Anti-Fungals

Anti-Fungals

Pyrimidines
1. 5 Fluorocytosine
  1. 5-Fluorouracil
    1. FUTP
      1. Fluorodine Triphosphate
        Incorporated into RNA
    2. FdUMP
      1. Thymidine synthetase
        Inhibits DNA synthesis
    3. Cryptococcus
      1. Most Candida
  2. Taken up by fungal specific cytosine permease
Polyenes
1. Nystatin
  1. Topical
  2. Oral and Vaginal Candidosis
2. Amphotericin B
  1. Broad spectrum empirical
  2. IV 1x
  3. Lipid ambisome
3. Bind sterols causing membrane breakage
Echocandins
1. Anidulafungin
  1. headache, nausea, liver
2. Micafungin
  1. headache, liver
3. Caspofungin
  1. Hypookalemia, fever, chillls, liver
    1. High conc, paradoxical effect
4. Bind to Fksp1 subunit of B-1-3-D glugan synthesis
  1. Component of fungal synthase
5. IV 1x
6. aspergillus and most candida
Terbafine
1. Tinea infections
  1. Capitis
  2. Pedis
  3. Corporis
  4. Curis
2. Oral 1x
3. Tablets, cream, spray
4. altered liver function and taste perception
5. Inhibits squalene epoxidase (ergosterol)
Azoles
1. Imidazoles
  1. Ketconazole
  2. Topical
  3. Superficial Skin Infections
  4. Clotimazole
  5. Econazole
  6. Miconazole
2. Triazoles
  1. Posconazole
    1. Oral 3-4x
      1. Aspergillus
        Fusarium
        coccididiomycosis
  2. Fluconazole
    1. Oral/IV 1x
      1. Crypto, men.
        Candida
        coccididiomycosis
  3. Itraconazole
    1. Oral/IV 2-4x
      1. Aspergillus
        Candida
        Cryptococcus
        Histoplasmosis
  4. Voricaonzole
    1. Oral/IV 2x
      1. Aspergillus
        Candida
        Fusarium
        Scedosporum
  5. lanosterol-14-a- demethylase
    1. Inhibits ergosterol production
      1. conv of lanosterol to ergosterol
        build up of methylsterols

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