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Flashcards in antifungal meds Deck (14):

fungi characteristics

Fungi have rigid cell walls containing chitin and polysaccharides along with a cell membrane containing ergosterol.


Drug for superficial mycoses

• Clotrimazole/ Lotrimin
• Nystatin/ Mycostatin
• Fluconazole/ Diflucan
• Griseofulvin/ Fulvicin
• Itraconazole/ Sporanox
• Ketoconazole/ Nizoral
• Miconazole/ Monistat
• Terbinafine/ Lamisil


Drug for systemic mycoses

• Amphotericin B
• Fluconazole/ Diflucan
• Flucytosine/ Ancoban
• Griseofulvin/ Fulvicin
• Itraconazole/ Sporanox
• Ketoconazole/ Nizoral


Clotrimazole/ Lotrimin

• Category: Antifungal
• Indication: Superficial mycoses such as
tinea pedis, tinea cruris and ring worm as
well as yeast vaginitis.
• MOA: Binds to ergosterol molecules on
the fungal cell membrane and causes
membrane leakage during cell division. • Char: Topical creams, lotions and
ointments. Increasing resistance of tinea and candida has occurred.


Nystatin/ Mycostatin

• Category: Antifungal, may be used both topically and systemically.
• Indication: Superficial mycoses such as ring worm, tinea pedis, tinea cruris and treatment of oral candidiasis (thrush) as well as esophageal and vaginal Candida Cryptococcus is also sensitive to Nystatin.
• MOA: Binds to ergosterol molecules on fungal cell membrane resulting in loss of membrane integrity death of the fungal cell.


Nystatin/mycostatin char , uses, se

Char: Topical creams, ointments, lotions and PO form for thrush often in the form of granules. Nystatin in parenteral form is being studied in Phase II and III trials.

• Negligible oral absorption allows for diminished side effects. N/V are possible.

• Nystatin is often used as prophylaxis in patients who are at risk for fungal infections, such as AIDS patients with a low CD4+ count and patients receiving chemotherapy.


nystatin cont

Nystatin/ Mycostatin

• Nystatin oral suspension is indicated for the treatment of candidiasis in the oral cavity

• Nystatin suspension for oral administration contains 100,000 USP Nystatin units per mL.

• GI absorption of Nystatin is minimal and most orally administered Nystatin is passed unchanged in the stool.


Terbinafine/ Lamisil

• Terbinafine is mainly effective on the group of fungi known as dermatophytes.
• As a 1% cream or powder it is used for superficial skin infections such as tinea cruris, tinea pedis and tinea corporis.
• Oral 250 mg tablets are often prescribed for the treatment of onychomycosis of the toenail or fingernail due to the dermatophyte Tinea unguium.


Terbinafine/Lamisil dosage and SE

The FDA-labeled dosage of oral Terbinafine is 250 mg per day given continuously for 6 weeks to treat fingernail fungal infections and 12 weeks to treat toenail infections.
• Common side effects include abdominal discomfort, diarrhea and nausea as well as headache. Less commonly, elevated liver enzymes, hepatitis, liver damage and even liver failure have been reported


Fluconazole/ Diflucan

• Category: Antifungal, both topical and systemic.
• Indication: Superficial mycoses such as yeast vaginitis as well as systemic or meningeal mycotic infections by fungi such as Cryptococcus or Histoplasmosis.
• MOA: Inhibits fungal membrane synthesis.


Flucanozole/Diflucan SE, char

Fluconazole/ Diflucan
• Char: Oral, IV, vaginal suppository. It can inhibit the cytochrome enzyme systems responsible for metabolism of many drugs.
• Side effects: Nausea and vomiting with oral and IV doses.


Amphotericin B/Amphocil

• Category: Antimycotic
• Indication: Systemic fungal infections such
as systemic Candidadiasis, Histoplasmosis, Coccidiomycosis, Aspergillus and Blastomyces.
• MOA: Binds to ergosterol molecules on the fungal cell membrane and disrupts membrane integrity, resulting in the death of the fungal cell.

Naturally occurring polyene macrolide produced by Streptomyces nodosus.


Amphotericin B/Amphocil

• Char: IV. (May be used via intrathecal route for fungal meningitis or fungal brain abscess.
• Side effects: Very severe side effect profile. Fevers and shaking chills are common. (“Ampho-terrible” and “shake and bake” are terms used to describe the severe side effects).


Amphotericin B/ Amphocil

Amphotericin B/ Amphocil
• Side effects: Pre-treatment with Benadryl, NSAIDs or Prednisone often used to mitigate the fever and chills. Hypotension, renal impairment and severe anemia can occur.

shake and bake