Imidazoles

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Imidazoles

• fungistatic at low concentration
• fungicidal at higher

Drugs in class

• clotrimazole
• econazol
• fenticonazole
• miconazole

Mechanism

• inhibits a cytochrome P₄₅₀ Enzyme with high specificity for fungal cytochrome
• interferes with ergosterol synthesis
• increased membrane fluidity causes leakage and dysfunction of membrane bound enzymes

Route

• pessaries
• creams

Adverse Effects

• inhibit testosterone synthesis
  • gynaecomastia
  • impotence
• inhibit cortisol synthesis
  • adrenal insufficiency

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