David Taylor Flashcards
When can terbinafine not be used?
> 12 years old only.
How can ringworm be treated?
Topical azoles.
Topical corticosteroids can be added.
When would oral therapy be considered for ringworm?
Topical failure, Immunocompromised, Widespread infection. Griseofulvin is rarely given. Terbinafine 250mg daily. (2-4wks in T.cruris, 4wks T.corporis)
What doses of itraconazole should be given orally for ringworm?
100mg daily for 15 days
OR
200mg daily for 7 days.
How should Tinea Capitis be treated?
Orally plus shampoos.
- terbinafine creams twice weekly.
Griseofulvin 1g daily or in divided doses for 8-10 weeks (and 2 weeks after symptoms improve). [microsporum]
Terbinafine 250mg daily for up to 4 weeks. (unlicensed) [trichophyton]
In what patients is griseofulvin contraindicated?
Patients with severe liver disease and systemic lupus erythematous. (SLE)
Breast feeding.
Avoid during pregnancy and for one month after treatment stops, men should not father children for 6 months after treatment ends.
AVOID IN LIVER FAILURE/DISEASE
What dose of terbinafine should be given orally for ringworm treatment?
250mg daily.
2-4wks in T. cruris, 4wks T. corporis
Why are long courses of griseofulvin needed?
Does not persist in keratinous tissue after end of therapy.
Narrow therapeutic window.
What dose of terbinafine is given for Tinea Capitis?
250mg daily for up to 4 weeks.
How does the use of terbinafine to ringworm vary?
Terbinafine 250mg daily (2-4wks in T. cruris, 4wks T. corporis)
What effect does griseofulvin have on alcohol?
Potentiates it, may impair driving ability.
Take with or after fatty food.
What is the first line treatment of athletes foot?
Imidazole cream for 2-4 weeks
Terbinafine cream for 1 week in over 12s.
What dose of griseofulvin should be given orally for severe athletes foot?
500mg daily or in divided doses for 4-8 weeks.
And for 2 weeks after symptoms are resolved.
In what patients should the use of terbinafine be avoided?
Pregnancy, liver disease, severe renal impairment.
Why dose terbinafine concentrate in the dermis, epidermis and adipose tissue?
Lipophilic drug.