Pharmacodynamics<unk>  has several known mechanisms of action. It is considered fungistatic, fungicidal, antibacterial, antiinflammatory, antitrichomonal, and antipruritic. Like other imidazole antifungals,<unk>  blocks the synthesis of ergosterol by inhibiting the 14α-demethylase enzyme. Ergosterol is a critical component of the fungal cell membrane. Inhibition of ergosterol synthesis prevents fungal cells from multiplying and impairs hyphae growth. Chemically,<unk>  contains a benzothiophene ring which makes it unique from other imidazole antifungals. A benzothiophene ring is a sulfur analogue of the indole ring found in the amino acid tryptophan. Tryptophan is found in the fungal membrane in addition to lipids such as ergosterol. The benzothiophene ring in<unk>  mimics tryptophan and increases the drugs ability to form pores in the fungal cell membrane. If the cell membrane is made sufficiently leaky by these pores the fungal cell will die from loss of ATP and other effects which can include calcium disregulation. These pores are believed to open at about 10 minutes following topical application of<unk> . One hour following topical application, approximately 90% of fungal cells die from lack of energy (due to ATP loss) and general loss of homeostasis.<unk>  is thought to be the only Benzothiophene antifungal with this mechanism of action.<unk>  has also antiinflammatory and antipruritic action. It inhibits the release of proinflammatory cytokines from activated immune cells. It has been shown that<unk>  activates the p38/COX2/PGE2 pathway. PGE2 can have a variety of important effects in the body including activation of the body's fever response.<unk>  also has antibacterial action. It is hypothesized that the mechanism of action again involves<unk> 's ability to form pores by mimicking tryptophan. It has also been shown that<unk>  can kill Trichomonas vaginalis in vitro. The exact mechanism of action is as yet unknown.<unk>  also appears to inhibit the dimorphic transformation of Candida albicans into pathogenic fungi. The following fungal organisms, among others, are known to be susceptible to<unk> : * Candida albicans * Epidermophyton floccosum * Trichophyton mentagrophytes * Trichophyton rubrum
Sertaconazole
Itraconazole
Ketoconazole
Efinaconazole
Posaconazole
Miconazole
Nystatin
Levoketoconazole