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Antifungal Drugs

 

I. Drugs Used To Treat Systemic Mycoses

(1. Antibiotics)

Amphotericin B

• Spectrum: Canndida

albicans, Candida krusei, Cryptococcus neoformans

• Side Effects: Can be
lethal effects. High fever, tachycardia, dyspnea, vomiting

                      If intravenously given;
Nephotoxicity, Hepatotoxicity, Arythmia

• Mechanism of Action:
Binds with ergosterol, a componenet of fungal cell membrane

Caspofungin – sol inj.

• Spectrum: ”

• Side Effects: Increased
plasma creatinine, anemia, hypokalemia, etc.

                    [Don’t give in pregnancy]

•Mechanism of Action:
Disturbing the integrity of cell wall

 

(2. Synthetic Drugs)

»Azoles

Fluconazole 200 mg

• Spectrum: Candida,

Histoplasma, Coccidioides, Blastomyces

• Side Effects: Rash,
headache, abdominal pain, elevated liver enzymes

• Mechanism of Action:
Inhibits Cytochrome P450

Ketoconazole

• Spectrum: ”

• Side Effects: Risk for
hepatotoxicity

• Mechanism of Action:
Interferes with the ergosterol synthesis

Itraconazle

Voriconazole

 

  »Antimetabolites

Flucytosine

 

II. Drugs Used To Treat Superficial Mycoses

(1. Antibiotics)

Nystatin – tablet 500000 IU

• Spectrum: Candida(Cutaneous, vaginal, mucosal, esophageal)

• Side Effects: Diarrhea, Tachycardia-rare,
Hypersensitivity including Stevens-Johnson syndrome, rash, itching …

• Mechanism of Action: Binds to ergosterol and make pores leading to K+
leakage

♦ Bioavailability – 0% on oral

  Metabolism – None

  Excretion – Fecal

 

 

(2. Synthetic Drugs)

»Azoles

Ketoconazole

• Spectrum:
Athlete’s foot, ringworm, candidiasis, jock itch, tinea versicolor …

• Side Effects: Liver damage, adrenal problems

• Mechanism of Action:…

Miconazole – Gel oral 2% 40g, tablet buccal 50 mg

Clotrimazole

Econazole

 

  »Allilamines

Naftifine

Terbinafine

 

  »Others

Ciclopirox olamine – nail lacquer

Salicylic acid

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