Antifungals: Difference between revisions
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See also [[Antifungal spectrum of activity]] |
See also [[Antifungal spectrum of activity]] |
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= Polyenes = |
== Polyenes == |
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* Mechanism: bind to ergosterol in the cell membrane and create pores |
* Mechanism: bind to ergosterol in the cell membrane and create pores |
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* Examples: [[Amphotericin B]] |
* Examples: [[Amphotericin B]] |
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= Triazoles = |
== Triazoles == |
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* Mechanism: inhibit 14-alpha demethylase (aka. Cyp51p, encoded by Erg11 genes), which is required for synthesis of ergosterol from lanosterol, thus disrupting the cell wall. |
* Mechanism: inhibit 14-alpha demethylase (aka. Cyp51p, encoded by Erg11 genes), which is required for synthesis of ergosterol from lanosterol, thus disrupting the cell wall. |
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** [[Isavuconazole]] |
** [[Isavuconazole]] |
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= Echinocandins = |
== Echinocandins == |
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* Mechanism: disrupt synthesis of beta-glucan in the cell wall by inhibiting 1,3-beta glucan synthase |
* Mechanism: disrupt synthesis of beta-glucan in the cell wall by inhibiting 1,3-beta glucan synthase |
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Revision as of 19:36, 15 August 2019
See also Antifungal spectrum of activity
Polyenes
- Mechanism: bind to ergosterol in the cell membrane and create pores
- Examples: Amphotericin B
Triazoles
- Mechanism: inhibit 14-alpha demethylase (aka. Cyp51p, encoded by Erg11 genes), which is required for synthesis of ergosterol from lanosterol, thus disrupting the cell wall.
- Examples
- Fluconazole: Used as aspergillosis prophylaxis
- Voriconazole: First line treatment for invasive aspergillosis
- Posaconazole: Second line treatment for invasive aspergillosis
- Does not require adjustment in hepatic disease?
- Isavuconazole
Echinocandins
- Mechanism: disrupt synthesis of beta-glucan in the cell wall by inhibiting 1,3-beta glucan synthase
- Examples
- Micafungin
- Caspofungin: Febrile neutropenia
- Anidulafungin: ICU (high APACHEII), no renal or hepatic dosing needed
