sulfonamides
-inhibits dihydropteroate synthase in the
biosynthesis of folic acid
echinocandins
-inhibit glucan synthase, an enzyme required for
cell wall formation
polyenes
-binds to ergosterol on the fungal membranes to
form pores that allow the influx of ions
ciclopirox
-inhibits protein synthesis and also chelates
polyvalent cations
azoles
-inhibit lanosterol 14-alpha-demethylase, an
enzyme used in the synthesis of ergosterol, to
reduce production of ergosterol and increase levels
of precursors
flucytosine
-prodrug converted by fungal enzymes to create 5-
fluorouracil, which replaces uracil in the RNA to
act as an antimetabolite and blocks DNA synthesis
methenamine
-prodrug- produces formaldehyde and ammonia in
acidic conditions
ansamycin
-Inhibits bacterial DNA-dependent RNA
polymerase and thus inhibits RNA transcriptions
fosfomycin
-Inhibits phosphoenolpyruvate transferase, which
produces diphosphate-N-acetylmuramic acid, thus
inhibiting the first step in cell wall formation
metronidazole
-prodrug- activated by bacterial PFOR to form a
radical anion, which generates a superoxide anion,
causes damage to DNA and proteins
Fluoroquinolone
-Inhibits DNA gyrase and topoisomerase IV
ibrexafungerp
-not an echinocandin, but this drug has the same
MOA
allylamine
-inhibits squalene epoxidase, the enzyme that
breaks down squalene, to cause toxic accumulation
of squalene
clioquinol
-inhibits proteasomes to induce apoptosis
nitrofurantoin
-prodrug activated by bacterial enzymes to generate
a superoxide anion that reacts with ribosomal
proteins, decreases synthesis of proteins, DNA,
and RNA
systemic fungal infections
Tx for Polyenes?
TB
Tx for Anasamycins?
skin infections, vaginal yeast infections
Tx for Azoles?
all topical for tinea pedis
Tx for Allylamines?
more severe/systemic infections (IV only)
Tx for Echinocandins?