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Imidazoles are often the drugs of first choice for treating tinea because they are more effective than other topical drugs described above. The mode of action of imidazoles is to make fungal cells leaky by inhibiting an enzyme necessary for ergosterol synthesis.
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However, it is recommended that local anaesthetics should not be injected into inflamed tissue as this increases absorption into blood and consequently increases the risk of side effects.
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Amorolfine is a novel topical antifungal drug. It has a similar action to terbinafine affecting synthesis of fungal cell membrane ergosterol and is generally fungicidal.
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Examples of opioid analgesics are fentanyl and morphine. However, opioid analgesics cause respiratory and cardiovascular depression, which is additive to that of general anaesthetics.
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