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INTRODUCTION

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This chapter will be most useful after having a basic understanding of the material in Chapter 57, Antifungal Agents in Goodman & Gilman’s The Pharmacological Basis of Therapeutics, 12th Edition. In addition to the material presented here, the 12th Edition contains:

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  • Structural formulas for each of the antifungal agents in addition to the figures reproduced here

  • Table 57-1 Pharmacotherapy of Mycoses which lists the drugs used for different mycoses

  • Table 57-7 Pharmacokinetics of Echinocandins in Humans which shows the pharmacokinetic differences among caspofungin, micafungin, and anidulafungin

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LEARNING OBJECTIVES

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  • Understand the mechanisms of action and resistance of antifungal agents.

  • Describe the therapeutic uses of antifungal agents in the context of treatment for fungal diseases.

  • Develop knowledge of the common and unique toxicities of antifungal agents.

  • Understand the drug–drug interactions that can occur with the use of azole antifungal agents.

  • Know the differences in treating invasive fungal infections with systemic drugs versus superficial infections with topical antifungal agents.

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DRUGS INCLUDED IN THIS CHAPTER

  • Amphotericin B (FUNGIZONE); colloidal dispersion (AMPHOTEC, AMPHOCIL); liposomal formulation (AMBISOME); lipid complex (ABELCET)

  • Anidulafungin (ERAXIS)

  • Butenafine (MENTAX, LOTRIMIN ULTRA)

  • Butoconazole (FEMSTAT 3, others)

  • Caspofungin (CANCIDAS)

  • Ciclopirox olamine (LOPROX, others)

  • Clotrimazole (LOTRIMIN, MYCELEX, GYNE-LOTRIMIN, others)

  • Fluconazole (DIFLUCAN, others)

  • Flucytosine (ANCOBON)

  • Griseofulvin (GRIFULVIN and GRIS-PEG)

  • Haloprogin (HALOTEX)

  • Isavuconazole (BAL 8557) (investigational)

  • Itraconazole (SPORANOX, others)

  • Ketoconazole (NIZORAL, others)

  • Micafungin (MYCAMINE)

  • Miconazole (MICATIN, ZEASORB-AF, MONISTAT 7, MONISTAT 3, MONISTAT 1, others)

  • Naftifine (NAFTIN)

  • Nystatin (MYCOSTATIN, NILSTAT, NYOTRAN, others)

  • Oxiconazole (OXISTAT)

  • Posaconazole (NOXAFIL)

  • Sertaconazole (ERTACZO)

  • Sulconazole (EXELDERM, SULCOSYN)

  • Terbinafine (LAMISIL, others)

  • Terconazole (TERAZOL, others)

  • Tioconazole (VAGISTAT 1, others)

  • Tolnaftate (AFTATE, TINACTIN, others)

  • Undecylenic acid (DESENEX, others); Calcium undecylenate (CALDESENE, CRUEX)

  • Voriconazole (VFEND)

  • Whitfield’s Ointment

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Table Graphic Jump Location
MECHANISMS OF ACTION AND RESISTANCE OF ANTIFUNGAL DRUGS
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Figure 43-1

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