Some antifungal drugs are available only in topical forms for treating a variety of mycoses of the skin and mucous membranes. Some of the systemic antifungals are also available in topical forms. Fungi that cause these mycoses are called dermatophytes. These diseases include a variety of tinea infections, which are often referred to as ringworm, although the causal organism is a fungus, not a worm. These mycoses include tinea infections such as athlete’s foot (tinea pedis), jock itch (tinea cruris), and yeast infections of the mouth and vagina often caused by Candida. Because the antifungal drugs reserved for use as topical agents are often too toxic for systemic administration, care is necessary when using them near open or draining wounds that might permit systemic absorption.
Therapeutic Actions and Indications
The topical antifungal drugs work to alter the cell permeability of the fungus, causing prevention of replication and fungal death. They are indicated only for local treatment of mycoses, including tinea infections.
Pharmacokinetics
These drugs are not absorbed systemically and do not undergo metabolism or excretion in the body.
药动学
这些药物为非系统性吸收，不在人体内代谢和排泄。
Contraindications and Cautions
Because these drugs are not absorbed systemically, contraindications are limited to a known allergy to any of these drugs and open lesions. Econazole can cause intense, local burning and irritation and should be discontinued if these conditions become severe. Gentian violet stains skin and clothing bright purple; in addition, it is very toxic when absorbed, so it cannot be used near active lesions. Naftifine, oxiconazole, and sertaconazole nitrate should not be used for longer than 4 weeks due to the risk of adverse effects and possible emergence of resistant strains of fungi. Sulconazole should not be used for longer than 6 weeks due to the risk of adverse effects and possible emergence of resistant strains of fungi. Terbinafine should not be used for longer than 4 weeks. This drug should be stopped when the fungal condition appears to be improved or if local irritation and pain become too great to avoid toxic effects.
Adverse Effects
When these drugs are applied locally as a cream, lotion, or spray, local effects include irritation, burning, rash, and swelling. When they are taken as a suppository or troche, adverse effects include nausea, vomiting, and hepatic dysfunction (related to absorption of some of the drug by the GI tract) or urinary frequency, burning, and change in sexual activity (related to local absorption in the vagina).
dermatophyte – n. 皮肤癣菌
tinea – n. 癣
ringworm – n. 钱癣
mycosis – n. 真菌病
tinea pedis – n. 脚癣
jock itch – n. 股圆癣
tinea cruris – n. 股癣
azole-type antifungals -- 唑类抗真菌药
butoconazole – n. 布康唑
Gynazole – n. 【奥】加纳唑
clotrimazole – n. 克霉唑
Lotrimin – n. 【奥】洛替敏
Mycelex – n.
econazole – n. 益康唑
Spectazole – n. 1%硝酸益康唑
ketoconazole – n. 酮康唑
Extina – n.
Nizoral – n. 里素劳片
Xolegel – n.
miconazole – n. 咪康唑
Fungoid – n.
Lotrimin AF – n.
Monistat – n. 硝酸咪康唑
oxiconazole – n. 奥昔康唑
Oxistat – n. 硝酸奥昔康唑软膏
sertaconazole nitrate – n. 硝酸舍他康唑
Ertaczo – n.
sulconazole – n. 硫康唑
Exelderm – n.
terbinafine – n. 特比萘芬
Lamisil – n. 兰美抒
terconazole – n. 特康唑
Terazol – n.
tioconazole – n. 噻康唑
Vagistat-1 – n.
Monistat-1 – n.
butenafine – n. 布替萘芬
Mentax – n. 布替那非
ciclopirox – n. 环吡酮
Loprox – n. 环吡司霜
Penlac Nail Lacquer – n. Penlac甲漆剂
gentian violet – n.龙胆紫
naftifine – n. 萘替芬
Naftin – n. 萘替芬霜
tolnaftate – n. 托萘酯
Aftate – n.
Tinactin – n. 癣退
undecylenic acid – n. 十一烯酸
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