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Amphoteri

FIGURE 48-1 Mechanism of action of amphotericin, imidazoles, triazoles, and allylamines in fungi. Amphotericin B and other polyenes, such as nystatin, bind to ergosterol in fungal cell membranes and increase membrane permeability. The imidazoles and triazoles, such as itraconazole and fluconazole, inhibit 14-a-sterol demethylase, prevent ergosterol synthesis, and lead to the accumulation of 14-a-methylsterols. The allylamines, such as naftifine and terbinafine, inhibit squalene epoxidase and prevent ergosterol synthesis. The echinocandins (e.g., caspofungin) inhibit the formation of glucans in the fungal cell wall.

Cell wall synthesis

Caspofungin

Nucleic acid synthesis

5- Flucytosine

Lanosterol synthesis

Naftiline Terbinafine

Ergosteroi synthesis

Fluconazole Itraconazole Voriconazole

FIGURE 48-1 Mechanism of action of amphotericin, imidazoles, triazoles, and allylamines in fungi. Amphotericin B and other polyenes, such as nystatin, bind to ergosterol in fungal cell membranes and increase membrane permeability. The imidazoles and triazoles, such as itraconazole and fluconazole, inhibit 14-a-sterol demethylase, prevent ergosterol synthesis, and lead to the accumulation of 14-a-methylsterols. The allylamines, such as naftifine and terbinafine, inhibit squalene epoxidase and prevent ergosterol synthesis. The echinocandins (e.g., caspofungin) inhibit the formation of glucans in the fungal cell wall.

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