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Terbinafine
Mechanism of action:
Terbinafine is an allylamine derivative. Terbinafine inhibits squalene epoxidase, an enzyme involved in fungal cell membrane synthesis. This enzyme catalyzes the conversion of squalene into 2,3-epoxysqualene, an early step in the ergosterol biosynthesis pathway. By inhibiting squalene epoxidase, Terbinafine reduces downstream ergosterol production, resulting in incomplete fungal cell membrane structure. At the same time, squalene continuously accumulates because it cannot be converted into 2,3-epoxysqualene, causing toxicity and ultimately suppressing fungal growth and potentially causing cellular damage.
Reference(s):
1. Darkes MJ et al. (2003). Terbinafine: a review of its use in onychomycosis in adults. Am J Clin Dermatol.
2. Ryder NS et al. (1992). Terbinafine: mode of action and properties of the squalene epoxidase inhibition. Br J Dermatol.
3. Meletiadis J et al. (2006). Human pharmacogenomic variations and their implications for antifungal efficacy. Clin Microbiol Rev.