ANTI-FUNGAL DRUGS

Yogapriya.vB.Opt(IIIyr)

INTRODUCTION

• Fungal infections may be systemic and superficial• They may occur as primary disease or secondary to treatment with

antibiotics,anticancer drugs or due to HIV infection

CLASSIFICATION OF ANTI FUNGAL DRUGS

ANTIFUNGAL ANTIBIOTICS

i)POLYENES Amphotericin BNystatinHamycin

ii)OTHERS GriseofulvinANTIMETABOLITES Flucytosine(5 FC)AZOLES

i)IMIDAZOLE ClotrimazoleMiconazoleKetaconazoleEconazole

ii)TRIAZOLES FluconazoleItraconazoleteraconazole

ALKYLAMINES TerbinafineOTHER TOPICAL AGENTS Tolnaftate

Benzoic acidciclopirox

AMPHOTERICIIN B

• It is a polyene antibiotic• It is obtained from Streptomyces nodosus• it is fungistatic at low and fungicidal at high concentration• Amphotericin is not absorbed orally.it is given I.V and it is widely

distributed in the body

Adverse effect • Fever,chills,muscle spasm,vomiting,hypotension and headache on I.V

infusion• Pain and thrombophlebitis at the site of injection• Also renal impairment,neurotoxicity and anemia

NYSTATIN

• It is obtained from Streptomyces noursei• It has action similar to amphotericin B• But it is too toxicfor systemic use• So it is used topically• It is used in local cnandidial infections like oral thrush and vaginal

candidias

HAMYCIN

• It is another polyene antibiotic• It is used topically for cutaneous candidias and otomycosis

GRISEOFULVIN

• It is a fungistatic• It is obtained from penicillium griseofulvum• It is given orally for superficial dermatophytosis• It acts by binding to micro tubular protein in the nucleus• This distrupts mitotic spindle and inhibits mitosis in the fungus• Griseofulvin is poorly water soluble• Also bioavailability is poor microfined particles or fatty food enhance its

absorption• It binds to keratin of the skin

Adverse effect• Allergic reactions,hepatitis and nephrotoxicity

ANTIMETABOLITES

FLUCYTOSINE

• It is a fluorinated pyrimidine• It is effective agaist Cryptococcus neoformans and candida• It is converted to 5-fluorouracil which inhibits DNA synthesis

Adverse effects• Bone marrow depression and GI disturbances

Uses• It is used in cryptococcal meningitis and systemic candidias

AZOLES

IMIDAZOLES & TRIAZOLES

• Azoles are newer synthetic antifungals• They are orally effective and less toxic• They have broad spectrum antifungal activity

KETOCONAZOLE

• It is orally effective and is well absorbed• Food and low gastric pH enchance its absorption

Adverse effect• Gastric irritation,nausea,vomiting,headache and allergic reactions• Inhibition of adrenal and gonadal steroid synthesis• This results in gynecomastia,infertility,loss of libido and

azoospermia

Uses• Mucocutaneous candidiasis and dermatophytosis• Cushing syndrome• Deep mycosis

ITRACONAZOLE

• It is the most potent azole• It is given orally• Absorption is increased by food and gastric acid• Less effect on hepatic microsomal enzymes• Also it does not affect steroid synthesis• It is available both for oral and I.V use

TERBINAFINE

• It is a synthetic anti fungal effective against dermatophytes and candida

• It is fungicidal and orally effective• It gets concentrated in keratin it acts by inhibiting ergosrerol

synthesis

Adverse effect• GI disturbances,rashes and headache

THANK YOU FOR LISTENING