Topical antifungal
Topical antifungal drugs are used to treat fungal infections on the skin, scalp, nails, vagina or inside the mouth.
These drugs inhibit the production of ergosterol, which is a fundamental component of the fungal cell membrane and wall.
Common examples of azole antifungals include clotrimazole, econazole, ketoconazole, miconazole, and tioconazole.
The only polyene antifungal available topically is nystatin, which works by binding to ergosterol thus disrupting the integrity of the fungal cell membrane.
The general mechanism of action for topical antifungal drugs is the disruption of the cell membrane.
[citation needed] Fungal infections are commonly caused by dermatophytes, yeasts or molds.
Therefore, different types of antifungals can selectively remove fungal pathogens from the host with minimum toxicity.
[citation needed] Topical antifungals are generally safe to use in adults, seniors and children, Different dosages may be required for patients of different age groups.
Consult a pharmacist or clinician if the treated area shows signs of increased irritation or possible sensitization such as erythema, pruritus, burning, blistering, swelling, or oozing.
[citation needed] Azole antifungals are generally divided into two groups, imidazoles and triazoles.
Common examples of imidazoles include clotrimazole, econazole, miconazole, ketoconazole, while fluconazole, itraconazole, posaconazole and voriconazole fall under triazoles group.
Both groups cause substantial damage in fungal membrane integrity by lowering ergosterol levels, along with the loss of cytoplasmic components, thus bringing similar effects to the polyene antifungals.
[3][4] Azole antifungal drugs exert their effects by inhibiting the synthesis of the sterol components of the fungal membrane.
Avoid intravaginal preparations (particularly those that require the use of an applicator) in young girls who are not sexually active, unless there is no alternative (in children).
[citation needed] Polyene antifungals have high affinity for ergosterol in fungal cell membranes.
Allylamines are a new type of antifungal drug that is highly selective for the fungal enzyme but has a minimal effect on humans.
Allylamines allow the active ingredients in the medication to accumulate well within the stratum corneum of the skin and nails to exert their actions.
However, the leakage of cellular constituents resulting from the decreased cell permeability is only apparent at high drug concentrations.
They both inhibit the enzyme squalene-epoxidase, which converts squalene to lanosterol, the raw material for producing ergosterol in fungal cells.
There has been limited evidence showing the effectiveness of undecylenic acid in treating nail and scalp fungal infections.
