ANTIFUNGAL AGENTS - Flucytosine: accidentally nadiscover

1. Tinea capitis: infection sa scalp habang dinidiscover anf 5-FU; devoid of

2. Tinea barbae: beard anticancer properties but became a
3. Tinea fasciae: face potent antifungal agent; pyrimidine
4. Tinea cruris: jock itch analog; much narrower than
5. Tinea pedis: athlete’s foot amphotericin B
6. Tinea manum: hands (palms) - Azoles: either imidazoles:
7. Tinea ungium: onchomycosis ketoconazole, miconazole, clotrimazole;
8. Tinea versicolor/ptyriasis: malasazia furfur or triazole: itraconazole, fluconazole,
voriconazole, posaconazole;
Other info: *itraconazole, fluconazole,
Rose Gardener foot: Sporotrix shenckii voriconazole, posaconazole-
DOC: KISS (SuperSaturatedPotassium Iodide; “- systemically used or iniinom
azoles” *ketoconazole, miconazole,
Candidal vulvovaginitis: milk clotrimazole- pinapahid sa balat; topical
ejection/presentation drug; mas toxic sa triazoles
Cryptococcus neoformans: pigeon droppings, - Ketoconazole: inhibits androgen and
india ink nigrosin adrenal steroid synthesis; first oral azole
used however bc of its toxicity naging
WHAT ARE THE DRUGS MANAGING FUNGAL topical nalang;
INFECTIONS? - Itraconazole: choice for the treatment
1. FATTY ACIDS of histoplasma and Blastomyces
- Propionic acid: present in our sweat - Fluconazole: DOC for fungal meningitis
(0.01% present in our skin); kahit na (Cryptococcal meningitis) caused by
present, di niya napapatay lahat; Cryptococcus neoformans *mas deadly
natural defense ang fungal infection pag systemic na
- Undecylenic acid: destructive - Voriconazole: invasive aspergillosis
distillation of castor oil - Posaconazole: salvage therapy for
2. POLYENES invasive aspergillosis
- Amphotericin B: MOA: magbbind sa - Echinocandins: only available in IV
ergosterol at bubutasin and cell wall ng formulations
fungi; only efficacious antifungal drug - Terbinafine: available in oral
for systemic use; broadest; DOC for formulation; keratophilic: good for the
systemic mycoses skin, fungicidal
 Infusion-related Toxicity: - Topical Azoles
Fever, Chills, Muscle spasms,
N&V, and Hypotension TUBERCULOSIS
 Cumulative (pag sobrang tagal - Pulmonary tuberculosis: “Koch Dse”
na nagtetake) Toxicity: Renal - Causative agent: Mycobacterium
Damage, Liver Dysfunction tuberculosis
- Nystatin: from Streptomyces noursei; - Acid fast staining “Ziehl-Neelsen stain”
oral agent for oral candidiasis; orally Hot Method: Ziehl-Neelsen stain
used Cold Method: Kimyoun Method
3. SYSTEMIC ANTIFUNGAL DRUGS FOR
MUCOCUTANEOUS INFECTIONS Drugs used in TB
- Griseofulvin: from the species for RIPE: Rifampin, Isoniazid, Pyrazinamide and
penicillium; Ethambutol; DOC for TB; before is streptomycin
kaso may toxicity kaya second line agent nalang AMINOSALICYLIC ACID
siya; RIPES - Can cause crystauria
*Isoniazid and Rifampin: two most active drugs
among the RIPE; kaya administered sila for 9
mos and will cure 95-98% cases of TB; addition
of pyrazinamide and ethambutol for the first 2
months allows the total duration of therapy to
be reduced to 6 mos w/o loss of efficacy; di
pwedeng maprolong yung dalawa ng mahaba
kasi magkakadamage ng tao kaya nagkaRIPE

ISONIAZID
- MOA inhibits synthesis of mycolic acid
(very important component ng cell wall
ng Mycobacterium tuberculosis);
mawawalan ng rigidity yung cell wall
- Prodrug activated by KatG
(Mycobacterial catalase-peroxidase
- Toxicity:
Peripheral Neuropathy- kaya kailangan
ng Vitamin B6 (Pyridoxine)

RIFAMPIN
- Orange to red coloration ng body
secretions like sweat

ETHAMBUTOL
- Can cause optic neuropathy/ Visual
Acuity- red-green color discrimination

PYRAZINAMIDE
- Hepatoxicity, Hyperuricemia- hinde
pwede sa mga mataas ang uric acid or
gouty arthritis

ALTERNATIVE SECOND-LINE DRUGS

ETHIONAMIDE:
- Adverse reactions: hepatoxicity (bawal
sa may liver dysfunction)

CAPREOMYCIN
- Adverse reactions: nephrotoxic and
ototoxic, local pain and sterile abscess

CYCLOSERIN
- Inhibitor of cell wall synthesis
- Nagccause ng peripheral neuropathy-
bibigyan ng Vitamin B6