Anti-fungal drugs are the medicines required to treat either superficial (means outside body) or deep tissues infections caused by fungus. There are many drugs of this category depending upon its mechanism and extent of its action.
What is fungus?
Before proceeding forward, we should be aware about what fungus actually is? To answer this question, fungi are eukaryotic organisms which are capable enough to cause cutaneous, subcutaneous and even systemic infections.
They occur in two forms i.e yeasts (are single celled fungus) and molds ( multicellular fungus).
They grow in temperatures like 25-37°C. Majorly, they cause skin infections, hair infections, nails, though have the capability to also cause systemic infections like affecting lungs, mouth, throat, urinary tract, and other parts as well.
The types of infections caused by fungus are ringworm, yeast infection, athlete’s foot etc. these infections result into itching at the site of fungus attack, redness, pain as the fungus invades with infection in skin, nails, mouth, throat, and other mucous membrane.
These infections should be treated as soon as possible otherwise if left untreated may pose serious problems to the body or might lead to death as well.
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What are Antifungal Drugs?
As mentioned, these treatments help to treat fungal infections both topically and systemically. The era of antifungals started back in the 1950s which flooded the market with two drugs, which are ‘Amphotericin B’ and ‘Griseofulvin’ used to treat systemic and topical fungal infections respectively.
With passing years, there was development in new fungus treating drugs coming into the market. After these drugs, ‘Flucytosine’ was introduced, followed by imidazoles, and the triazoles, which has been the safest option since then, a better alternative to amphotericin B and griseofulvin.
How can we forget about the new drug ‘terbinafine’? There was a release of semi synthetic drugs into the market with the classified name as ‘Echinocandins’.
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Points to remember when selecting a drug?
- Broad spectrum activity: it should possess this activity, it means that particular drug should be effective against multiple types of fungus causing issues and is also able to prevent recurrence of that infection.
- Minimal adverse effects: of course, if is the requirement with not only these category drugs but also for other medications as well. Go for the drugs providing effective treatment with minimal side effects.
- Sustained release effect: this means that choose the drug which gives long term treatment which helps in treating current infection and also avoid recurrence of fungal infections easily.
- Quick-relief: This is one of the factors which cannot be avoided. Always go with products which provide instant relief from infection which will ultimately treat infection. It also helps in relieving pain due to itchiness and redness.
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Types of antifungal drugs
Classification antifungal drugs
Antifungal antibiotics
- Polyenes- Amphotericin B, Nystatin
- Echinocandins- Caspofungin
- Heterocyclic benzofuran- Griseofulvin
Anti- metabolite- Flucytosine
Azoles
- Imidazoles: topical and system treatment
- Topical: Clotrimoxazole, econazole
- System: ketoconazole
- Triazoles: Fluconazole, itraconazole
- Allylamine: terbinafine
- Topical drugs: tolnaftate, undecylenic acid
These antifungals kill fungus by stopping it from multiplying or growing. There are a variety of antifungal medications with different types of action. The healthcare provider will prescribe the medication as per need or as per problem. Options include:
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Activity of different class of antifungal drugs
- The class of azoles antifungals works by stopping the fungi from growing. In this class of drugs, only ketoconazole is used topically and others are used orally. They act as broad-spectrum action, which is active against Candida, fungus causing deep mycosis, Nocardia, and Leishmania.
- Echinocandins are new semi-synthetic antifungals that attack and damage the fungus wall known as chitin. They cause less toxicity in comparison to Amphotericin B.
- Polyenes are natural antifungal medications that act by destroying the fungus cell.
- Anti-metabolite class of drug which includes Flucytosine acts by inhibiting the activity of thymidylate acid which is an important component for fungus DNA synthesis.
- Allylamines are topically active drugs for treatment against a class of fungus Candida which has fungicidal activity.
- Tolnaftate is used as a topical applicant for treating tinea cruris, and tinea corporis.
- Undecylenic acid acts as fungistatic used topically. For its effective treatment it is used along with zinc salt. It is used for treatment of nappy rash, tinea pedis.
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Best anti-fungal tablets
- clotrimazole (Canesten)
- econazole
- miconazole
- terbinafine (Lamisil)
- fluconazole (Diflucan)
- ketoconazole (Daktarin)
- nystatin (Nystan)
- amphotericin
In the bracket against each drug, brand name has been mentioned through which name these drugs are available in the pharmacist store.
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Antifungal drugs Side effects
Side effects vary for different class of drugs and also on the dosage regimen, type of infection, pharmacokinetics as weel.
- Itching on skin
- redness
- feeling sick
- diarrhoea
- skin rashes
- Abdominal pain or upset stomach
- burning sensation
An antifungal drug may rarely cause serious issues like:
- Liver damage (jaundice).
- Severe allergic reactions like anaphylaxis.
- Severe allergic skin reactions, such as blisters and peeling skin.
Antifungal drugs Safety Advice
- Even though these drugs are available as OTC but don’t consume it without physicians consent.
- Better to only consume dosage regimen as mentioned by the physician, otherwise it might impose serious health issues.
- They are not recommended in pregnancy and while breastfeeding and if required so, better to consult doctor for this.
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