Paper II — 2025 March (Supplementary (SAY)) (2019 Scheme) — Qv
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Paper II
2025 March (Supplementary (SAY)) (2019 Scheme) · 100 marks · 180 min
Question
The mechanism of action of the drug terbinafine is:
a) Inhibition of fungal cell wall synthesis
b) Disruption of fungal cell membrane integrity
c) Inhibition of squalene epoxidase in the ergosterol synthesis pathway
d) Inhibition of fungal DNA synthesis
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Answer
Correct answer: c) Inhibition of squalene epoxidase in the ergosterol synthesis pathway
Terbinafine inhibits squalene epoxidase, an earlier step in the ergosterol synthesis pathway than the azoles’ target (lanosterol demethylase). Blocking this step both depletes ergosterol and causes toxic squalene accumulation within the fungal cell, contributing an additional fungicidal mechanism beyond simple ergosterol depletion — used predominantly for dermatophyte infections, particularly onychomycosis.