anti-fungal

antibiotics

amphotericin B - binds to ergosterol...puts holes in membrane

for lumen of GI fungus - ORAL version

TI - narrow
K+ supplements, due to renal wasting of K and Mg

DONT USE in anemia, renal diease, hypokal, hypo mag
can cause thomboplebitis

C. lusitaniae and P. boydii - innately resistance to amp B

antimetabolites

flucytosine- blocks DNA syn

use with deep candida infections,
CRYPTOCOCCAL mengistis with AmP B

Chromoblastomycosis (with Itraconazole)

azoles

ketoconazole/fluconazole
blocks ergosterol synthesis
can become resistant by changing sterol gene

- inhib andro + cortiosteroids
- potentiates other drugs (warafin)

FLUCONAZOLE - good in CNS

Adverse - gynecomast, libido, impotence

Seborrheic dermatisis - Ketoconazole
Contra - no prego

systemic drugs
(superfical infections)

griseofulvin - disrupts mitotic spindle, Fungistatic

works against DERMATOPHYTES
HAIR, NAILS, SKIN (KERATIN)
can induce Cp450

systemic drugs
(superfical infections)

terbinafine - blocks syn of ergo
hair nail skin

inhibits squalene epoxidase

topical antifung

nystatin - local candidiasis in OBESE PTs, where skin rubs
vaginal, oral, cutaneous

topical antifung

tolnaftate - tinea pedis (not against canddia)

antifung azoles topical

dermatophyte infections
TENIA versicolor

echinocandids

capsofungin, micafungin (prophylaxis for BMT), anuidugafungin

fungal cell walls...

Aspergillus & Candida
-resistance with FSK1 mutation

caution in hepatic insuff