Ci

Figure 6.3 • Mechanism of action of 5-fluorocytosine.

Ciclopirox Olamine25

6-Cyclohexyl-1-hydroxyl-4-methyl-2(1H )-pyridinone ethanolamine salt (Loprox) is a broad-spectrum antifungal agent intended only for topical use. It is active against der-matophytes as well as pathogenic yeasts (C. albicans) that are causative agents for superficial fungal infections.

Ciclopirox is considered an agent of choice in the treatment of cutaneous candidiasis, tinea corporis, tinea cruris, tinea pedis, and tinea versicolor. It is a second-line agent for the treatment of onychomycosis (ringworm of the nails). Loprox is formulated as a cream and a lotion, each containing 1% of the water-soluble ethanolamine salt. Ciclopirox is believed to act on cell membranes of susceptible fungi at low concentrations to block the transport of amino acids into the cells. At higher concentrations, membrane integrity is lost, and cellular constituents leak out.

Nucleoside Antifungals

Flucytosine26

5-Fluorocytosine, 5-FC, 4-amino-5-fluoro-2(1#)-pyrimidi-none, 2-hydroxy-4-amino-5-fluoropyrimidine (Ancobon). 5-Fluorocytosine is an orally active antifungal agent with a very narrow spectrum of activity. It is indicated only for the treatment of serious systemic infections caused by susceptible strains of Candida and Cryptococcus spp.

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