Discussion Board Review Flashcards
What are the differences in treatment for tinea corporis, tinea cruris, tinea capitis, and tinea pedis?
Tinea corporis- Topical antifungals- Azole or allylamine (Clotrimazole, econzaole, oxiconazole, sulconazole, terbinafine, butenafine). Tx for at least 1 week after symptoms clear.
Tinea cruris- Topical antifungals- Azole or allylamine (Clotrimazole, econzaole, oxiconazole, sulconazole, terbinafine, butenafine). For severe inflammation-systemic antifungal (ketoconazole?, terbinafine po?) and/or topical/systemic glucocorticoids.
Tinea capitis- Oral antifungals- Terbinafine (2 to 4 weeks/more effective) or Griseofulvin (6-8 weeks).
Tinea pedis- Topical antifungals- Sertaconazole, also undecylenic acid, tolnaftate, other azoles.
Compare and contrast migraine vs. cluster headaches.
Migraine : Aura, more common in women , n/v, cluster is more common in men , debilitating, no aura , can happen 1-2 times per day for 3 months
Cluster: No Aura, no vomiting, more debilitating, attacks last from 15 min to 2 hours, no family history, more common in males.
Tx directed at prophylaxis: systemic glucocorticoids, Verapamil, lithium, sumatriptan or oxygen
What is Serotonin Syndrome (SS)? What are the symptoms of SS?
Insomnia, sweating , HTN, tachycardia, muscle rigidity
What are the preferred medications for abortive therapy for migraine headaches?
Serotonin agonist (1B&1D) (triptan), Ergots, serotoning 1F-agonist (Diatan), CGRP antagonist + ASA, opoioids
Why do glucocorticoids have greater anti-inflammatory activity than NSAIDs?
NSAIDs suppress inflammation primarily by inhibiting prostaglandin production. Glucocorticoids share this mechanism and act in 3 other specific ways:
- it results in suppressing the immune system, by inhibition of pro-inflammatory mediators (prostaglandins, leukotienes, cytokines),
- induce gene expression of anti-inflammatory genes,
- suppuressing activation of immune cells (Tcells, macrophages, Neutrophils)
glucocorticoids have much greater anti-inflammatory effects than do NSAIDs.
Should Celebrex be used in patients with existing heart disease? Why or why not?
There is strong evidence that coxibs, like other nonaspirin NSAIDs, increase the risk of MI, stroke, and other serious cardiovascular events; therefore, the drug should be avoided in patients with existing heart disease and those who have just undergone CABG surgery, and should be used with caution in patients with cardiovascular risk factors, such as hypertension, diabetes, and dyslipidemia.
