Antifungals To Threadworms

Question 1

Oral ketoconazole

Answer 1

• MHRA suspected the use of oral ketoconazole to treat fungal infections because the risk of hepatoxicity is greater than the benefit in treating fungal infections
• reserved for specialists to treat crushing syndrome

Patient and carer oral use:
- Recognise signs of liver disorder(anorexia,nausea,vomitting,fatigue)
- Dizziness may affect the performance of skilled tasks

Question 3

Voriconazole

Answer 3

• avoid exposure to direct sunlight or use of sun beds
• seek medical attention if any sunburn or a severe skin reaction following exposure to light or sun
• patient should keep alert card with them at all times
• monitor liver function before starting treatment, then at least weekly for 1 month and then monthly during treatment
• they are hepatoxic and phototoxic

Question 4

What parts of the body do dermatophytes affect and what are the different common dermatophyte infections?

Answer 4

• skin
• hair
• Nail (otc referral 3 infected nails)

Question 5

Athletes foot=tinea pedis

Question 6

Tinea Coporis= ring worm

Question 7

Tinea capitis - head ringworm

Question 8

Fungal nail infection - Tinea unguium

Question 9

Dermatophyte infections

Answer 9

Tinea infections

Question 10

Risk factors that increase the likelihood of getting these infections:

Answer 10

Diabetes,immunocompromised (eg.HIV), poor circulation and peripheral arterial disease

Question 11

When do we give topical anti fungal vs oral systemic anti fungal?

• TOPICAAAAAAAL

Answer 11

Topical therapy - mild localised fungal skin infection eg. Tinea corporis and tinea pedis_

Question 12

Systemic therapy?

Answer 12

• If topical fails
• many areas affected
• if site or infection is difficult to treat (eg, nails and scalp)
• oral terbinafine and itraconazole (broader spectrum) preferred over griseofluvin
• tinea capitits is treated systemically

Question 13

Helminth infection - Threadworms

Answer 13

• Anthelmintics are effective in threadworms(pinworms) infections
• combine use with hygiene measures to break cycle of auto- infection
• treat all family members
• mebendazole is drug of choice ( pts for more than 6 months)
• Give single 100mg dose
• Second dose may be given after 2 weeks to prevent reinfection

Question 14

Mebendazole prescribing? Age and dose?

Answer 14

• can be sold to public in adults and children under 2 years
• Single max dose is 100mg
• Supplied in container less than 800mg