this is a very lengthy and boring topic and most of the time people left this topic of medical studies.but as a doctor we should know every single drug related to any diseases.

2. DRUGS FOR CUTANEOUS
MYCOTIC INFECTIONS
FATIMA MERAJ
DOW UNIVERSITY OF HEALTH SCIENCES

3. ORGANISMS THAT CAUSE CUTANEOUS
MYCOTIC INFECTIONS
• These are mold like fungi called DERMATOPHYTES or
TINEA.
• The three common fungi that cause dermatomycoses are:
1)Trichophyton
2)Microsporum
3)Epidermophyton

4. DRUGS( SQUALENE EPOXIDASE
INHIBITORS)
• Squalene is a biochemical precursor of whole family of steroids.
• Ergosterol is an essential steroid of fungal cell membrane which
require squalene for its formation.
• Squalene epoxidase inhibitors act by inhibiting squalene
epoxidase enzyme which is used for oxidation of squalene
thereby blocking the synthesis of ergosterol.
• Accumulation of toxic amount of squalene results in increased
membrane permeability and death of fungal cell.

5. TERBINAFINE
• Oral Terbinafine is the drug of choice for treating dermatophyte
onychomycoses which is a fungal infection of nails.
• Also used for TINEA CAPITIS ( infection of scalp)
• Better tolerated
• Shorter duration of therapy
• More effective than Itraconazole and Griseofulvin
• Topical antifunfals are ineffective.
• Effective against Candida Trichophyton Epidermophyton

6. PHARMACOKINETICS
• Terbinafine is available in oral and topical administration. The
bioavailability after oral administration is only 40% due to first pass
metabolism.
• It is highly protein bound and may be deposited in skin nails and
adipose tissue
• Half life is 200 to 400 hours.
• Excreted via urine that’s why should be avoided in patients with renal
impairment.

7. ADVERSE EFFECTS
• Common adverse effects include
Diarrhea, Dyspepsia, Nausea ,Headache and Rash
• Taste and visual disturbances have been reported
• Serum hepatic transaminases elevation is also seen

8. SOME OTHER SQUALENE OXIDASE
INHIBITORS
NAFTIFINE:
Active against Trichophyton,
Microsporum, Epidermophyton
• Used in the form of cream or gel for the treatment
of tinea corporis(ring worm) , tinea
pedis(athelete’foot/infection of feet) , tinea cruris(
infection of groin which is the junction between
thigh and abdomen)
• Duration of treatment is 2 to 4 weeks

9. GRISEOFULVIN
• Mechanism of action: It causes disruption of mitotic
spindle and inhibition of fungal mitosis so it is
called FUNGISTATIC
• Requires a long duration of treatment like 6 to 12
months
• Adequately absorbed from GIT and absorption is
enhanced by high-fat meals.
• It also induces formation of anticoagulants

10. NYSTATIN
• This drug is similar to Amphotericin
B
• Negligibly absorbed from GIT
• Not used parenterally due to
systemaic toxicity
• Administered as oral agent for the
treatment of oropharyngeal

11. CICLOPIROX
• It inhibits the transport of essential elements in the fungal
cell,disrupting the synthesisof DNA or RNA and proteins
• Ciclopirox shampoo is used for treatment of seborrheic
dermatitis.
• Like other drugs it is also used as topical administration

12. IMIDAZOLES
• These are azole derivatives.
• Topical administration is used for tinea cruris, tinea
pedis,tinea corporis, oropharyngeal and vulvovaginal
candidiasis
• Oral ketoconazole is rarely used nowadays due to the
risk of severe liver injury and adrenal insufficiency.

13. TOLNAFTATE
•It distorts the hyphae and stunts the
mycelial growth in susceptible fungi.
•It is also available in the form of
solutions, cream and powder