What Is a Topical Antifungal?

Antifungal drugs: Fungal infections can be divided into superficial fungal infections and deep fungal infections. Superficial infections are caused by ringworms invading skin, hair, fingernails and other body surface parts. High, less harmful. Deep fungal infections are caused by candida and cryptococcus invasion of internal organs and deep tissues, with a low incidence and great harm. Of all antifungal infections, only fluconazole and flucytosine can penetrate the blood-brain barrier to treat central fungal infections.

Drugs that inhibit or kill fungi. In addition to some ancient antifungal drugs such as salicylic acid, retinoxin, iodine, sulfur, etc., the new drugs with significant antifungal effects are antibiotics and synthetic drugs. Antibiotics. There are mainly griseofulvin, nystatin and amphotericin B. Griseofulvin is only effective for dermatophytosis, mainly tinea corporis, tinea corporis, tinea corporis, onychomycosis, etc. When taken orally, 20 to 30 days is a course of treatment, and it is necessary to combine topical treatment for ringworm. For a long period of use, a few superficial fungi produce resistant strains, and ketoconazole can be replaced. Nystatin can be used to treat gastrointestinal candidiasis and topical to treat skin and mucosal candidiasis. It can also be made into a medicine. Amphotericin B is mainly used to treat deep mycosis, such as systemic candidiasis, cryptococcosis, aspergillosis, concomitant mycosis, blastomycosis, paracoccidiosis in Brazil, coccidiosis and histoplasmosis . Add this medicine to a 5% glucose solution and slowly instill intravenously. synthetic drugs. Including: imidazole drugs (such as clotrimazole, econazole, miconazole and ketoconazole, etc.), flucytosine, allylamine derivatives. 5-Fluorocytosine treats candidiasis, cryptococcosis, and coloromycosis. Clotrimazole, econazole and miconazole are basically for external use. Miconazole is also administered intravenously. Ketoconazole can also be taken orally. When applied topically, it mainly treats skin fungal diseases and skin candidiasis. Oral and intravenous infusions are used to treat deep and superficial mycosis.

Antifungal drugs can easily affect white blood cells and liver function. Long-term use can cause transient GPT rise or white blood cell decline. 5-Fluorocytosine is excreted from the urine. Those with poor renal function can accumulate in the blood and cause poisoning. Therefore, those with poor renal function should be disabled or used with caution. Amphotericin B can damage the kidneys and cause a decrease in blood potassium. Some people have chills and fever. A few people can cause thrombophlebitis. Ketoconazole should pay special attention to liver damage. Long-term use can cause decreased levels of androgen in the blood and suppression of adrenal sebum function.

5-Fluorocytosine is prone to drug resistance. To avoid the development of drug resistance, large doses can be used from the beginning, and it can also be used in combination with amphotericin B. The two drugs have a synergistic effect. 5-Fluorocytosine can also be used in combination with ketoconazole. Amphotericin B cannot be combined with ketoconazole because the two drugs interfere with each other.

The clinical trial of itraconazole has a broad antibacterial spectrum, low toxicity, and is better than ketoconazole. It treats aspergillosis, cryptococcosis, histoplasmosis, candidiasis, sporotrichosis, pigmented blastomycosis, and skin. Ringworm and other diseases have good effects. Also available for external use are benzimidazole, fluconazole, ciclopirox and naftifine.

Echinocandins are a new class of antifungal drugs that interfere with the synthesis of -1,3-glucose in the fungal cell wall by non-competitively inhibiting -1,3-glucose synthetase, resulting in changes in the permeability of the fungal cell wall. The cells lysed and died. Echinocandins have a unique mechanism of action, with a broad antibacterial spectrum, strong antifungal effect, long half-life, fewer and less adverse reactions, and good patient tolerance. They can be used as potential additions to polyolefins and azoles. Drugs or synergistic drugs and good alternative drugs are worthy of clinical popularization. However, because of the high price of such drugs, it brings a certain economic burden to patients and is limited to a certain degree in clinical use.