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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
Q

Treatment for Tinea VERSICOLOR

A

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

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

26
Q

When to CONTACT MD

in Fungal Infections

A

No clearing of infection after _>_4 Weeks
normally use BID for 3-4 weeks

DIABETES

TOENAILS

painful + foul smelling

INFLAMMED / SWOLLEN

27
Q

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

A

CANDIDIASIS

Candida albicans, different type of fungus

28
Q

What NON-RX Antifungal medication?

does NOT have any DIRECT ANTIFUNGAL ACTIVITY

approved for relief of Inflammatory Conditions

ASTRINGENT / ANtibacterial

BID

A

SALTS OF ALUMINUM

BID

not an antifungal, just for _inflammatory_

29
Q

Complementary Therapies for

FUNGAL INFECTIONS

A

BITTER ORANGE

TEA TREE OIL

GARLIC

30
Q

What type of Fungal Infection?

Lesions begin as small / circular / scaly lesions

Pruritus

A

Tinea CORPORIS

can occur on any part of the body

Zoophilic = EXPOSED Skin

Anthropophilic = Occluded areas

31
Q

Alternative Agents for

vulvovaginal candidiasis​

A

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
Q

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

A
  • *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+ vs 2+

local irritation burning itching _DRYNESS_

33
Q

Stages of Progression of Fungal Infection

A

Incubation

Enlargement

Refractory Period

34
Q

When to REFER TO MD for

VULVOVAGINAL CANDIDIASIS​

A

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
Q

Non-pharmacologic therapy

of Fungal infections

A
  • 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
Q

What BODY PARTS does this genera of pathogenic fungi affect?

Trichophyton

A

T = THEM ALL

AFFECTS THEM ALL

Pedis / Crusis / Captis / Corposis / Unguim

Feet / Groin / SCALP / Body / Nails

37
Q

Which formulation of Anti-Fungals are

MOST EFFICIENT & EFFECTIVE?

A

CREAMS or SOLUTIONS

  • sprays / powders are less effective*
  • patient adherecnce is INFLUENCED by product selection tho*
38
Q

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

A

Tinea UNGUIUM** = **ONCHOMYCOSIS

NAILS

lose their SHINY LUSTER

can become opaque / thick / rough / yellow / frail

seperation from nail bed

39
Q

What BODY PARTS does this genera of pathogenic fungi affect?

Microsporum

A

miCrosporum

starts with C

Captis + Corposis

SCALP + GROIN

40
Q

What NON-RX Antifungal medication?

PREVENTS & TREATS Tinea PEDIS

Solution > cream

Talc powder absorbs water

BID F2-4Weeks –> 6 weeks

2+ y/o

A

TOLNAFTATE 1%

FEET

AE = stinging

BID F2-4 weeks –> 6 weeks

41
Q

RX PRODUCTS

for fungal infections

A

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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