5. CLASSIFICATION OF ANTI-FUNGALS
Based on route of administration
Systemic fungal infections
Amphotericin B
Flucytosine
Triazoles
Ketoconazole
Echinocandins
6. CLASSIFICATION OF ANTI-FUNGALS
Based on route of administration
Topical anti-fungal
1-Nystatin
2-Miconazole
3-Econazole
4-Clotrimazole
5-Terbinafine
6- Benzoic acid with salicylic acid (Whitfield’s ointment)
7. AMPHOTERICIN B
It is not absorbed orally so given by slow I/V infusion.
Mechanism of action:
Ergosterol: Sterol in cell membrane of fungi
It binds to ergosterol and causes formation of artificial pores in fungal
cell membrane.
Pore allows the leakage of intracellular ions and macromolecules.
It has the widest antifungal spectrum.
9. AMPHOTERICIN B
Clinical uses:
It is drug of choice for most systemic fungal infections.
1-Intrathecally in fungal meningitis
2-Locally for corneal ulcers and keratitis
Adverse effects:
1-Infusion related reactions: Premedication with antihistamines ,
glucocorticoids.
2-Nephrotoxicity: renal tubular acidosis
3-Hypokalemia
4-Hypomagnesemia
5-Anemia
6-Intrathecal: Seizures and neurological damage
10. AZOLES
Azoles are synthetic compounds
Mechanism of action:
Inhibit synthesis of ergosterol by inhibition of fungal CYP450 enzyme.
Clinical uses :
1-Candidiasis
2-Coccidioidal and cryptococcal meningitis
3-Histoplasmosis
4-Invasive aspergillosis
5-Blastomycosis
11. AZOLES
Adverse effects of azoles
1-Diarrhea
2-Rash
3-Hepatotoxicity
4-Prolong QT interval
5-Visual disturbances:
Blurred vision, altered colour perception and photophobia.
6-Long-term use :
Actinic keratosis
Squamous cell carcinoma.
