ANTIFUNG

A LS

ANTIFUNGALS
A. Superficial Mycoses
1. Griseofulvin

-PO, Fungistatic
-MOA: Binds to keratin (Protection of the
skin from new infection)
-Increased absorption w/ fatty meal
-USE: Ringworm/Dermatophytes

ANTIFUNGALS
2. Nystatin
-Topical, Polyene antifungal
-MOA: Binds to ergosterol & create holes
USE: Tx of cutaneous/
mucocutaneous candidiasis

ANTIFUNGALS
3. Terbinafine
-Fungicidal
MOA: Inhibition of squalene epoxidase,
accumulation of squalene ergosterol
(toxic to fungal cell)

ANTIFUNGALS
4. AZOLES
MOA: Inhibition of Fungal CYP450
0 Ketoconazole
0 Clotrimazole (Canesten)
0 Ticonazole (Trosin)
0 Miconazole (Daktarin)
0 Fluconazole
0 Itraconazole

ANTIFUNGALS
5. Miscellaneous agents:
0 AP-AP solution Salicylic acid
0 Whitfields ointment salicylic + Benzoic acid
0 Potassium iodide
0 Selenium sulfide (Selsun blue)
-Head and shoulders shampoo (antidandruff)

ANTIFUNGALS
B. Less serious mycoses
1. Ketoconazole First azole introduced to be
used clinically
USE: Cutaneous candidiasis
Antiseborrheic (nizoral)

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2. FLUCONAZOLE
Tx: Systemic candidiasis
DOC: Cryptococcosis
3. ITRACONAZOLE
-2nd line for less serious mycoses
-2nd line for amphotericin B

ANTIFUNGALS
C. SYSTEMIC MYCOSES
1. Amphotericin B
-grandfather of antifungals
MOA: Binding to ergosterol that results to
formation of pores on the plasma
membrane
USE: Systemic mycoses
Initial tx to reduce fungal burden
Combine w/ flucytosine

ANTIFUNGALS
2. Voriconazole
USE: DOC for Aspergillosis
Tx for Fluconazole resistant Candidiasis
3. Echinocandins (newest)
MOA: Inhibits the synthesis of (1,3)D-glucan,
a
component of the cell wall of fungi
Ex: Caspofungin

ANTIFUNGALS
4. POSACONAZOLE
DOC: Mucomycosis/Zygomycosis
also has an activity against Candida &
Aspergillus

COMMON FUNGAL INFECTIONS

1. Pityriasis
Pityriasis versicolor or An-An
-CM: White patches/
Hypo or Hyperpigmentation
Pityriasis rosea

COMMON FUNGAL INFECTIONS

2. Tinea nigra
CM: Dark pigment on the palms

3. Tinea Pedis (athletes foot)

COMMON FUNGAL INFECTIONS

4. Tinea cruris
aka Jockitch / had-had

5. Sporotrichosis
occupational disease of gardeners
Tx: Potassium Iodide soln

COMMON FUNGAL INFECTIONS

6. Coccidioidomycosis
aka Valley fever / Desert rheumatism

7. Histoplasmosis
MOT: Bat droppings
CM: Mimics the signs & symptoms of PTB

COMMON FUNGAL INFECTIONS

8. Candidiasis
most common systemic fungal infection
CA: Candida albicans True hyphae
Candida krusei & Candida lusetanie
-resistant to fluconazole

COMMON FUNGAL INFECTIONS

9. Cryptococcosis one of the biomarkers of AIDS

CA: Cryptococcus neoformans

Staining: India Ink
CM: Cryptococcal Meningitis
MOT: Pigeon droppings
Tx: Fluconazole
Std Tx: Amphotericin B + Flucytosine
Amphotericin B creates holes in the fungal cells
Flucytosine- for the yeast but not capable to cross
BBB

COMMON FUNGAL INFECTIONS

10. ASPERGILLOSIS
CA: Aspergillus fumigatus
CM: Pulmonary aspergilloma
or formation of fungal ball
DOC: Voriconazole