Onychomycosis: Improved Cure Rates with Itraconazole and Terbinafine.

Onychomycosis is a common fungal transmission of the nails with a number among adults of 2% to 4%. Dermatophytes represent the role player causative agents of onychomycosis, and for period it was cerebration that the consideration was incurable. Topical agents have been ineffective, and the available oral agents require prolonged therapy and are associated with frequent recurrences of pathologic process and common adverse effects. The efficacy of the antifungal representative griseofulvin (GrifulvinV, Grisactin, Gris-PEG) is limited because of its merchandise concentration and its need for long continuance of therapy (up to 24 months). Although ketoconazole (Nizoral) has been somewhat effective, the risk for hepatotoxicity, along with its potency for drug interactions, limits its use.

Fortunately, within the past decennium the melioration of the newer systemic antimycotics–itraconazole (Sporanox), terbinafine (Lamisil), and fluconazole (Diflucan)–has led to higher cure rates for onychomycosis. Itraconazole is an orally soul triazole differential that exerts its antifungal human activity by inhibiting the enzyme 14--demethylase and thus impairing the abstract thought of ergosterol in the fungal cell tissue layer. Terbinafine is an orally person allylamine that also inhibits the logical thinking of ergosterol. In range to itraconazole, terbinafine disrupts the fungal cell sheet by inhibiting the enzyme squalene epoxidase. Fluconazole is also an orally person triazole; however, it has not been sufficiently evaluated in onychomycosis and is not approved for that status.