Antifungals

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Author:
USUHS14
ID:
150733
Filename:
Antifungals
Updated:
2012-04-28 16:33:44
Tags:
Pharm antifungals
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pharm antifungals
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  1. Amphotericin B
    • Polyene
    • binds to sterols (especially ergosterol) in cell membranes, perturbing the cell membrane and causing leakage of cell components
    • Can cause permanent decrease in GFR
  2. Itraconazole
    • Azole: Inhibits ergosterol synthesis via inhibition of 14-alpha-demtehylase (a CYP-450); Inhibitor of CYP3A4
    • Azole of choice for dermatophytoses and onychomycosis
    • Can precipitate CHF in susceptible pts.
  3. Fluconazole
    • Azole: Inhibits ergosterol synthesis via inhibition of 14-alpha-demtehylase (a CYP-450); Inhibitor of CYP3A4
    • Good CNS penetration
    • Use for Candida esophagitis and Amphotericin B resistant AIDS associated cryptococcal meningitis
  4. Posaconazole
    • Azole: Inhibits ergosterol synthesis via inhibition of 14-alpha-demtehylase (a CYP-450); Inhibitor of CYP3A4
    • Drug of choice for fluconazole and itraconazole resistant Candida
  5. Voriconazole
    • Azole: Inhibits ergosterol synthesis via inhibition of 14-alpha-demtehylase (a CYP-450); Inhibitor of CYP3A4
    • Drug of choice for treatment of invasive Aspergillus
    • Can cause blurred vision, photophobia, and altered color perception
  6. Terbinafine
    • Allylamine
    • Inhibition of fungal squalene epoxidase (ergosterol synthesis)
    • Can be used topically or orally for tinea or cutaneous Candida infections
  7. Ciclopirox Olamine
    • Pyridone antifungal that inhibits uptake of essential extracellular nutrients
    • Topical treatment of dermatomycosis (including infx of hair and nails)
  8. Caspofungin
    • Echinocandin
    • Inhibits beta(1,3)-D-glucan synthase which makes glucan, an essential cell wall component
    • Use for candidiasis and invasive aspergillosis
  9. Flucytosine
    • Cystosine analogue
    • Makes bad RNA and inhibits synthesis of dTMP
    • Used with amphotericin B
  10. Griseofulvin
    • Disrupts microtubule function resulting in aberrant mitoses
    • Use orally with dermatomycosis
    • No good against Candida

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