainly by Microsporum canis and is very common in Persian cats. The goals of this study were: to evaluate the clinical and mycological cure in the animais treated with terbinafine in pulse therapy compared with continuous therapy; the accumulation of terbinafine in cats hair and the time that it is maintained in therapeutical concentrations after its suspension; correlates the clinical cure with the quantity of the drug in the hair and compare the side effects in pulse therapy in relation to continuous therapy. In this study were included 27 Persian cats, 17 healthy carriers of M. canis and 10 cats with dermatophytosis. The group I was composed of 13 females treated with pulse therapy, during the first seven days in the dosis of 20 mg/kg, daily, followed by a period of suspension of the medication for 21 days, subsequently, it was realized a new cycle of therapy, more seven days of terbinafine in the dosis of 40 mg/kg daily, repeating a period of suspension for another 21 days . The group 11 was composed of 14 males, that received continuous therapy, during 56 days, in the first 28 days they received the oral dosis of 20 mg/kg daily and 40 mg/kg daily for the next 28 days. The animais were submitted to two mycological cultures collected by the carpet square method with 15 days of interval, before and after the therapy. It was realized also manual avulsion of the cats hair for the quantification of terbinafine by high performance liquid chromatography (HPLC) in the days zero, seven, 28, 35 and 56. Every 15 days, blood samples were taken for hepatic function evaluation. There were clinical and mycological cure in 100% of treated animais; the concentrations of terbinafine in cats hair were maintained above therapeutical concentrations in pulse therapy in the dosis of 20, and also in 40 daily oral administration, but there was a higher accumulation of the drug when it was used in the higher dosis in continuous therapy. Although were seen emesis in the first week of therapy, and also higher serical activities of hepatic enzymes. There were no alterations in the values of AL T and FA in the pulse therapy group. Terbinafine had good efficacy and was secure for the treatment of healthy carriers of M. canis and also in animais with dermatophytosis.

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biophysics and Physical Chemistry Candidate: Andrea Malovaná Supervisor: Ing. Martin Drastík, Ph. D. Diploma thesis: Simplification of terbinafine HPLC analysis of samples based on biodegradable polyesters A HPLC method for determination of terbinafine in samples consisting of copolymers of lactic and glycolic acid was optimized and validated. The development of the method was based on the finding of suitable chromatographic conditions for separation of terbinafine. The separation was performed on the Ascentis Express ES-CN, 15 cm × 4.6 mm; 2.7 μm core- shell column. The mixture of the citrate phosphate buffer pH 4 and acetonitrile in ratio 40:60 (v/v) was chosen as the mobile phase. The mobile phase flow rate was set to 1.4 ml/min and the temperature to 30 řC. The injection volume of samples containing terbinafine was 5 µl. The UV detection at 226 nm was employed. The retention time of terbinafine was 3.3 min. The whole analysis was completed within 4 min. The method was validated, following parameters were tested: column efficiency, factor of symmetry, LOD, LOQ, linearity, repeatability and robustness. Keywords: terbinafine, HPLC, core-shell column, PLGA

As dermatofitoses dos carnívoros domésticos são infecções fúngicas superficiais, causadas habitualmente por dois gêneros fúngicos: Microsporum sp e Trichophyton sp. Trata-se de uma antropozoonose, com importância na saúde pública Objetivou-se: caracterizar a população de cães e gatos acometidos por dermatofitose atendidos no Serviço de Dermatologia do HOVET /USP num período de 27 meses; determinar a valia do exame histopatológico como metodologia diagnóstica; e comparar a eficácia da griseofulvina e da terbinafina na terapia das dermatofitoses. Foram atendidos 76 animais com diagnóstico de dermatofitose, 47,3% pertenciam à espécie fetina e 52,7% à canina O agente etiológico isolado com maior freqüência em caninos e felinos foi Microsporum canis. Não se observou distribuição sazonal. Os cães de raça definida foram os mais acometidos (75,0%), dentre estes, aqueles da raça Yorkshire Temer (23,3%). Os felinos com e sem definição racial igualmente acometidos, porém os Persas (93,7%) foram os mais acometidos dentre aqueles com plena definição. Observou-se que a maioria dos animais infectados apresentava menos de um ano de idade (65,8%). As lesões mais observadas foram: alopecia, eritema, escamas e crostas. A maioria das lesões apresentava configuração circular e estavam localizadas nas regiões cefálicas, de tronco e de membros. O prurido esteve ausente em 50,0% dos caninos e em 88,8% dos felinos. As lesões dos cães tinham caráter mais inflamatório. O exame histopatológico mostrou-se pouco sensível (28,6%) e com alto número de falsos negativos (71,4%). A griseofulvina (5Omg/kg/dia) foi eficaz em l00,0% dos casos, sem acarretar efeitos colaterais, com média de tempo para cura de 41 dias. Já a terbinafina na dose de cinco mg/kg/dia, apresentou eficácia de 81,8%, sem induzir efeitos colaterais e com êxito terapêutico em 21 dias. Demonstrou-se assim, que a dose de 20 mg/kg/dia demonstrou a mesma eficácia que a dose de cinco, porém, com efeitos colaterais em 16,6% dos animais tratados, com tempo médio para cura de 33 dias. Demonstrou-se que a terbinafina é uma boa alternativa terapêutica, porém, a griseofulvina ainda se constitui na droga de eleição para o tratamento das dermatofitoses de caninos e felinos. / Dermatophytosis in domestic carnivorous are superficial infections caused mainly by two genus of fungus: Microsporum sp and Trichophyton sp. This disease is an anthropozoonosis important for public health. The goals of this study were: characterize the population of cats and dogs with dermatophytosis treated in the Dermatology Service of HOVET FMVZ/USP in a period of 27 months; evaluate the validity of the histopathological exam as a methodology of diagnosis; and compare the efficacy of griseofulvin and terbinafine in the therapy of the dermatophytosis. Seventy six animals (47,3% were felines and 52,7% were canines) were evaluated in this study. The more frequent isolated etiological agent in canines and felines was Microsporum canis. Seasonality was not observed. The dogs with a defined breed were more predisposed (75,0%) and the Yorkshire Terrier dogs had a higher proportion of positive cultures (23,3%). The felines with or without breed definition got the same frequency, however, the Persians (93,7%) were more predisposed among those of pure breed. It was noticed that the majority of infected animals were under one year of age (65,8%). The most observed lesions were: alopecia, crusts, erythema and scales. The majority of the lesions had a circular form and were found in the cephalic, trunk and limb regions. There was no pruritus in 50,0% of the canines and 88,8% of the felines. The lesions were more inflammatory in dogs. The histopathological exam had a low sensitivity (28,6%) and a high number of false negatives (71,4%).Griseofulvin (50 mg/kg/day) was effective in 100,0% of the cases, with no side effects, the average time for cure was 41 days. The terbinafine used at the dosage of 5 mg/kg/day showed an efficacy of 81,3%, no side effects were observed as well and average time for cure was 21 days. The same efficacy using the dosage of 20 mg/kg/day of terbinafine was observed, although side effects were observed in 16,6% of the animals treated with an average time for cure of 33 days. The present study demonstrated that terbinafine is a good therapeutical alternative, although griseofulvin is still the first choice drug for the treatment of dermatophytosis in dogs and cats.