Azoles are synthetic compounds that can be classified according to the number of nitrogen atoms in the five-membered azole ring into either:
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Imidazoles : (Clotrimazole, econazole, fenticonazole, Ketoconazole, Miconazole, tioconazole and sulconazole are given topically for cutaneous infections , whereas
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Triazoles : FLUCONAZOLE, ITRACONAZOLE, VORICONAZOLE , , Posaconazole, ISAVUCONAZOLE given systemically for the treatment or prophylaxis of cutaneous and systemic fungal infections.
Although these drugs have similar mechanisms of action and spectra of activity, their pharmacokinetics and therapeutic uses vary significantly. In general
Mechanism of action: fungistatic.
The azoles inhibit the fungal cytochrome P450 3A enzyme, which is responsible for converting lanosterol to ergosterol, the main sterol in the fungal cell membrane which disrupts membrane structure and function, which, in turn, inhibits fungal cell growth.
Drug interactions of Azoles:
All azoles inhibit the hepatic CYP450 3A4 isoenzyme to varying degrees.
Contraindications of Azoles
Azoles are considered teratogenic, and they should be avoided in pregnancy unless the potential benefit outweighs the risk to the fetus.