Quicklist of key drugs:

Amphotericin B

Cytolytic via ergosterol binding: Broad spectrum: mainly for life-

Forms pores in membrane threatening infections; given IV

via liposome suspension

oral: not absorbed - topical

Nystatin

Cytolytic via ergosterol (as for Topical only (too toxic for systemic

Amp B) use); for Candida

Flucytosine

Antimetabolite in combination only for meningitis (toxic to bone marrow) & blastomycoses

Griseofulvin

Antimitotic via microtubule Oral for dermatophytosis

Inhibition

Ketaconazole

Blocks ergosterol synthesis via Oral for mucocutaneous candidiasis;

P₄₅₀ inhibition (not selective) coccidoidal mycoses

Miconazole

Blocks ergosterol synthesis Topical for Candida; dermatophytes

Clotrimazole

oropharyngeal infection

Intraconazole

Selective block of ergosterol Oral (no CSF penetration) for

Dermatophytoses; Aspergillus;

Endemic mycoses

Fluconazole “ Oral (good CSF penetration) for

Meningitis; Candida; prophylactic

for marrow transplants & AIDS

Verconazole “ Latest triazole; oral and IV (good

CSF penetration) for Aspergillus;

Meningitis; Candida

Terbinafine inhibits squalene metabolism - Cutaneous mycoses

Naftifine squalene is toxic; also blocks

Ergosterol **

Caspofungin Blocks cell wall synthesis via IV: invasive candidiasis &

inhibition of beta (1,3)-D- aspergillus

Glucan synthesis

Category: Pharmacology Notes