Antifungals: Difference between revisions

Latest revision as of 02:48, 8 February 2022

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 prophylaxis or treatment for Candida
- Voriconazole: First-line treatment for invasive aspergillosis
- Itraconazole
- Posaconazole: Second-line treatment for invasive aspergillosis, but first-line for prophylaxis
- 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

@@ Line 1: / Line 1: @@
 See also [[Antifungal spectrum of activity]]
-== Polyenes ==
+==Polyenes==
-* Mechanism: bind to ergosterol in the cell membrane and create pores
+*Mechanism: bind to ergosterol in the cell membrane and create pores
-* Examples: [[Amphotericin B]]
+*Examples: [[Amphotericin B]]
-== Triazoles ==
+==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.
+*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
+*Examples
-** [[Fluconazole]]: Used as aspergillosis prophylaxis
+**[[Fluconazole]]: Used as prophylaxis or treatment for [[Candida]]
-** [[Voriconazole]]: First line treatment for invasive aspergillosis
+**[[Voriconazole]]: First-line treatment for [[invasive aspergillosis]]
+**[[Itraconazole]]
-** [[Posaconazole]]: Second line treatment for invasive aspergillosis
+**[[Posaconazole]]: Second-line treatment for [[invasive aspergillosis]], but first-line for prophylaxis
-*** Does not require adjustment in hepatic disease?
-** [[Isavuconazole]]
+**[[Isavuconazole]]
-== Echinocandins ==
+==Echinocandins==
-* 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
-* Examples
+*Examples
-** [[Micafungin]]
+**[[Micafungin]]
-** [[Caspofungin]]: Febrile neutropenia
+**[[Caspofungin]]: Febrile neutropenia
-** [[Anidulafungin]]: ICU (high APACHEII), no renal or hepatic dosing needed
+**[[Anidulafungin]]: ICU (high APACHEII), no renal or hepatic dosing needed
 [[Category:Antimicrobials]]