This report presents a case of a potential pharmacokinetic drug-drug interaction (DDI) between fluconazole (FLU) and vancomycin (VCM) in a patient who underwent hepatobiliary surgery and biliary drainage. The patient was receiving treatment with vancomycin, meropenem, and fluconazole for an infectious condition. The exact effects of FLU and VCM on each other’s pharmacokinetics have not been fully explored. However, understanding the role of renal transporters (such as multidrug resistance-associated proteins, organic cation transporters, and P-glycoprotein) in the excretion of these drugs is crucial for predicting drug disposition and optimizing dosage. Inhibiting these transporters is often the underlying mechanism of drug interactions. Pharmacokinetic monitoring showed that when FLU was co-administered with VCM, the trough concentration and half-life of VCM increased unexpectedly compared with when VCM was given alone. These alterations in pharmacokinetic parameters suggest a possible DDI between FLU and VCM. Therefore, caution should be exercised when these drugs are used together, and VCM trough concentrations should be carefully monitored to minimize toxicity risk.
The demand for the development of therapeutic compounds targeting infectious diseases has surged over the past three years, particularly in response to the COVID-19 pandemic. This study aims to compile and analyze the pharmacological effects of metal-based organic complexes against a variety of viral infections, including COVID-19. A systematic review of the existing literature was conducted using databases such as Medline, Scopus, PubMed, and ScienceDirect. The methodology involved data gathering, summarization, and analysis of relevant studies. Antiviral activities are exhibited by metal complexes with various ligands, including hydrazones and thiosemi-carbazones (Pt(II), Pd(II), Ga(III), Pd(II), Co(III), Ni(II), Cu(II)), fluoroquinolones and quinolines (Pd(II)), phenylquinoline, phenylpyridine, tetrahydropyrimidines (Ag(I)), phenanthroline (Cu(II)), and valacyclovir (Cu(II)). Metal complexes containing Zn(II), Co(II), Cu(II), Ni(II), Mg(II), and Mn(II) have shown antiviral properties against DNA viruses, particularly herpes simplex viruses HSV-1 and HSV-2. HIV-inhibiting complexes have been identified with metals such as Au(II), Co(II), Cu(II), Fe(III), La(III), Mg(II), Ni(II), Pd(II), Pt(II), and Ru(II). In light of the persistent global spread of SARS-CoV-2, the development of effective treatments for COVID-19 remains a priority. Investigations into potential therapeutic agents for combating SARS-CoV-2 are focusing on compounds like auranofin and metal complexes of Cu(II), Ni(II), Mn(II), and Zn(II) combined with Coumarin.
Eurasian Academy of Medicine and Dentistry