Antifungals

• Antifungal drug - used to treat fungal infections such as athlete's foot, ringworm, candidiasis, and serious systemic infections such as cryptococcal meningitis
• Mycosis - a condition in which fungi pass the resistance barriers of the human or animal body and establish infections
• Fatty Acids:

  • MOA - insertion into bilayer and leakage
  • SAR - higher molecular weight members have the advantage of having lower volatility
• Propionic Acid - sodium and calcium propionates, preservative
• Sodium Caprylate - found in coconut and palm oil
• Zinc Caprylate - used as topical fungicide, astringency of zinc decreases inflammation and wetness
• Zinc Propionate - fungicide on adhesive tape
• Undecylenic Acid "10-Undecenoic acid, Decenex, Cruex" - made by destructive distillation of castor oil, for diaper rash as sodium undecylenate
• Triacetin "Glyceryl triacetate, Enzactin, Fungacetin" - fungicidal properties are due to acetic acid formation, action is self-limiting because esterases are inactivated below a pH of 4
• Salicylic Acid - antiseptic and keratolytic, is commonly combined with benzoic acid to form the Whitfield's ointment
• Haloprogin USP - treatment of superficial tinea infection; photosensitive
• Ciclopirox Olamine - primary use for candidiasis and tinea infection and secondary use for the treatment of onchomycosis
• Clioquinol - substitute for iodoform, for atopic dermatitis
• Flucytosine "5-fluorocytosine, Ancobon" - orally active antifungal, for serious systemic infections caused by Candida and Cryptococcus sp. ; prodrug
• Flucytosine + Amphotericin = Cryptococcal meningitis
• Flucytosine + Itraconazole = Chromoblastomycosis
• Polyenes:

  • MOA: Bind to Ergosterol = Cellular leakage = false membrane components
  • SAR: Contains NLT 2 double bonds and a lactone