ANTI FUNGAL REVIEW
MYCOSIS ?
SUPERFICIAL MYCOSIS SYSTEMIC MYCOSIS
CLASSIFICATION • DRUGS FOR SYSTEMIC MYCOSIS Amphotericin B AZOLES Fluconazole Itraconazole ketoconazole Flucytosine
DRUGS FOR MUCOCUTANOUES MYCOSIS
GRISEOFULVIN
TERBINAFINE
DRUGS FOR SUPERFICIAL MYCOSIS Nystatin Clotrimazole Miconazole Econazole
SUPERFICIAL MYCOSES Dermatophyte infections • Ring worms • tinea Candida infections •Cutaneous •Moucosa Alimetary tract. • vaginal
Infection
Superficial mycoses Drugs Route
Imidazoles Ring worm Clotrimazole Econazole Tinea Miconazole Sulconazole
Topical Topical Topical Topical Topical
Candida Infections
Cutaneous
amphotericin
Topical
Clotrimazole
Topical
Econazole
Topical
Miconazole
Topical
Nystatin
Topical
Candida Infections amphotericin Mucosa Fluconazole Alimentary ketoconazole tract Miconazole Nystatin
IV Orally / IV Only Orally Lozenges / Gel / Suspension or tablets
Candida Infections Clotrimazole Econazole Vaginal
Isoconazole ketoconazole Miconazole Nystatin
Pessaries Vaginal tablets cream
Systemic mycosis Aspergillosis Candidiasis Coccidiodoidomycosis Cryptococcosis Histoplasmosis Sporotrichosis
Classification of anti fungal drugs according to Mechanism of action
Drugs that disrupt the cell membrane Drugs that inhibit mitosis
Drugs that disrupt cell membranes
• Polyene antibiotics •Amphotericin B •Nystatin
AZOLES Imidazoles
Triazoles
Ketoconazole Miconazole Clotrimazole Isoconazole Ticonazole Fluconazole Itraconazole
Mechanism of action • Polyene antibiotics Binds to sterols (ergo sterol) present in the cell Membranes Leakage of intracellular ions & enzymes Cell death
Azoles • Imidazoles (KIMC) Interfere with fungal oxidative enzymes Lethal accumulation of hydrogen peroxide Triazoles (FI) Inhibit demethylase enzyme damage cell membrane
Drugs that inhibit Mitosis • Griseofulvin • Flucytosine
Flutycosine
5 flurouracil
Inhibit nucleic acid synthesis