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Squalene monooxygenase Solute carrier organic anion transporter family member 1B1 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 ATP-binding cassette sub-family C member 3 Solute carrier family 22 member 5 Cytochrome P450 1A2 Cytochrome P450 2C19 Cytochrome P450 3A4 Cytochrome P450 2C9 Cytochrome P450 1A2 Squalene synthase Cytochrome P450 1A2 Cytochrome P450 2C19 Cytochrome P450 3A4 Cytochrome P450 1A2 Cytochrome P450 2C8 Cytochrome P450 1A2 Cytochrome P450 2B6 Cytochrome P450 2C9 Cytochrome P450 1A2 Terbinafine (S)-2,3-Epoxysqualene Cholesterol N-Desmethylhydroxyterbinafine Carboxyterbinafine N-Desmethylterbinafine dihydrodiol derivative (2) N-Desmethylterbinafine dihydrodiol derivative (1) 1-Naphthoic acid 1-Naphthalenemethanol Terbinafine Terbinafine Terbinafine N-Desmethylterbinafine dihydrodiol derivative (1) Carboxyterbinafine N-Desmethylhydroxyterbinafine N-Desmethylterbinafine dihydrodiol derivative (1) N-Desmethylhydroxyterbinafine N-Desmethylterbinafine dihydrodiol derivative (2) N-Desmethylterbinafine dihydrodiol derivative (2) 1-Naphthalenemethanol 1-Naphthoic acid N-Desmethylterbinafine 1-Naphthaldehyde Hydroxyterbinafine Terbinafine dihydrodiol derivative (1) Terbinafine dihydrodiol derivative (2) Squalene O2 NADPH H2O NADP Farnesyl pyrophosphate H+ NADPH PPi NADP O2 O2 NADPH H2O NADP H+ NADPH NADP NADPH O2 H+ NADP H2O O2 H+ H2O NADPH O2 NADP NADPH O2 NADP NADPH O2 NADP H2O H+ NADPH O2 NADP Heme Heme Heme Heme Heme Magnesium Heme Heme Heme Heme Heme Heme Heme Heme Heme Steroid Biosynthesis Renal excretion FAD Blood Vessel Intestinal Lumin Hepatocyte Intestinal Epithelial Cell Endoplasmic Reticulum Blood Vessel Inhibiting Squalene monooxygenase prevents cholesterol biosynthesis. Cholesterol is essential to the synthesis of fatty acids which are essential to cell membrane integrity. While Terbinafine doesn't have an affinity for human Squalene Monooxygenase, it can inhibit it as well as the fungal enzyme. Cholesterol would normally travel to all parts of the body where it is essential for steroid hormones, bile acids, and vitamin D along with cell membrane integrity. After time Terbinafine can cause cholesterol jaundice. Terbinafine can cause liver damage which can lead to liver death caused by the toxic levels of squalene in the liver. 80% is excreted in the urine. There is no Terbinafine present in the urine. 20% of Terbinafine travels through the bile and is excreted through the feces. Cytosol Bile Ducts
Endoplasmic Reticulum SQLE SLCO1B1 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 SLC22A5 CYP1A2 CYP2C19 CYP3A4 CYP2C9 CYP1A2 FDFT1 CYP1A2 CYP2C19 CYP3A4 CYP1A2 CYP2C8 CYP1A2 CYP2B6 CYP2C9 CYP1A2 Terbinafine (S)-2,3- Epoxysqualene Cholesterol N- Desmethylhydroxyterbinafine Carboxyterbinafine N- Desmethylterbinafine dihydrodiol derivative (2) N- Desmethylterbinafine dihydrodiol derivative (1) 1-Naphthoic acid 1- Naphthalenemethanol Terbinafine Terbinafine Terbinafine N- Desmethylterbinafine dihydrodiol derivative (1) Carboxyterbinafine N- Desmethylhydroxyterbinafine N- Desmethylterbinafine dihydrodiol derivative (1) N- Desmethylhydroxyterbinafine N- Desmethylterbinafine dihydrodiol derivative (2) N- Desmethylterbinafine dihydrodiol derivative (2) 1- Naphthalenemethanol 1-Naphthoic acid N- Desmethylterbinafine 1- Naphthaldehyde Hydroxyterbinafine Terbinafine dihydrodiol derivative (1) Terbinafine dihydrodiol derivative (2) Squalene Oxygen NADPH Water NADP Farnesyl pyrophosphate Hydrogen Ion NADPH Pyrophosphate NADP Oxygen Oxygen NADPH Water NADP Hydrogen Ion NADPH NADP NADPH Oxygen Hydrogen Ion NADP Water Oxygen Hydrogen Ion Water NADPH Oxygen NADP NADPH Oxygen NADP NADPH Oxygen NADP Water Hydrogen Ion NADPH Oxygen NADP Steroid Biosynthesis Renal excretion
SQLE SLCO1B1 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 SLC22A5 CYP1A2 CYP2C19 CYP3A4 CYP2C9 CYP1A2 FDFT1 CYP1A2 CYP2C19 CYP3A4 CYP1A2 CYP2C8 CYP1A2 CYP2B6 CYP2C9 CYP1A2 Terbina S23O Lanol N-Desme Carbo N-D d d N-D d d 1-Na ac 1-Napht Terbina Terbina Terbina N-D d d Carbo N-Desme N-D d d N-Desme N-D d d N-D d d 1-Napht 1-Na ac N-Desme 1-Napht Hydro T d d 1 T d d 2 Squalen O2 NADPH H2O NADP FarPP H+ NADPH PPi NADP O2 O2 NADPH H2O NADP H+ NADPH NADP NADPH O2 H+ NADP H2O O2 H+ H2O NADPH O2 NADP NADPH O2 NADP NADPH O2 NADP H2O H+ NADPH O2 NADP Heme Heme Heme Heme Heme Mg2+ Heme Heme Heme Heme Heme Heme Heme Heme Heme PW000050 Ren exc FAD Blood Vessel Intestinal Lumin Hepatocyte Intestinal Epithelial Cell Endoplasmic Reticulum Blood Vessel Inhibiting Squalene monooxygenase prevents cholesterol biosynthesis. Cholesterol is essential to the synthesis of fatty acids which are essential to cell membrane integrity. While Terbinafine doesn't have an affinity for human Squalene Monooxygenase, it can inhibit it as well as the fungal enzyme. Cholesterol would normally travel to all parts of the body where it is essential for steroid hormones, bile acids, and vitamin D along with cell membrane integrity. After time Terbinafine can cause cholesterol jaundice. Terbinafine can cause liver damage which can lead to liver death caused by the toxic levels of squalene in the liver. 80% is excreted in the urine. There is no Terbinafine present in the urine. 20% of Terbinafine travels through the bile and is excreted through the feces. Cytosol Bile Ducts
Endoplasmic Reticulum SQLE SLCO1B1 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 ABCC3 SLC22A5 CYP1A2 CYP2C19 CYP3A4 CYP2C9 CYP1A2 FDFT1 CYP1A2 CYP2C19 CYP3A4 CYP1A2 CYP2C8 CYP1A2 CYP2B6 CYP2C9 CYP1A2 Terbina S23O Lanol N-Desme Carbo N-D d d N-D d d 1-Na ac 1-Napht Terbina Terbina Terbina N-D d d Carbo N-Desme N-D d d N-Desme N-D d d N-D d d 1-Napht 1-Na ac N-Desme 1-Napht Hydro T d d 1 T d d 2 Squalen O2 NADPH H2O NADP FarPP H+ NADPH Ppi NADP O2 O2 NADPH H2O NADP H+ NADPH NADP NADPH O2 H+ NADP H2O O2 H+ H2O NADPH O2 NADP NADPH O2 NADP NADPH O2 NADP H2O H+ NADPH O2 NADP PW000050 Ren exc