Antifungals: Difference between revisions
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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]] |
| − | + | = 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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* Examples |
* Examples |
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| − | ** Fluconazole: Used as aspergillosis prophylaxis |
+ | ** [[Fluconazole]]: Used as aspergillosis prophylaxis |
| − | ** Voriconazole: First line treatment for invasive aspergillosis |
+ | ** [[Voriconazole]]: First line treatment for invasive aspergillosis |
| − | ** Posaconazole: Second line treatment for invasive aspergillosis |
+ | ** [[Posaconazole]]: Second line treatment for invasive aspergillosis |
*** Does not require adjustment in hepatic disease? |
*** Does not require adjustment in hepatic disease? |
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| + | ** [[Isavuconazole]] |
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| − | + | = 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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* Examples |
* Examples |
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| − | ** 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 |
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Revision as of 20:36, 14 August 2019
See also Antifungal spectrum
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
