This document discusses various anti-fungal drugs used to treat superficial and deep fungal infections. It describes the classes of anti-fungal drugs including azoles like fluconazole and itraconazole which inhibit fungal enzymes, allylamines like terbinafine which inhibit fungal sterol synthesis, and echinocandins like caspofungin which inhibit fungal cell wall synthesis. For each drug, it provides information on mechanisms of action and typical dosage regimens depending on the type of fungal infection being treated.

1. ANTI FUNGAL DRUGS

4. ANTI FUNGAL DRUGS
•ANTI FUNGAL DRUGS used to
treat superficial and deep
fungal infections.

23. NYSTATIN
Dose
• 500,000 to 1 million units as oral tab
tds – intestinal candidiasis.
• 400,000-600,000 units oral
suspension qid – oral candidiasis.

28. HETEROCYCLIC BENZOFURAN
•Griseofulvin – MOA
• it Arrests fungal cell activity by
disrupting mitotic spindle
structure.

31. Dose :
• 125-200 mg qid with meals, duration
depends on the site of infection:
• Scalp-4weeks
• Palm,soles:6-8 week
• Finger nails: 6-8 month
• Toe nails : 10-12 month.

36. ECHINOCANDIS
•Caspofungin
•Micafungin
•Anidulafungin

39. CASPOFUNGIN
•It Inhibits synthesis of b (1,3)-D-
glucan in susceptible aspergillus
species.
•Dose : 70 mg loading dose infused
IV over 1 hour,
•followed by 50 mg IV daily.

40. Con---------
• Micafungin,Anidulafungin
similar action to caspofungin.

41. ANTIMETABOLITE
•Flucytosine MOA:
•It penetrate fungal cells and
cause defective protein
synthesis.

42. DOSE
•50-150 mg/kg daily per oral in
four equall divided doses q6
hours.

44. Azoles

45. IMIDAZOLES
•Clotrimazole
•Econazole
•Miconazole
•Oxiconazole
•Ketoconazole

46. CLOTRIMAZOLE
•It interferes with fungal cell wall
synthesis by inhibiting formation
of ergosterol and increasing cell
wall permeability that makes the
fungus susceptible to osmotic
instability.

47. •Ergosterol is a sterol found in cell
membranes of fungi and protozoa,
•Because many fungi and protozoa
cannot survive without ergosterol,
•it is the enzymes

48. LOCAL APPLICATION DOSES AVAILABILITY
•Applies to the following strengths:
•1%; 500 mg;
•100 mg-1%;
•100 mg;
•200 mg-1%; 200 mg; 2%

49. KETOCONAZOLE
•Candidiasis : 200 mg PO daily in a
single dose. (Candida fungus)
•Onychomycosis : 200-400mg PO
daily.
•Tinea capitis: 3.3-6.6mg/kg PO
daily.

50. •Onychomycosis is a fungal
infection of the toenails or
fingernails that may involve any
component of the nail unit,
including the matrix, bed, or plate.

51. •

53. •Tinea capitis is a disease caused by
superficial fungal infection of the
skin of the scalp, eyebrows, and
eyelashes,

55. TRIAZOLES
•Fluconazole
•Itraconazole
•Voriconazole
•Posaconazole

56. FLUCONAZOLE
•It inhibits fungal cytochrome
p450- enzyme activity
•( responsible for fungal sterol
synthesis)
•and weakens fungal cell walls.

57. Dose :
•Oropharyngeal candidiasis : 100
mg/day for 2 weeks.
•Candida esophagitis : 100 mg/day
for 2-3 weeks.

58. •Meningitis : 200-400 mg/day for
4-12 weeks/longer.
•Cutaneous candidiasis : 150 mg
weekly for 4 weeks.

59. ITRACONAZOLE DOSE
•Aspergillosis – 200 mg od/bd with
meals for 3 months.
•Onychomycosis : 200 mg/day for 3
months.
•Dermatophytosis : 100-200 mg od
for 7-15 days.

61. VORICONAZOLE DOSE
•200 mg oral bd taken 1 hour before
or 1 hour after meals,
•Begin iv infusion with 6 mg/kg 12
hourly infused over 2 hours twice
followed by 3-4 mg/kg 12 hourly.

62. POSACONAZOLE DOSE
•200 mg qid or 400 mg bd with
meals.

63. ALLYLAMINE
•TERBINAFINE - MOA
•It inhibits squalene epoxidase
•, a key enzyme in sterol
biosynthesis of fungi,

64. • This enzyme inhibition results in a
deficiency of ergosterol accumulation
of sterol within fungal cell.
• Dose : 250mg PO daily for 6 weeks.

66. NURSING
RESPONSIBILITIES

67. Assess for ---------
•Intake and output ratio
•Observe for decreased urine out
put
•Change in specific gravity-to know
renal function

68. •Edema
•Vital signs
•Allergic reactions
•Hypokalemia
•Ototoxicity .

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