Antifungal Drugs D. Kumaraswamy Department of pharmacology SRM MCH&RC FUNGAL INFECTIONS (MYCOSES) Deep/ Superficial systemic Fungal infections (Superficial) Dermatomycosis (bcc cup) (cid:122) Tinea pedis (athlete’s foot) (cid:122) Tinea corporis (skin ringworm) (cid:122) Tinea cruris (groin) (cid:122) Tinea capitis (scalp) (cid:122) Tinea unguium (nails) (cid:122) Tinea barbae (beard) (cid:122) Tinea mannum(hand) (cid:122) Candidiasis – skin, mouth, vagina (cid:122) oropharynx DEEP MYCOSES aspergilus Blastomyces Candida Coccidiodes Cryptococcus Histoplasma Antifungal drugs- Classification (5) 1. ANTIBIOTICS Amphotericin B, (AMB), Nystatin, Hamcyin, Natamycin Griseofulvin 2. ANTIMETABOLITES: 5-Fluorocytosine (5-FC) inhibition of nucleic acid synthesis Antifungal drugs- Classification 3. AZOLES Imidazoles: (Topical): Clotrimazole, (cid:122) Econazole, Miconazole, Oxiconazole (Systemic): Ketoconazole Trizoles: ( Systemic) Itraconazole, Fluconazole, Voriconazole Inhibition of ergosterol synthesis 4. ALLYLAMINE: Terbinafine Inhibition of lanosterol and ergosterol synthesis 5. OTHER TOPICAL AGENTS: Tolnaftate, Undecylenic acid, Benzoic acid, Quiniodochlor, Ciclopirox olamine, Sod. thiosulfate. Amphotericin B - MOA In fungi: ergosterol in membranes: higher (cid:122) affinity than mammalian cholesterol for AmB Ergosterol: Only present in fungal cell (cid:122) membrane and not in animal cell Ergosterol: Polyenes combine with it, get (cid:122) inserted into the membrane and several molecules together orient themselves and form a micropore. The Fungal Cell Wall mannoproteins β1,3 β1,6 glucans Cell β1,3 glucan chitin membrane synthase ergosterol