Hey, all, welcome back to the real-life pharmacology podcast. I'm your host, pharmacist, Derek Christensen.

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available for all to benefit from all right the drug of the day today is ketoconazole

brand name is nizoril as you could expect from the ending ketoconazole this is an

azole antifungal so it's use typically going to be used for treating fungal infections.

I can't say I've really seen it used for anything else other than that in clinical practice.

And its use is pretty rare and I'll discuss the reasons for that coming up here.

But there are a couple off-label uses that have been reported, advanced prostate cancer,

as well as Cushing's syndrome.

So we have an oral formulation as well as a topical formulation.

So topical formulation we can utilize for cutaneous candidiasis, certain types of dermatitis, tini infection.

And I want to talk on the mechanism of action a little bit here.

So essentially as an antifungal, this medication alters the permeability of the fungal cell wall. So it blocks

fungal cytochrome P-450. In addition to that, it also inhibits biosynthesis of triglycerides and

phospholipids that are necessary for the fungus to grow and survive.

Now, I alluded to the off-label use of Cushing's syndrome.

So this medication actually inhibits some adrenal enzymes that are responsible for cortisol

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