Treatment of fungal infections Flashcards
Systemic antifungal agents.
Amphotericin B. - Polyene
Azoles -
Imidazoles and Triazoles
Echinocandins
Antimetabolites
Allylamines - terbinafine
Griseofulvin
Amphotericin B
mechanism and use.
the main Polyene class drug. the main antifungal for severe, systemic infections.
Binds ergosterol in the fungal membrane and produces pores.
It also generates oxidative reactions and ROS when metabolized by the fungi.
It does also bind cholesterol weakly, and has some major side effects.
Nephrotoxicity, fever, myalgia, hypotension, bronchospasm.
Liposomal amphotericin B has better penetration and lower side effects but is more expensiv.e
Azoles
mechanism
Inhibit Ergosterol synthesis, from lanosterol to ergosterol conversion
GI and liver toxicity
Aconazole
Ketokonazol
Itraconazol
Terbinafine
mechanism
An allylamine
Inhibits Ergosterol syntehsis
From squalene.
Nystatin
mechanism
Also a polyen
Only used topically, because it has very high toxicity when ingested.
Echinocandins
name and mechanism
Capsofungin
Inhibit Beta-glucan synthase
Cell wall component.
Anti-metabolite antifungal drugs
names and mechanism
Flucytosine
Forms 5-fluorouracil in the cytoplasm
Useful against
Candida
C. neoformans
S. cerevisiae
Griseofulvin
mechanism and use
Oral agent used against dermatophytes, especially the onchynomycoses, because it accumulates in the keratin of nails and hair.
Inhibits microtubules of the fungal cells, thus blocking mitosis.
has GI side effects, diarrhea, nausea.
What are the topical antifungal agents
Nystatin is only topical
Others can all also be given as topical agents.
