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Amphotericin B
- Polyene
- binds to sterols (especially ergosterol) in cell membranes, perturbing the cell membrane and causing leakage of cell components
- Can cause permanent decrease in GFR
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Itraconazole
- Azole: Inhibits ergosterol synthesis via inhibition of 14-alpha-demtehylase (a CYP-450); Inhibitor of CYP3A4
- Azole of choice for dermatophytoses and onychomycosis
- Can precipitate CHF in susceptible pts.
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Fluconazole
- Azole: Inhibits ergosterol synthesis via inhibition of 14-alpha-demtehylase (a CYP-450); Inhibitor of CYP3A4
- Good CNS penetration
- Use for Candida esophagitis and Amphotericin B resistant AIDS associated cryptococcal meningitis
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Posaconazole
- Azole: Inhibits ergosterol synthesis via inhibition of 14-alpha-demtehylase (a CYP-450); Inhibitor of CYP3A4
- Drug of choice for fluconazole and itraconazole resistant Candida
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Voriconazole
- Azole: Inhibits ergosterol synthesis via inhibition of 14-alpha-demtehylase (a CYP-450); Inhibitor of CYP3A4
- Drug of choice for treatment of invasive AspergillusCan cause blurred vision, photophobia, and altered color perception
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Terbinafine
- Allylamine
- Inhibition of fungal squalene epoxidase (ergosterol synthesis)
- Can be used topically or orally for tinea or cutaneous Candida infections
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Ciclopirox Olamine
- Pyridone antifungal that inhibits uptake of essential extracellular nutrients
- Topical treatment of dermatomycosis (including infx of hair and nails)
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Caspofungin
- Echinocandin
- Inhibits beta(1,3)-D-glucan synthase which makes glucan, an essential cell wall component
- Use for candidiasis and invasive aspergillosis
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Flucytosine
- Cystosine analogue
- Makes bad RNA and inhibits synthesis of dTMP
- Used with amphotericin B
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Griseofulvin
- Disrupts microtubule function resulting in aberrant mitoses
- Use orally with dermatomycosis
- No good against Candida
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