Anti-Fungal Drugs: Classification, Mechanism, Uses, Adverse Effects, Dosage, Contraindications & Drug Interactions

 ANTIFUNGAL DRUGS

1. Classification

A. Systemic (Oral/IV): Amphotericin-B, Ketoconazole, Fluconazole, Itraconazole, Flucytosine, Griseofulvin
B. Topical: Clotrimazole, Terbinafine, Luliconazole

2. Important Drugs

Amphotericin-B

• MOA: Binds to ergosterol → forms pores in fungal membrane.
• Use: Systemic mycoses.
• Adverse: Nephrotoxicity, fever, chills.
• Contraindication: Renal disease.

Ketoconazole / Fluconazole / Itraconazole

• MOA: Inhibits ergosterol synthesis.
• Use: Candidiasis, ringworm.
• Adverse: Hepatotoxicity, hormonal effects.
• Interaction: Antacids ↓ absorption.

Clotrimazole

• Use: Topical fungal infections (skin, vagina).

Flucytosine

• MOA: Inhibits DNA/RNA synthesis.
• Use: Cryptococcal meningitis.

Griseofulvin

• MOA: Inhibits fungal mitosis.
• Use: Dermatophyte infections.
• Adverse: Headache, hepatotoxicity.

Topical Agents

• Terbinafine: Inhibits squalene epoxidase → fungicidal.
• Luliconazole: New topical agent for ringworm.

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