Anti viral, Anti fungal, Anti helmintics drug. Antiviral drugs are a class of medication used specifically for treating viral infections rather than bacterial ones. Most antivirals are used for specific viral infections, while a broad-spectrum antiviral is effective against a wide range of viruses. Unlike most antibiotics, antiviral drugs do not destroy their target pathogen; instead they inhibit their development.
Antiviral drugs are one class of antimicrobials, a larger group which also includes antibiotic (also termed antibacterial), antifungal and antiparasitic drugs, or antiviral drugs based on monoclonal antibodies. Most antivirals are considered relatively harmless to the host, and therefore can be used to treat infections. They should be distinguished from viricides, which are not medication but deactivate or destroy virus particles, either inside or outside the body. Natural antivirals are produced by some plants such as eucalyptus.
Anti-herpetic agents
| Generic | Brand Name |
|---|---|
| Acyclovir | Zovirax, Sitavig |
| Brivudine | Helpin |
| Docosanol | Abreva |
| Famciclovir | Famvir |
| Foscarnet | Foscavir |
| Idoxuridine | Herplex, Dendrid |
| Penciclovir | Denavir |
| Trifluridine | Viroptic |
| Valacyclovir | Valtrex |
| Pritelivir | Inhibitor of the viral helicase-primase enzyme complex, currently under investigation |
Anti-influenza agents
| Generic | Brand Name |
|---|---|
| Adamantane Derivatives | |
| Amantadine | Symmetrel |
| Rimantadine | Flumadine |
| Neuraminidase Inhibitors | |
| Oseltamivir | Tamiflu |
| Peramivir | Rapivab |
| Zanamivir | Relenza |
Allylamines
| Generic name | Brand name |
|---|---|
| Amorolfin | Locery® (nail lacquer) |
| Butenafine | Lotrimin® Ultra (cream, spray), Mentax® (cream) |
| Naftifine | Naftin® (cream, gel) |
| Terbinafine | Lamisil® (cream, gel, spray, solution, oral granules, tablets) |
Allylamines are synthetic antifungals with activity against a wide range of dermatophytes. Allylamines act via inhibition of the squalene epoxidase formation, which blocks the synthesis of ergosterol.
Azoles
| Generic name | Brand name |
|---|---|
| Imidazoles | |
| Bifonazole | Canespor® (cream) |
| Butoconazole | Femstat® 3 (vaginal cream), Gynazole® 1 (vaginal cream) |
| Clotrimazole | Canesten ® (cream, solution), Clocreme® (cream), Cruex® (spray powder), Desenex® (cream) , Femcare® (vaginal), Fungoid® (solution), Gyne-Lotrimin® (cream), Gynix® (vaginal tablets), Lotrimin (cream), Mycelex® (solution, troches), Pedesil® (ointment), Trivagizole® (cream) |
| Econazole | Ecoza® (foam), Spectazole® (cream) |
| Fenticonazole * | Lomexin®, Gynoxin® |
| Ketoconazole | Nizoral® (oral tablets, cream, shampoo), Extina® (foam), Ketodan (foam), Kuric® (cream), Xolegel® (gel) |
| Isoconazole* | Icaden®, Travogen® |
| Luliconazole | Luzu® (cream) |
| Miconazole | Cavilon® (antifungal cream), Cruex® (spray), Desenex® (topical powder), Fungoid® (cream, tincture), Lotrimin® AF Athlete’s Foot Spray (deodorant powder, powder, liquid), Lotrimin® AF Athlete’s Foot powder, Lotrimin® AF Jock Itch spray powder, Micatin® (cream), Monistat® 1, Monistat® 3, Monistat® 7, Ting® (antifungal spray powder, spray liquid), Vagistat® 3, Zeasorb® AF (powder, lotion) |
| Omoconazole* | Fongamil® |
| Oxiconazole | Oxistat® (cream, lotion) |
| Sertaconazole | Ertaczo® (cream) |
| Sulconazole | Exelderm® (cream, solution) |
| Tioconazole | Monistat® 1 Simple Therapy, Vagistat® 1 |
| Terconazole | Terazol® 3 (vaginal cream, vaginal suppositories), Terazol® 7 (vaginal cream), Terconazole® (vaginal cream, vaginal suppositories), Zazole® (vaginal cream, vaginal suppositories) |
| Triazoles | |
| Albaconazole | Under® investigation |
| Efinaconazole | Jublia® (topical gel, solution) |
| Fluconazole | Diflucan® (tablets, capsules, injection) |
| Isavuconazole | Cresemba® (capsules, injection) |
| Itraconazole | Sporanox® (capsules, oral solution, injection), Onmel® (tablets) |
| Posaconazole | Noxafil® (tablets, oral suspension, injection) |
| Ravuconazole | Under investigation |
| Terconazole | Terazol® 3, Terazol® 7 (vaginal cream, vaginal suppositories) |
| Voriconazole | Vfend® (oral suspension, injection) |
| Arylguanidines (Thiazoles) | |
| Abafungin* | Abasol® (cream, gel) |
| * Not available in U.S. | |
Azoles (imidazole and triazole derivatives) are a large group of synthetic antifungal agents. Azoles are essentially fungistatic, and have a relatively broad antifungal spectrum. The azole antifungals have many drug-drug interactions because of their interference with cytochrome P-450 enzymes.
Imidazoles are considered first-line agents for most dermatophyte infections. Topical formulations are widely used for the treatment of superficial fungal infections and vaginal candidiasis. Imidazoles are very toxic when taken orally, so they are available only as topical formulations.
Triazoles are generally used for prophylaxis and treatment of invasive fungal infections and systemic mycosis.
Arylguanidines are a novel class of synthetic antifungal drugs.
Summary of the use of topical antifungals used in the treatment of tinea corporis, cruris and pedis
Polyenes
| Generic name | Brand name |
|---|---|
| Amphotericin B | Fungilin® (lozenges, oral suspension) |
| Nystatin | Nilstat® (oral drops, capsules, powder, tablets) |
| Natamycin (pimaricin) | |
| Trichomycin (hachimycin) |
The polyenes are naturally occurring compounds with a very broad antifungal spectrum. Polyenes act by binding to sterols in the fungal cell membrane, thereby interfering with membrane integrity and causing leakage of essential metabolites. Most polyenes are used topically, but intravenous amphotericin remains an important agent for the treatment of systemic fungal infections. The risk of nephrotoxicity limits the use of amphotericin B.
Echinocandins
| Generic name | Brand name |
|---|---|
| Anidulafungin | Eraxisin® injection |
| Caspofungin | Cancidas® injection |
| Micafungin | Mycamine® injection |
Echinocandins are the most recently developed class of antifungals. Echinocandins are used mainly for the treatment of severe, invasive Candida infections. Echinocandins are safer than other classes of antifungals and have a broad spectrum, and synergistic effect in combination therapy.
Miscellaneous Antifungal Drugs
| Generic name | Brand name |
|---|---|
| Thiocarbamates | |
| Tolnaftate | Tinactin®, Aftate®, Breezee®, Ting® |
| Antimetabolites | |
| Flucytosine | |
| Benzylamines | |
| Butenafine | Mentax® (cream), Lotrimin® (cream) |
| Other antifungals | |
| Griseofulvin | Gris-PEG® (tablets), Grifulvin® V (tablets), Grisactin® |
| Ciclopirox | Ciclodan® (cream, solution, topical suspension), Loprox® (cream), Penlac® (solution, nail lacquer), Loprox® (topical suspension, gel, shampoo) |
| Selenium sulfide | Selsun®, Exsel® |
| Tavaborole | Kerydin® |
Anthelmintics
Anthelmintics are agents that destroy or expel parasitic worms (helminths). Interestingly, most anthelmintics were developed for use in veterinary medicine.
| Generic | Brand Name |
|---|---|
| Bephenium | |
| Diethylcarbamazine | |
| Ivermectin | Sklice, Stromectol, Ivomec, Mectizan |
| Niclosamide | Niclocide |
| Piperazine | |
| Praziquantel | Biltricide |
| Pyrantel | Antiminth, Aut, Cobantril, Helmex, Lombriareu, Trilombrin |
| Pyrvinium | Vanuin, Viprynium |
| Benzimidazoles | |
| Albendazole | Albenza |
| Flubendazole | Fluvermal |
| Mebendazole | Mebendacin, Mebutar, Nemazole, Vermox |
| Thiabendazole | Foldan, Mintezol, Minzolum, Triasox |
Scabicides & Pediculicides
Scabicides are agents that kill scabies mites and mite eggs.
Pediculicides are agents used to kill head lice.
| Generic | Brand Name |
|---|---|
| Benzyl benzoate | Ascabiol |
| Benzyl benzoate/disulfiram | Tenutex |
| Lindane | GBH, G-Well, Kwellada, Kwildane, PMS Lindane |
| Malathion | Derbac, Ovide |
| Permethrin | Acticin, Elimite |
| Pediculicides (only for lice infestations) | |
| Benzyl alcohol | Ulesfia |
| Piperonyl butoxide/pyrethrins | Pronto Lice Kill System |
| Spinosad | Natroba |
| Scabicides (only for scabies infestations) | |
| Crotamiton | Eurax |
References
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