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PDAT1 > 8 - Fungal > Flashcards

8 - Fungal Flashcards

1
Q

What products to use for PREGNANCY

in treating vulvovaginal candidiasis

A

Butoconazole / Clotrimazole / Miconazole

BCM

Try to withold treatment during the 1st trimester

SELF TREATMENT IS NOT APPROPRIATE

breastfeeding, is okay with ANY PRODUCT

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2
Q

Treatment Approach for

VULVOVAGINAL CANDIDIASIS

A

Reestablish normal Vaginal Floral

Self-treatment is appropriate for uncomplicated disease
w/ infrequent episodes + mild/moderate symptoms

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3
Q

What NON-RX Antifungal medication?

Imidazole derivative, ​inhibits biosynthesis of sterols

Fungistatic / FungiCIDAL

Pedis / Crusis / Corpsis

BID Q4WEEKS

2+ y/o

A

MICONAZOLE 2%

FEET / GROIN / BODY

BID F4WEEKS

AE = skin irritation / burning / stinging

SAME AS CLOTRIMAZOLE 1%

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4
Q

What BODY PARTS does this genera of pathogenic fungi affect?

Epidermophyton

A

Same as Micro but adding the FEET/ Pedis

Pedis / Crusis / Corposis

Feet + Groin + Scalp

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5
Q

Fungal infection of what affected area of the body?

Tinea Crusis

A

GROIN

cursed groin

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6
Q

What NON-RX Antifungal medication?

Pedis / Cruris / Corporis

BID F4WEEKS

2+ y/o

A

CLOTRIMAZOLE 1%

SAME AS MICONAZOLE 2%

BID 4WEEKS

2+

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7
Q

What type of Fungal Infection?

seen as hypo or HYPER - PIGMENTED lesions

Patients are often ASYMPTOMATIC

primaryly found on the TRUNK of body

warm climate

A

Tinea VERSICOLOR

Pityrosporum Orbiculare

Clotrimazole 1% + Miconazole 2% + Tolnaftate 1%
QD for 14 days

Selenium Sulfide
Lathe for 5 min, rinse -> Repeat QD f2weeks then taper use

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8
Q

OTC Treatment of

VULVOVAGINAL CANDIDIASIS​

A

1 / 3 / 7 Day treatments

Usually only Miconazole 2% / Clotrimazole 1%

RX = Butoconazole / 2%/4% Ticonazole

ONLY USE OTC if condition has been DIAGNOSED in the PAST

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9
Q

Non pharmacologic Therapy for

VULVOVAGINAL CANDIDIASIS

A

Decreased consumption of Sucrose / Refined Carbs

Consume YOGURT

D/C meds that are known to INCREASE susceptibility

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10
Q

EX-ST of FUNGAL INFECTIONS

A

NAILS / SCALP INVOLVED = Unguium / Capitis

Face / mucous membranes / genitalia involved

unclear factor / unsuccessful treatment / WORSENING

Signs of possible **Secondary Bacterial Infection = OOZING**
excessive exudation (oozing)

Diabetes / Systemic Infection / Immune Deficiency

Fever / Malaise

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11
Q

What NON-RX Antifungal medication?

FungiSTATIC

PEDIS
BID

  • *Cruris / Corporis**
  • *QD**
A

UNDECYLENIC ACID

DIFFERENT DOSE FOR PEDIS = BID

Corposis / Cruris = QD

mild irritation / burning

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12
Q

Which Fungal infections can NOT be treated with OTC topical therapy?

A

Tinea UNGUIUM = Onychomycosis

Tinea CAPTIS = sCalp

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13
Q

Contributing Factors of

Fungal Infections

A

Poor Hygiene

TROPICAL climate

Immunocompromised / Impaired Circulation

CONTACT w/ infected person / animal

TRAUMA to skin

poor nutrition

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14
Q

What type of Fungal Infection?

Most common fungal infection

PRURITIS = most common symptom

may become inflammatory / pustular + sting

From: public pools / bathing

Sports / tight socks/shoes / hyperhidrosis

A

Tinea PEDIS** = **ATHLETE’S FOOT

Trichophyton or Epidermophyton

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15
Q

What NON-RX Antifungal medication?

Fungal cell death

PEDIS
BID F1Week or QD F4weeks
ONE OF 2 THAT CAN BE EFFECTIVE IN 1 WEEK​

  • *CRURIS / UNGUIUM**
  • *QD F2 Weeks**

12+ y/o

A
  • *_BUTENAFINE 1%
  • ONE OF 2 THAT CAN BE EFFECTIVE IN 1 WEEK​*_**

FEET + GROIN + UNGUIUM

unguim = QD f2weeks

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16
Q

Counseling / Directions for treatment of

VULVOVAGINAL CANDIDIASIS

A

only use OTC if been diagnosed

Start treatment AT NIGHT b4 bed

May use PAD, to prevent leakage
DO NOT USE TAMPON

  • *Complete FULL COURSE CONSECUTIVELY**
  • even during MENSTRUAL FLOW!*

AVOID SEXUAL CONTACT USE PROTECTION

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17
Q

Fungal infection of what affected area of the body?

Tinea Corposis

A

BODY

BODY = CORPSE

18
Q

Fungal infection of what affected area of the body?

Tinea Captis

A

SCALP**

sCalp = CAPTIS

19
Q

What type of Fungal Infection?

Occurs most often in AA Female Children

spread by direct contact or contact with fomites

  • *Can NOT be managed with OTC PRODUCTS**
  • OTC can not penetrate hair follicles*

requires systemic RX therapy

A

Tinea CAPTIS

sCalp

4 varients:
non-inflammatory / inflammatory / BLACK DOT / Favus

20
Q

What type of Fungal Infection?

Pruritus + Erthematous Eruptions

typically seen in males

small vesicles / scaling / pruritus / pain

lesions w/ demarcated margins

Factors: Wet clothing / heat / friction / obesity

A

Tinea CRUSIS** = **JOCK ITCH

Groin

Trichophyton + Epidermophyton

21
Q

Fungal infection of what affected area of the body?

Tinea Pedis / Unguim

A

FEET / FOOT = Pedis

NAILS = UNGUIM

22
Q

What type of Fungal Infection?

Children are HIGHLY susceptible

Factors: contact sports / warm / humid / stress / obesity

A

Tinea CORPORIS** = **RINGWORM

Trichophyton / Microsporum / Epidermophyton

ALL 3 INCLUDE CORPORIS

23
Q

What type of Fungal Infection?

WHITE vaginal discharge + Pruritus

High incidence in women of childbearing age

Predisposing factors:

tight clothing / medications / diabetes / obesity

sexual activity / pregnancy

A

VULVOVAGINITIS

candida albicans, not tinea

24
Q

Clinical Presentation = S/Sx

of Fungal infections

A

Mild Itching

SCALING

Exudative inflammatory process:
denudation / fissuring / crusting / discoloration

25
**Treatment for Tinea VERSICOLOR**
**Clotrimazole 1% + Miconazole 2% + Tolnaftate 1% QD for _14 days_** **_Selenium Sulfide_** Lathe for **5 min**, rinse -\> **Repeat QD f2weeks** then taper use
26
**When to CONTACT MD** in **Fungal Infections**
*No clearing of infection after **_\>_*****_4 Weeks_** normally use BID for 3-4 weeks ## Footnote **DIABETES** **TOENAILS** **painful + foul smelling** **INFLAMMED / SWOLLEN**
27
What type of Fungal Infection? Seen as **erythematous pustules** found in **_interiginous areas_** Increased incidence in **immunosuppressed / DIABETICS / \<6M/O** Predisposed factors: **MOIST macerations / OCCLUDED macerations**
**_CANDIDIASIS_** Candida albicans, different type of fungus
28
What NON-RX Antifungal medication? *_does NOT have any **DIRECT ANTIFUNGAL ACTIVITY**_* approved for relief of **Inflammatory Conditions** **ASTRINGENT / ANtibacterial** **BID**
**_SALTS OF ALUMINUM_** **BID** *not an antifungal, just for **_inflammatory_***
29
**Complementary Therapies for** **FUNGAL INFECTIONS**
**BITTER ORANGE** **TEA TREE OIL** **GARLIC**
30
What type of Fungal Infection? Lesions begin as **small / circular / scaly lesions** **Pruritus**
**_Tinea CORPORIS_** can occur on **any part of the body** **Zoophilic = EXPOSED Skin** **Anthropophilic = Occluded areas**
31
**Alternative Agents for** **vulvovaginal candidiasis​**
**LACTOBACILLUS** oral capsules **Gentian Violet Dye** 1-2 times daily for 5 days **YOGURT** **Boric Acid** 600mg in size 0 gel capsule --\> vaginally 1-2 times QD for 14 days
32
What NON-RX Antifungal medication? * *_BID 1-4 Weeks_** * *_ONE OF 2 THAT CAN BE EFFECTIVE IN 1 WEEK_** **Fungal cell death** **Pedis / Cruris / Corporis** **_12 y/o and older_**
* *_TERBINAFINE 1%_** * **_ONE OF 2 THAT CAN BE EFFECTIVE IN 1 WEEK_*** _FEET / GROIN / BODY_ _**same as Clotrimazole 1% & Miconazole 2% but age is 12+ v**s 2+_ *local irritation burning itching **_DRYNESS_***
33
**Stages of Progression of Fungal Infection**
**Incubation** **Enlargement** **Refractory Period**
34
**When to REFER TO MD for** **VULVOVAGINAL CANDIDIASIS​**
**_FIRST EPISODE_** of vaginal symptom **_PREGNANT or \<12 Y/O_** **Fever / Back,ab Pain / Rash / SMELLY DISCHARGE** **_NO IMPROVEMENT/WORSENS AFTER 3 DAYS_** or still there after FULL COURSE of therapy (1 week) Symptoms that **Returns within 2 MONTHS**
35
**Non-pharmacologic therapy** **of Fungal infections**
* To prevent spreading,* use a **seperate towel + DRY** effected area * do NOT **_share towels / clothing_*** Launder towerls / clothing in **HOT water + DRY on HOT** **cleanse skin daily w/ soap & water** remove oils + substances that promote fungi growth **Protective footwear** **_D/C Antifungal if Irritation / Sensitation / WORSENING_**
36
What BODY PARTS does this genera of pathogenic fungi affect? ## Footnote **Trichophyton**
**T** = **THEM ALL** **_AFFECTS THEM ALL_** Pedis / Crusis / Captis / Corposis / Unguim Feet / Groin / SCALP / Body / Nails
37
**Which formulation of Anti-Fungals are** **MOST EFFICIENT & EFFECTIVE?**
**CREAMS or SOLUTIONS** * sprays / powders are less effective* * patient adherecnce is INFLUENCED by product selection tho*
38
What type of Fungal Infection? *can be associated with **_tinea pedis_*** **FDA has NOT approved SELF TREATMENT** w/ topical OTC products Requires **SYSTEMIC PRESCRIPTION THERAPY** b/c *_OTC treatment can't penetrate nail beds_* *otc is fine for the SKIN around the nails*
**_Tinea UNGUIUM**_ = _**ONCHOMYCOSIS_** NAILS **lose their SHINY LUSTER** can become **opaque / thick / rough / yellow / frail** **seperation from nail bed**
39
What BODY PARTS does this genera of pathogenic fungi affect? ## Footnote **Microsporum**
mi**C**rosporum starts with **C** **Captis + Corposis** SCALP + GROIN
40
What NON-RX Antifungal medication? **_PREVENTS & TREATS Tinea PEDIS_** Solution \> cream **Talc powder absorbs water** **BID F2-4Weeks** --\> 6 weeks 2+ y/o
**_TOLNAFTATE_** 1% **FEET** AE = stinging **BID F2-4 weeks --\> 6 weeks**
41
**RX PRODUCTS** **for fungal infections**
**_CICLOPROX 0.77% Gel / gream / suspension 8% lacquer_** **UNGUIUM QD F48WEEKS,** local irritation **_Setaconazole 2% Cream_** BID 4 weeks, antiinflammatory **_Econazole 1% Cream/Foam_** QD 4 weeks -\> local irritation **_Ketoconazole 2% Cream / shampoo/foam/gel_** QD 6 weeks -\> local irritation **_Naftifine 1% cream/gel + 2% cream/gel_** QD / BID 2-4 Weeks

PDAT1 (27 decks)

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