Antifungal drugs

Itraconazole generally is well tolerated. However, serious potentially life-threatening adverse effects, including congestive heart failure, pulmonary edema, and hepatotoxicity, have occurred rarely in patients receiving IV or oral itraconazole. In clinical studies evaluating itraconazole for the treatment of systemic fungal infections, adverse effects requiring discontinuance of the drug occurred in up to 11% of patients; the median duration of therapy before discontinuance was 81 days (range: 2-776 days).

Terbinafine hydrochloride is a synthetic allylamine antifungal agent. Terbinafine is structurally and pharmacologically related to naftifine.

Terbinafine is an infective / antifungal agent that inhibits squalene epoxidase, resulting in ergosterol deficiency and a corresponding accumulation of squalene within the fungal cell leading to fungal cell death. It is indicated in the treatment of onychomycosis of the toenail or fingernail caused by dermatophytes.

Econazole nitrate is a topical / antifungal agent. It increases cell membrane permeability in susceptible fungi. It is indicated in the treatment of tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis (ringworm), cutaneous candidiasis, and tinea versicolor.

An antifungal substance obtained by fermentation using certain strains of Streptomyces noursei. It contains mainly tetraenes, the principal component being nystatin A:. The potency is not less than 4400 units/mg and not less than 5000 units/mg if intended for oral use, calculated with reference to the dried substance. It is a yellow or slightly brownish hygroscopic powder.

Trimetrexate is reported to be incompatible with foscarnet. Trimetrexate should not be mixed with folinic acid or chloride ions, since precipitation occurs instantly.

Natamycin is a polyene antifungal active against Candida and Fusarium spp. In addition it is active against the protozoan Trichomonas vaginalis.

Miconazole is an imidazole antifungal with similar antimicrobial activity to that of ketoconazole. It also has some activity against Aspergillus spp., Cryptococcus neoformans, Pseudallescheria boydii, and some Gram-positive bacteria including staphylococci and streptococci.

Ketoconazole has a wide spectrum of antimicrobial activity including activity against Blastomyces dermatitidis, Candida spp., Coccidioides immitis, Epidermophyton floccosum, Histoplasma capsulatum, Malassezia spp., Microsporum canis, Paracoccidioides brasiliensis, Trichophyton mentagrophytes, and T. rubrum. Some strains of’Aspergillus spp., Cryptococcus neoformans, and Sporothrix schenckii are sensitive.

Sporanox (Itraconazole) is active against Aspergillus spp., Blastomyces dermatitidis, Candida spp., Coccidioides immitis, Cryptococcus neoformans, Epidermophyton spp., Histoplasma capsulatum, Malassezia furfur, Microsporum spp., Paracoccidioides brasiliensis, Sporothrix schenckii, and Trichophyton spp. Itraconazole also has some antiprotozoal activity againstLeishmania spp.