00:00 We have a new class of drugs, the prototypical drug of which is griseofulvin. 00:06 Now it is not active topically. 00:09 It actually an orally ingested agent for skin infections. 00:14 So that's sometimes kind of confusing to a lot of medical students. 00:18 It's a skin drug but it's not used topically. 00:20 It's distributed to the stratum corneum where it binds to various proteins. 00:27 It should not be used in patients with porphyria because you can actually precipitate a porphyria crisis with this agent. 00:35 In terms of how it works, it actually inhibits microtubule formation in the dermatophytes. 00:41 It's a fungistatic so it's absorbed into fungal cells through an active transporter. 00:46 The toxicity of this agent includes, headache and GI distress, fever, rash and flushing from the histamine release that you sometimes get. 00:55 Now the other thing that's really important with this agent is that it will interfere with warfarin levels. 01:00 So be careful of your warfarin dosing in your INR's when you start this medication. 01:07 Terbinafine is available both in oral and in topical forms. 01:13 Like griseofulvin it is distributed to the stratum corneum where it binds to various proteins. 01:19 It's actually much more effective then griseofulvin. 01:23 And we see it all the time used in fungal infections. 01:29 In terms of how it works, it inhibits squalene epoxidase. 01:35 It accumulates, there's an accumulation of squalene and this interferes with ergosterol synthesis. 01:43 And this is actually a fungicidal activity. 01:45 Toxicity once again same as the other ones. 01:48 Headache, GI distress, fever, rash and flushing from histamine release. 01:53 And once again this drug also will interfere with warfarin dosing and levels.
The lecture Griseofulvin and Squalene Epoxidase Inhibitor (Terbinafine) – Antifungals by Pravin Shukle, MD is from the course Antimicrobial Pharmacology. It contains the following chapters:
Which statement about griseofulvin is INCORRECT?
What is a similarity between terbinafine and griseofulvin?
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