Antifungal drugs (with mechanism of action) mnemonic

Azoles:

(inhibit conversion of lanosterol to ergosterol which is major component of the cell wall of fungi --> increase permeability --> lysis and death)

Fluconazole - Fluid Fluco flows into CNS (used for cryptococcal meningitis) - safe in pregnancy

also Candida (not Candida krusei or Candida glabrata) and vaginal candidiasis as alternative to topical meds

Itraconazole - largely equal to fuconazole but less easy to use; rarely the best initial therapy for anything

Clotrimazole - Cutaneous (topical) (also Miconazole, a stretch!)

Voriconazole - inVasive aspergillosis, Visual disturbances; covers all Candida

Posaconazole - Potent Posa - decreases Potassium levels, Platelet count, Prophylaxis for invasive aspergillosis, candida in immunocomp.; also covers mucormycosis or Mucorales

other examples: Miconazole, sertaconazole, sulconazole

Tolnaftate (INN) is a synthetic thiocarbamate, which is believed to inhibit squalene epoxidase, but the exact MOA is unknown;

less effective than azoles; useful in ringworm infections

Naftifine is an allylamine antifungal drug for the topical treatment of tinea pedis, tinea cruris, and tinea corporis. Naftifine has triple action: antifungal, antibacterial and anti-inflammatory. Its precise mechanism of action is unknown, but may involve selectively blocking sterol biosynthesis via inhibition of the squalene 2,3-epoxidase enzyme. The half-life is approximately 2–3 days.

Echinocandins:

EchinocanDIN’s- end in GIN: Glucan INhibitors**:** CaspofunGIN, MicafunGIN, andidulafunGIN

• excellent for neutropenic fever patients (better than amphotericin - less mortality)
• does not cover Cryptococcus
• no significant human toxicity because they noncompetitively inhibit beta-1,3-D-glucan synthase enzyme complex in susceptible fungi to disturb fungal cell glucan synthesis, which does not exist in humans.