![]() ![]() ![]() Itraconazole coadministration is contraindicated with quinidine, dofetilide, triazolam, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins eg, lovastatin, simvastatin), and ergot alkaloids. ![]() Itraconazole dosing for toenail infections, with or without fingernail involvement, is 200 mg daily for 12 weeks. Itraconazole dosing for fingernail infections is 200 mg twice daily for 1 week, then 3 weeks without itraconazole, followed by 200 mg twice daily for 1 week. It impairs cytochrome P-450-dependent metabolism of ergosterol, a major component of fungal cell membranes. Itraconazole is an oral triazole-class fungistatic antifungal agent approved for the treatment of onychomycosis (tinea unguium). 3 Ketoconazole is in pregnancy category C and is not recommended for pregnant or lactating women. Antacids decrease the absorption of ketoconazole. Warfarin coadministration results in increased anticoagulant response.Ī hepatotoxicity risk or warning exists with ketoconazole. Drug interactions with protease inhibitors?such as indinavir, ritonavir, and saquinavir? involve increased protease concentration. If clinical response is insufficient, the dose can be increased to 400 mg daily.ĭrug interactions with isoniazid, rifampin, carbamazepine, and phenytoin have been documented. Ketoconazole dosing for skin infections is 200 mg daily for 4 weeks. Ketoconazole impairs the synthesis of ergosterol, a sterol in fungal cell membranes, resulting in increased permeability and leakage of cellular components. Ketoconazole is an oral fungistatic imidazole-class antifungal agent used for infections not responding to griseofulvin that require systemic treatment. Griseofulvin is in pregnancy category C, and it should not be administered to pregnant women or women contemplating pregnancy. Side effects may include photosensitivity, skin rashes, cross-sensitivity with penicillin, and lupus-like syndrome or exacerbations. Griseofulvin induces hepatic microsomal enzymes. 3ĭrug interactions are possible with anticoagulants and could result in decreased hypoprothrombinemic activity, loss of oral contraceptive efficacy, reduced cyclosporine levels, and decreased salicylate levels. Griseofulvin is deposited in keratin precursor cells, which are then replaced by noninfected tissue. Griseofulvin is an oral agent with fungistatic activity against species of Trichophyton, Microsporum, and Epidermophyton that cause fungal infections of the feet, hair, and nails. Topical-agent categories include keratolytic/miscellaneous antifungals, antiseptic compounds, synthetic agents, imidazole derivatives, and allylamine derivatives. Oral agents include griseofulvin, ketoconazole (Nizoral), itraconazole (Sporanox), fluconazole (Diflucan), and terbinafine (Lamisil). 2Īntifungal agents are available as oral and topical treatments. These conditions lead to inflammation, desquamation, and pruritus, which cause a raised annular appearance of the skin commonly known as ringworm. Tinea pedis is a fungal infection of the foot tinea capitis, the scalp tinea corporis/cruris, the body/groin area and tinea unguium, the nail.Ĭonditions promoting dermatophyte or fungal growth include moisture, dead keratin, and occlusion. 1įungal infections are named according to the part of the body affected by the infection. The causative fungi in fungal infections of the skin are Trichophyton, Microsporum, and Epidermophyton. Dermatophytoses are fungal infections of the skin, hair, and nails caused by fungi called dermatophytes. ![]()
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