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Overview
 
Polyenes  
(Bind to ergosterol, forming destructive pores in cell membrane)
 Class Name of Drug(s) Indications
Amphotericin B
  • Amphotericin B
  • Systemic fungal infections
  • Widest spectrum of coverage
Nystatin
  • Nystatin
  • Candida ("swish and swallow")
Blocks Formation of Ergosterol
(A component of fungal cell membrane)
Azoles
(Inhibits fungal CYP450 3A)
Imidazoles
  • Ketoconazole
  • Clotrimazole
  • Miconazole
  • Systemic and superficial infections
  • Wide coverage
Triazoles
  • Fluconazole
  • Itraconazole
  • Voriconazole
  • Systemic and superficial infections
  • Wide coverage
Inhibits Squalene Epoxidase
Terbinafine
  • Terbinafine
  • Dermatophytes (especially nail infections)
Blocks Formation of β-glucan
(A component of fungal cell wall)
Echinocandins
  • Caspofungin
  • Micafungin
  • Anidulafungin
  • Aspergillus
    Candida
Blocks Pyrimidine Synthesis
(Blocks DNA synthesis)
Flucytosine
  • Flucytosine
  • Use with amphotericin B
  • Cryptococcus
    Candida
Other Mechanisms of Action
Griseofulvin
  • Griseofulvin
  • Dermatophytes
Selenium sulfide
  • Selenium sulfide
  • Malassezia
  • All antifungal drugs target the fungal wall or membrane except flucytosine, griseofulvin, and possibly selenium sulfide
 

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