fungal skin

Question 1

Which types of tinea cannot be treated with OTC?

Answer 1

Tinuea unguium(nails) and Tinea Capitus(head)

Question 2

Tinea Pedis type 1 symptoms

Answer 2

-cracks, scaling, maceration between toes(interdigital) especially toes 4 and 5
-pain and/or pruritis

Question 3

Tinea Pedis type 2 symptoms

Answer 3

mild inflammation with diffuse scaling on bottoms of feet

Question 4

Tinea Pedis type 3 symptoms

Answer 4

-vesicles or small pustules with scaling instep area

Question 5

Tinea Pedis type 4 symptoms

Answer 5

-macerated, weeping ulcerations on bottom of foot
-odorous
-painful

Question 6

When to not self treat tinea

Answer 6

-uncertain of cause
-initial treatment ineffective
-nails/scalp affected
-face or mucous membrane/genitials affected
-bacteria infection
-diabetes
fever/body aches

Question 7

Non pharma tinea

Answer 7

-dedicated towel for affected area
-wash and dry towels on high heat
-wash skin daily
-avoid occlusion of skin
-allow shoes to dry thoughly(dust inside with medication)
-foot protection

Question 8

Follow up recommendations for tinea

Answer 8

-expect some relief of itching, scaling, inflammation w/in XXX: if partial relief continue treatment, no relief see medical provider.

Question 9

Clotrimazole & miconazole MOA

Answer 9

Inhibit biosynthesis of sterols and damage fungal cell
membrane -> bacteriostatic

Question 10

Butenafine & terbinafine MOA

Answer 10

Inhibit squalene epoxidase (enzyme in fungi sterol
biosynthesis); squalene builds up in fungal cell & kills it

Question 11

Tolnaftate MOA

Answer 11

thought to stunt mycelial growth of fungi

Question 12

Undecylenic acid

Answer 12

interacts with cell membrane; fungistatic

Question 13

What should be avoided during use of antifungals?

Answer 13

topical hydrocortisone

Question 14

Drug interactions with antifungals

Answer 14

miconazole: increased warfarin effects?

Question 15

Aluminum salts MOA

Answer 15

astringent: reduces cell membrane permeability and decreases swelling, exudate production &
inflammation

Question 16

When should aluminum salts be used?

Answer 16

inflammatory and wet/soggy types of tinea pedis (dries
out)

Question 17

Forms of aluminum salts

Answer 17

-Aluminum acetate: dilute with 10-40 parts water and store up to 1 week
-Aluminum chloride 20-30%: best for wet wounds, BID until odor, wetness, maceration resolve(up to 1 week) then daily for 4 weeks(5 weeks total)

Question 18

treatment recommendations for tinea in groin area with well defined lesions

Answer 18

antifungal BID 2 weeks + nondrug care

Question 19

treatment recommendations for tinea in groin area with poorly defined lesions

Answer 19

refer

Question 20

treatment recommendations for tinea on other parts of body like trunk/under arms with clear center

Answer 20

antifungal BID for 4 weeks and nondrug care