1.

TOPICAL ANTIBACTERIALS
a. b. c. d. e. Mupirocin Gentamycin/Neomycin Polymyxin B Bacitracin Triple Antibiotic Treatment

2.

ANTIFUNGALS
a. Dermatophytic
i. TOPICAL AGENTS: 1. Keratolytic 2. Azoles a. Imidazole i. Ketoconazole ii. Clotrimazole iii. Miconazole 3. Allylamine a. Terbinatine b. Naftifine 4. Tolnaftate 5. Undecylenic acid/ undecanoic acid 6. Akapulko SYSTEMIC AGENTS 1. Griseofulvin 2. Imidazole a. Ketoconazole b. Fluconazole c. Itraconazole 3. Terbinatine Nystatin Imidazole 1. Ketoconazole 2. Fluconazole 3. Itraconazole Imidazole 1. Ketoconazole 2. Clotrimazole 3. Miconazole Selenium Sulfide Tolnaftate Zing Pyrithione Undecyclenic acid Whitfields ointment (12% Benzoic acid + 6% Salicylic acid)

ii.

b.

For Superficial Candidiasis

i. ii.

c.

For Ptyriasis Versicolor due to Malassezia Furfur

i.

ii. iii. iv. v. vi.

3.

ANTIVIRALS
a. TOPICAL i. ii. Aciclovir Penciclovir

4.

ECTOPARASITICIDES
a. b. c. d. e. Cindane Permethrin Crotamiton Sulfur Kakawati

(1) TOPICAL ANTIBACTERIALS

Drug
Mupirocin

MOA
Bacterial protein biosynthesis Isoleucyl tRNA synthetase

Spectrum of Activity
Gram (+)

Clinical Use
Impetigo Eradication of nasal carriage of S. aureus

Toxicity
Minimal Systemic absorption

Excretion
Urine

Gentamycin/ Neomycin

Elongation of peptide Binds to A site of 30S bacterial ribosomal unit Cell wall permeability Cell wall synthesis

Gram (-)

Primary infection Secondary infection

Polymixin B Bacitracin

Gram (-) Gram (+)

Superficial infections Superficial infections

Urine

(2) ANTIFUNGALS
DERMATOPHYTIC INFECTIONS
Drug TOPICAL ADMINISTRATION
Keratolytic (Whitfields ointment)

MOA

Spectrum of Activity

Clinical Use
Tinea Pedis Tinea Cruris Ring worm

Toxicity

Excretion

Azole

Decrease in ergosterol synthesis Fungal cytochrome p450

Ketoconazole

Mammalian p450 function Steroid Hormone synthesis Drug metabolism

Broad Spectrum

Candida Spp. C. neoformans Dermatophytes Endemic mycoses Urine, feces Vulvovaginal candidiasis Rinea versicolor Oropharyngeal candidiasis Balanitis Pityriasis versicolor

Clotrimazole Miconazole

Cell wall permeability Cell wall permeability

Broad Spectrum Broad Spectrum

Allylamine Terbinatine Sterol Biosynthesis Squalene epoxidase Mucocutaneous fungal injection Dermatophytes Yeast -Cidal -Static Epidermophyton Microsporium Trichophton Spp. Malassezia furfur Athletes foot Jock itch Diaper rash Prickly heat Sweatin in groin area Itchin, burning Tinea infections Insect bite Ring worms Eczema Scabies Itchiness Mouth wash for stomatitis Broad Spectrum Candida Urine

Naftifine

Ergosterol Biosynthesis Squalene monooxygenase Growth of dermatophyte

Urine, feces

Tolnaftane

Undecyclenic/ undecanoic acid

Akapulko

SYSTEMIC ADMINISTRATION
Itraconazole Same as ketoconazole but more selective

Cryptococcus Blastomycosis Coccidomycosis Histoplasmosis Fluconazole Fungal meningitis

SUPERFICIAL CANDIDIASIS
Nystatin Altered permeability Binds to ergosterol of membrane, enhance membrane permeability Narrow Spectrum Cutaneous and mucosal infection

Imidazole Ketoconazole Fluconazole

Epidermophyton Microsporum Trichophyton Spp.

Itraconazole

Onchomycosis tx Cl in Pxs with ventricular dysfunction

HMG-Coa Reductase inhibition will cause increased rhabdomyolysis

PHTYRIASIS VERSICOLOR DUE TO MALASSEZIA FURFUR

Imidazole Ketoconazole Clomitazole Micronazole Selenium sulfide Cytostatic on cells of epidermis and follicular epithelium Antiseborrheic and antifungal topical agent

Zinc pyrithione

UNKNOWN MOA, but it may be associated to DNA transcription factors

(3) TOPICAL ANTIVIRALS

Drug
Aciclovir Penciclovir

MOA
Inhibits viral DNA polymerase Inactive initially, but then it is activated by addition of phosphate groum. Akinase will approach the activated penciclovir and will add 2 more phosphate group to form penciclovir triphosphate Inhibits Viral DNA polymerase

Spectrum of Activity
HSV Type 1 & 2 Varicella Zoster

Clinical Use

Toxicity

Excretion
Kidney

(4) ECTOPARASITICIDES
Drug
Lindane Permethrin Inhibits sodium ion influx through nerve cell membrane channels delaying repolarization which cause paralysis and death of pest Unknown MOA

MOA

Spectrum of Activity

Clinical Use
Pediculosis pubis Pediculosis capitis Pyrethoid pediculocide and scabicide Scabicide Antipruritic Scabies

Toxicity
Neurotoxic Hemotoxic

Excretion

Urine

Crotamiton Sulfur

Effective and safe but has an unpleasant odor and stains clothing. Safe for infants and pregnant women

Kakawati

Tannin component is antidiarrheal, antidysenteric, antimutagenic, antioxidant, bactericidal, hepatoprotective, Pesticidal, vincidal

Nematicidal Insecticidal Antibacterial (Staph) Antiscabies Antipruritic Antipseudomonnas