DOCSLIB.ORG

Efficacy and Safety of Luliconazole (1%) Cream Versus Clotrimazole (1%) Cream in Tinea Infections of Skin

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Efficacy and Safety of Luliconazole (1%) Cream Versus Clotrimazole (1%) Cream in Tinea Infections of Skin EFFICACY AND SAFETY OF LULICONAZOLE (1%) CREAM VERSUS CLOTRIMAZOLE (1%) CREAM IN TINEA INFECTIONS OF SKIN A COMPARATIVE STUDY. DISSERTATION SUBMITTED TO THE TAMILNADU DR.M.G.R MEDICAL UNIVERSITY IN PARTIAL FULFILLMENT FOR THE AWARD OF THE DEGREE OF DOCTOR OF MEDICINE IN PHARMACOLOGY DEPARTMENT OF PHARMACOLOGY TIRUNELVELI MEDICAL COLLEGE TIRUNELVELI – 11 APRIL 2017 BONAFIDE CERTIFICATE This is to certify that the dissertation entitled “EFFICACY AND SAFETY OF LULICONAZOLE (1%) CREAM VERSUS CLOTRIMAZOLE (1%) CREAM IN TINEA INFECTIONS OF SKIN - A COMPARATIVE STUDY” submitted by DR.LAKSHMI PRABHA M to the Tamilnadu Dr. M.G.R. Medical University, Chennai, in partial fulfillment of the requirement for the award of the Degree of Doctor of Medicine in Pharmacology during the academic period 2014 – 2017 is a bonafide research work carried out by her under direct supervision & guidance. PROFESSOR AND H.O.D. DEAN Department of Pharmacology, Tirunelveli Medical College, Tirunelveli Medical College, Tirunelveli. Tirunelveli. CERTIFICATE This is to certify that the dissertation entitled “EFFICACY AND SAFETY OF LULICONAZOLE (1%) CREAM VERSUS CLOTRIMAZOLE (1%) CREAM IN TINEA INFECTIONS OF SKIN - A COMPARATIVE STUDY” submitted by DR.LAKSHMI PRABHA M is an original work done by her in the Department of Pharmacology, Tirunelveli Medical College, Tirunelveli for the award of the Degree of Doctor of Medicine in Pharmacology during the academic period of 2014-2017. Place : Tirunelveli GUIDE Date : Department of Pharmacology Tirunelveli Medical College Tirunelveli. DECLARATION I solemnly declare that the dissertation titled “EFFICACY AND SAFETY OF LULICONAZOLE (1%) CREAM VERSUS CLOTRIMAZOLE (1%) CREAM IN TINEA INFECTIONS OF SKIN-A COMPARATIVE STUDY” is done by me in the Department of Pharmacology, Tirunelveli Medical College, Tirunelveli. The dissertation is submitted to The Tamilnadu Dr.M.G.R.Medical University in partial fulfillment for the award of the degree of Doctor of Medicine in Pharmacology. Place: Tirunelveli DR. LAKSHMI PRABHA. M, Date: Postgraduate student, M.D Pharmacology, Department of Pharmacology, Tirunelveli Medical College, Tirunelveli-627011. ACKNOWLEDGEMENT First of all, I am grateful to the Almighty for the good health and wellbeing that were necessary to complete this research work. I am greatly indebted to Dr. K. Sithy Athiya Munavarah MD., Dean, Tirunelveli Medical College and Dr. S.M. Kannan MD., Vice Principal, Tirunelveli Medical College, Tirunelveli for their valuable support and generous permission for doing this research work. I wish to thank with due respect and deep gratitude to Dr. J.Ezhil Ramya M.D., Associate Professor and Head of the Department of Pharmacology for her inspiration, guidance and kind help rendered in completing this dissertation. I would like to express my deepest thanks to my guide Dr.B.Meenakshi M.D., Associate Professor for giving kind advices, aspiring guidance, motivation and encouragement throughout the research. I sincerely thank Dr.P. Nirmala Devi , M.D, Professor and HOD, Department of Dermatology for her support. With deep sense of gratitude, I thank the faculties of the department of dermatology and microbiology for sharing their implicit knowledge, support and encouragement during the course of this research work. I am immensely grateful to Dr. A. Dulcie Celia M.D., Assistant Professor, Dr.A.Geetha Rani M.D., Assistant Professor, & Dr. M. Shanthi M.D., Assistant Professor for their support and advice provided during the research work. I would like to thank the post graduates of Department of Pharmacology, for their friendly advice and sharing their illuminating views related to this study. I also express my sincere thanks to my family members for their moral support and encouragement to carry out this research successful as a postgraduate. CONTENTS S.No. Topics Page No. 1. INTRODUCTION 1 2. REVIEW OF LITERATURE 4 3. AIM OF THE STUDY 60 4. METHODOLOGY 61 5. RESULTS 69 6. DISCUSSION 93 7. CONCLUSION 98 8. APPENDIX I. Informed Consent Form II. Study Proforma III. Master Chart 9. BIBILIOGRAPHY INTRODUCTION Dermatophytosis is a common superficial fungal infection of the stratum corneum, hair and nails which contain keratin (1, 2). The fungi causing dermatophytosis belongs to the genera Trichophyton, Microsporum and Epidermophyton (3, 4). The specific causative agents of tinea corporis and tinea cruris most commonly are Trichophyton mentagrophytes, Trichophyton rubrum and Microsporum canis (5). The prevalence of dermatophytosis is around 20-25% worldwide, and its incidence continues to rise (6). Age, sex, host factors, immunological factors, environmental conditions and variety of other epidemiological factors contribute to the development of dermatophyte infections. Direct microscopic examination with potassium hydroxide (KOH) mount and culture of dermatophytes in suitable media are the two most common investigations that can be done to establish the diagnosis of dermatophytosis. Pottasium hydroxide mount aids in the detection of fungal hyphal elements while the culture aids in the identification of species of dermatophytes (7, 8). The pathogenesis of dermatophytosis is unique because the fungi do not invade the living tissues. Dermatophytes can form colonies only in the keratin containing tissues of the host but the mere presence of dermatophytes or its products elicits an allergic and an inflammatory response in the host .The host response developed vary in type and severity according to the nature of the 1 particular species of dermatophyte causing the infection. The dermatophytes remain as the only fungi to be dependent on human or animal hosts for their survival and dissemination (9). Topical therapy is sufficient for the treatment of tinea infections however systemic agents are needed when the area of involvement is large or when there is secondary infection and also in immuno-compromised individuals(5). At present, topical azoles and allylamines remain as the treatment of dermatophytosis. The main disadvantage with those agents is long duration of therapy, which results in poor compliance and a high rate of relapse. Many newer agents are introduced with advantages like once-daily application, short duration of therapy and hence lower relapse rates (10).The traditional imidazole antifungal agent Clotrimazole is effective in the treatment of dermatophytosis with cure rate of 60-100% on applying twice daily for 4 weeks (11). The vast majority of antifungals are applied twice daily, although the newer ones introduced are applied only once daily. At present the research is focused towards shortening the frequency of application of antifungals and the duration of therapy in order to increase the patient compliance, to increase the cure rates and to decrease the relapse rates. In the past few years, many new extended-spectrum topical antifungals have been introduced into the market. Luliconazole is one among those drugs which offers a good efficacy and tolerability with a short duration of treatment (12). 2 Luliconazole is topical imidazole antifungal agent which inhibits the ergosterol biosynthesis more effectively. It requires only once daily application because the reservoir property in the stratum corneum is greater for luliconazole (13). The present study was done to compare the efficacy and safety of topical luliconazole versus topical clotrimazole in tinea infections of skin. 3 REVIEW OF LITERATURE HISTORY: Dermatophytes were the earliest fungi discovered to cause infection in human beings and this discovery marked the beginning of medical mycology(14).Dermatophytes were found to cause superficial skin infections.Greek Physicians were aware of ring worm infections. The earliest records of dermatophytosis were in 16th century by the Dutch explorers (14). Robert Remak (1835 )was the first person to identify the fungi isolated from the lesions by observing via the microscope as rods and cones(15).But the mycotic nature of these was described by Schonlein in 1839.The clinical features of dermatophyte infection was first described by David Gruby and he also demonstrated that dermatophytosis is contagious in nature(16). Raymond Sabouraud, a french dermatologist had classified the dermatophytes into four genera namely Achorion, Epidermophyton, Microsporum and Trichophyton. He published his work ‘Les Teignes’ in 1910.He was the person who described about the methods to culture dermatophytes and also about the therapy for such infection. Then Emmons eliminated the genus Achorion and modified the taxonomy to lay out the current classification of dermatophytes which includes only three genera (15). 4 NOMENCLATURE: The word 'Tinea' or 'dermatophytosis' refers to infections caused by dermatophytes. The word “Tinea” is derived from Latin and it means worm or ‘clothes moth’(15).The tinea infections are commonly referred as ringworm lesions due to the distinct ring shaped lesions(17).The tinea infections are usually named in accordance with the anatomic sites involved(18). CLASSIFICATION: Ecological classfication: Ecological classification of dermatophytosis is based on the host preference of these pathogenic fungi. The variation in keratin composition leads to the difference in their host preference (19). The three types of dermatophytes according to their host preference are as follows: Anthrophiles: The primary host of these fungi is human beings. These fungi might also affect animals. The primary mode of transmission is from human to human. Some examples for anthrophiles are Trichophyton
Load more

Recommended publications
  • BRAND NAME COMPOSITION Packing Unit BRAND NAME
    BRAND NAME COMPOSITION Packing Unit DOIN-20 SOFT GEL CAP ISOTRETINOIN 20 MG SOFT GEL CAPS 10X1X10 BLISTER FENOGRAS 120 TAB FEXOFENADINE 120MG TABS 10X10 ALU ITRACHEM 100 CAP ITRACONAZOLE 100 MG CAPSULES 10X1X4 STRIP ITRACHEM 200 CAP ITRACONAZOLE 200 MG CAPSULES 10X1X4 STRIP KESHGAIN TABS BIOTIN10MG TABLETS(HAIR GROWTH TABS) 10X1X10 ALU SFLAZA 6 TAB DEFLAZACORT 6MG TABS 10X10 ALU TERBICHEM 250 TAB TERBINAFINE 250MG TABLETS 10X1X7 BLISTER AZYNEX 500 TAB AZITHROMYCIN 500 TAB 10X3 BLISTER BRAND NAME COMPOSITION Packing Unit BEAUTY SOAP WITH ALOE- ALOGLOW SOAP VERA,NEEM,KESAR,SANDAL,TULSI,OLIVE 75GM CARTOON OIL&GLYCERINE KETOLE SOAP KETOCONAZOLE 2% + CERTRIMIDE 0.5% 75GM CARTOON SCABICHEM SOAP PERMETHRIN 5% W/W 75GM CARTOON TRICLOSAN 0.2% + TEA TREE OIL + VIT E 0.4% + ULTRA-SHINE SOAP 75GM CARTOON TITANIUM DIOXIDE SHINE N BEAUTY SOAP NATURAL VIT.E WITH ALOE VERA SOAP 75GM CARTOON BRAND NAME COMPOSITION Packing Unit CALAMINE 15% W/V + ZINC OXIDE 5% W/V + CALACHEM LOTION 100ML CARTOON GLYCERINE 5% W/V CLEANSING LOTION (CETYL ALCOHOL 2.650% CETOCHEM LOTION 100ML CARTOON W/V + STEARYL ALCOHOL 0.260%W/V) CLOBSOL-S LOTION CLOBETASOL + SALICYLIC ACID 3% 50ML CARTOON KETOCONAZOLE 2%W/V + ZINC PYRITHIONE KETOLE-ZPTO SHAMPOO 50ML CARTOON 1%W/W SHAMPOO OCTYL METHOXY CINNAMATE 8% + SWISSGLOW-UV LOTION OXYBENZONE 6.5% + TITANIUM DIOXIDE 0.5% 100ML CARTOON SUNSCREEN LOTION SCABICHEM LOTION PERMETHRIN 5%W/V LOTION 50ML CARTOON BRAND NAME COMPOSITION Packing Unit CLINTOL POWDER CLOTRIMAZOLE 1%W/W POWDER 100GM SHRINK FINNOLE POWDER FLUCONAZOLE 0.5%W/W POWDER
    [Show full text]
  • Comparison of Efficacy of Combination of 2% Ketoconazole
    Open Access Original Article Comparison of Topical Treatments in Pityriasis Versicolor Pak Armed Forces Med J 2018; 68 (6): 1725-30 COMPARISON OF EFFICACY OF COMBINATION OF 2% KETOCONAZOLE SOLUTION WASH AND TOPICAL 1% CLOTRIMAZOLE WITH TOPICAL 1% CLOTRIMAZOLE ALONE IN CASES OF PITYRIASIS VERSICOLOR Ayesha Anwar, Naeem Raza, Najia Ahmed, Hyder Ali Awan* Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan, *King Abdul Aziz Naval Base, Jubail, Saudia Arabia ABSTRACT Objective: Comparison of efficacy of combination comprising 2% ketoconazole solution wash plus topical 1% clotrimazole versus topical 1% clotrimazole alone in management of patients with Pityriasis versicolor. Study Design: Randomized controlled trial. Place and Duration of Study: Dermatology department, Pak Emirates Military Hospital Rawalpindi, from Oct 2016 to Apr 2017. Material and Methods: Sixty patients of Pityriasis versicolor, both male and female were included in study. Diagnosis of Pityriasis versicolor was made clinically and confirmed microscopically by examining skin scrapings for fungal hyphae. Patients with concomitant systemic illnesses or those who had received anti-fungal in last three months were excluded from study. Random number tables were used to allocate patients to the two treatment groups. Group A received 2% ketoconazole shampoo twice per week for four weeks plus topical 1% clotrimazole twice daily application for 2 weeks. Group B received only topical therapy with 1% clotrimazole cream applied twice daily for 2 weeks. Assessment of treatment efficacy was done by clinical examination of patient and microscopy of skin scrapping for fungal hyphaedone at baseline and at end of study (4 weeks of treatment). A negative clinical examination and negative skin scrapping for fungal hyphae was considered effective therapeutic response.
    [Show full text]
  • Antifungals, Topical
    Therapeutic Class Overview Antifungals, Topical INTRODUCTION The topical antifungals are available in multiple dosage forms and are indicated for a number of fungal infections and related conditions. In general, these agents are Food and Drug Administration (FDA)-approved for the treatment of cutaneous candidiasis, onychomycosis, seborrheic dermatitis, tinea corporis, tinea cruris, tinea pedis, and tinea versicolor (Clinical Pharmacology 2018). The antifungals may be further classified into the following categories based upon their chemical structures: allylamines (naftifine, terbinafine [only available over the counter (OTC)]), azoles (clotrimazole, econazole, efinaconazole, ketoconazole, luliconazole, miconazole, oxiconazole, sertaconazole, sulconazole), benzylamines (butenafine), hydroxypyridones (ciclopirox), oxaborole (tavaborole), polyenes (nystatin), thiocarbamates (tolnaftate [no FDA-approved formulations]), and miscellaneous (undecylenic acid [no FDA-approved formulations]) (Micromedex 2018). The topical antifungals are available as single entity and/or combination products. Two combination products, nystatin/triamcinolone and Lotrisone (clotrimazole/betamethasone), contain an antifungal and a corticosteroid preparation. The corticosteroid helps to decrease inflammation and indirectly hasten healing time. The other combination product, Vusion (miconazole/zinc oxide/white petrolatum), contains an antifungal and zinc oxide. Zinc oxide acts as a skin protectant and mild astringent with weak antiseptic properties and helps to
    [Show full text]
  • NINDS Custom Collection II
    ACACETIN ACEBUTOLOL HYDROCHLORIDE ACECLIDINE HYDROCHLORIDE ACEMETACIN ACETAMINOPHEN ACETAMINOSALOL ACETANILIDE ACETARSOL ACETAZOLAMIDE ACETOHYDROXAMIC ACID ACETRIAZOIC ACID ACETYL TYROSINE ETHYL ESTER ACETYLCARNITINE ACETYLCHOLINE ACETYLCYSTEINE ACETYLGLUCOSAMINE ACETYLGLUTAMIC ACID ACETYL-L-LEUCINE ACETYLPHENYLALANINE ACETYLSEROTONIN ACETYLTRYPTOPHAN ACEXAMIC ACID ACIVICIN ACLACINOMYCIN A1 ACONITINE ACRIFLAVINIUM HYDROCHLORIDE ACRISORCIN ACTINONIN ACYCLOVIR ADENOSINE PHOSPHATE ADENOSINE ADRENALINE BITARTRATE AESCULIN AJMALINE AKLAVINE HYDROCHLORIDE ALANYL-dl-LEUCINE ALANYL-dl-PHENYLALANINE ALAPROCLATE ALBENDAZOLE ALBUTEROL ALEXIDINE HYDROCHLORIDE ALLANTOIN ALLOPURINOL ALMOTRIPTAN ALOIN ALPRENOLOL ALTRETAMINE ALVERINE CITRATE AMANTADINE HYDROCHLORIDE AMBROXOL HYDROCHLORIDE AMCINONIDE AMIKACIN SULFATE AMILORIDE HYDROCHLORIDE 3-AMINOBENZAMIDE gamma-AMINOBUTYRIC ACID AMINOCAPROIC ACID N- (2-AMINOETHYL)-4-CHLOROBENZAMIDE (RO-16-6491) AMINOGLUTETHIMIDE AMINOHIPPURIC ACID AMINOHYDROXYBUTYRIC ACID AMINOLEVULINIC ACID HYDROCHLORIDE AMINOPHENAZONE 3-AMINOPROPANESULPHONIC ACID AMINOPYRIDINE 9-AMINO-1,2,3,4-TETRAHYDROACRIDINE HYDROCHLORIDE AMINOTHIAZOLE AMIODARONE HYDROCHLORIDE AMIPRILOSE AMITRIPTYLINE HYDROCHLORIDE AMLODIPINE BESYLATE AMODIAQUINE DIHYDROCHLORIDE AMOXEPINE AMOXICILLIN AMPICILLIN SODIUM AMPROLIUM AMRINONE AMYGDALIN ANABASAMINE HYDROCHLORIDE ANABASINE HYDROCHLORIDE ANCITABINE HYDROCHLORIDE ANDROSTERONE SODIUM SULFATE ANIRACETAM ANISINDIONE ANISODAMINE ANISOMYCIN ANTAZOLINE PHOSPHATE ANTHRALIN ANTIMYCIN A (A1 shown) ANTIPYRINE APHYLLIC
    [Show full text]
  • Title 16. Crimes and Offenses Chapter 13. Controlled Substances Article 1
    TITLE 16. CRIMES AND OFFENSES CHAPTER 13. CONTROLLED SUBSTANCES ARTICLE 1. GENERAL PROVISIONS § 16-13-1. Drug related objects (a) As used in this Code section, the term: (1) "Controlled substance" shall have the same meaning as defined in Article 2 of this chapter, relating to controlled substances. For the purposes of this Code section, the term "controlled substance" shall include marijuana as defined by paragraph (16) of Code Section 16-13-21. (2) "Dangerous drug" shall have the same meaning as defined in Article 3 of this chapter, relating to dangerous drugs. (3) "Drug related object" means any machine, instrument, tool, equipment, contrivance, or device which an average person would reasonably conclude is intended to be used for one or more of the following purposes: (A) To introduce into the human body any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (B) To enhance the effect on the human body of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; (C) To conceal any quantity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state; or (D) To test the strength, effectiveness, or purity of any dangerous drug or controlled substance under circumstances in violation of the laws of this state. (4) "Knowingly" means having general knowledge that a machine, instrument, tool, item of equipment, contrivance, or device is a drug related object or having reasonable grounds to believe that any such object is or may, to an average person, appear to be a drug related object.
    [Show full text]
  • Therapeutic Class Overview Antifungals, Topical
    Therapeutic Class Overview Antifungals, Topical INTRODUCTION The topical antifungals are available in multiple dosage forms and are indicated for a number of fungal infections and related conditions. In general, these agents are Food and Drug Administration (FDA)-approved for the treatment of cutaneous candidiasis, onychomycosis, seborrheic dermatitis, tinea corporis, tinea cruris, tinea pedis, and tinea versicolor (Clinical Pharmacology 2018). The antifungals may be further classified into the following categories based upon their chemical structures: allylamines (naftifine, terbinafine [only available over the counter (OTC)]), azoles (clotrimazole, econazole, efinaconazole, ketoconazole, luliconazole, miconazole, oxiconazole, sertaconazole, sulconazole), benzylamines (butenafine), hydroxypyridones (ciclopirox), oxaborole (tavaborole), polyenes (nystatin), thiocarbamates (tolnaftate [no FDA-approved formulations]), and miscellaneous (undecylenic acid [no FDA-approved formulations]) (Micromedex 2018). The topical antifungals are available as single entity and/or combination products. Two combination products, nystatin/triamcinolone and Lotrisone (clotrimazole/betamethasone), contain an antifungal and a corticosteroid preparation. The corticosteroid helps to decrease inflammation and indirectly hasten healing time. The other combination product, Vusion (miconazole/zinc oxide/white petrolatum), contains an antifungal and zinc oxide. Zinc oxide acts as a skin protectant and mild astringent with weak antiseptic properties and helps to
    [Show full text]
  • Antifungals, Topical
    Antifungals, Topical Therapeutic Class Review (TCR) November 17, 2020 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, digital scanning, or via any information storage or retrieval system without the express written consent of Magellan Rx Management. All requests for permission should be mailed to: Magellan Rx Management Attention: Legal Department 6950 Columbia Gateway Drive Columbia, Maryland 21046 The materials contained herein represent the opinions of the collective authors and editors and should not be construed to be the official representation of any professional organization or group, any state Pharmacy and Therapeutics committee, any state Medicaid Agency, or any other clinical committee. This material is not intended to be relied upon as medical advice for specific medical cases and nothing contained herein should be relied upon by any patient, medical professional or layperson seeking information about a specific course of treatment for a specific medical condition. All readers of this material are responsible for independently obtaining medical advice and guidance from their own physician and/or other medical professional in regard to the best course of treatment for their specific medical condition. This publication, inclusive of all forms contained herein, is intended to be educational in nature and is intended to be used for informational purposes only. Send comments and suggestions to [email protected]. November
    [Show full text]
  • Ehealth DSI [Ehdsi V2.2.2-OR] Ehealth DSI – Master Value Set
    MTC eHealth DSI [eHDSI v2.2.2-OR] eHealth DSI – Master Value Set Catalogue Responsible : eHDSI Solution Provider PublishDate : Wed Nov 08 16:16:10 CET 2017 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 1 of 490 MTC Table of Contents epSOSActiveIngredient 4 epSOSAdministrativeGender 148 epSOSAdverseEventType 149 epSOSAllergenNoDrugs 150 epSOSBloodGroup 155 epSOSBloodPressure 156 epSOSCodeNoMedication 157 epSOSCodeProb 158 epSOSConfidentiality 159 epSOSCountry 160 epSOSDisplayLabel 167 epSOSDocumentCode 170 epSOSDoseForm 171 epSOSHealthcareProfessionalRoles 184 epSOSIllnessesandDisorders 186 epSOSLanguage 448 epSOSMedicalDevices 458 epSOSNullFavor 461 epSOSPackage 462 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 2 of 490 MTC epSOSPersonalRelationship 464 epSOSPregnancyInformation 466 epSOSProcedures 467 epSOSReactionAllergy 470 epSOSResolutionOutcome 472 epSOSRoleClass 473 epSOSRouteofAdministration 474 epSOSSections 477 epSOSSeverity 478 epSOSSocialHistory 479 epSOSStatusCode 480 epSOSSubstitutionCode 481 epSOSTelecomAddress 482 epSOSTimingEvent 483 epSOSUnits 484 epSOSUnknownInformation 487 epSOSVaccine 488 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 3 of 490 MTC epSOSActiveIngredient epSOSActiveIngredient Value Set ID 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 TRANSLATIONS Code System ID Code System Version Concept Code Description (FSN) 2.16.840.1.113883.6.73 2017-01 A ALIMENTARY TRACT AND METABOLISM 2.16.840.1.113883.6.73 2017-01
    [Show full text]
  • Abnormal Vaginal Discharge: What Does and Does Not Work in Treating Underlying Causes
    AE_French.1104.final 10/18/04 11:03 AM Page 890 Applied Evidence N EW R ESEARCH F INDINGS T HAT A RE C HANGING C LINICAL P RACTICE Abnormal vaginal discharge: What does and does not work in treating underlying causes Linda French, MD Michigan State University, East Lansing, Mich Jennifer Horton, DO Genesys Regional Medical Center Family Practice Residency, Grand Blanc, Mich Michelle Matousek, DO Henry Ford Health System, Detroit, Mich Practice recommendations part of this article, “Abnormal vaginal discharge: Using office diagnostic testing more effectively” ■ Treat bacterial vaginosis with oral or intravagi- (JFP 2004; 53[10]:805–814), abnormal discharge nal metronidazole or with clindamycin (SOR: is more likely to be bacterial vaginosis or no A); recurrences are common (SOR: C). pathogen at all. Potential delay in diagnosis and treatment of a sexually transmitted disease is ■ Oral and intravaginal imidazoles are also a concern. Increasing resistance of Candida equally effective in the treatment of sp. to imidazoles is associated with indiscriminate candidiasis (SOR: A); alternate therapies use of over-the-counter products. for resistant cases have been little studied. ■ Oral metronidazole is the standard ■ BACTERIAL VAGINOSIS therapy for trichomoniasis (SOR: A). The standard treatment for bacterial vaginosis Oral tinidazole, newly available in the (BV) has been oral metronidazole (Flagyl) 500 mg US in 2004, should be used in resistant twice daily for 5 to 7 days. Intravaginal 0.75% cases (SOR: B). metronidazole gel (MetroGel) has been shown to be as effective as oral metronidazole (SOR: A).1,2 Oral metronidazole can cause nausea and ntifungal medications for intravaginal use abdominal pain in some patients; vaginal treat- have been available in the United States ment may be preferable for them.
    [Show full text]
  • Multidrug Treatment with Nelfinavir and Cepharanthine Against COVID-19
    Supplemental Information Multidrug treatment with nelfinavir and cepharanthine against COVID-19 Hirofumi Ohashi1,2,¶, Koichi Watashi1,2,3,4*, Wakana Saso1,5.6,¶, Kaho Shionoya1,2, Shoya Iwanami7, Takatsugu Hirokawa8,9,10, Tsuyoshi Shirai11, Shigehiko Kanaya12, Yusuke Ito7, Kwang Su Kim7, Kazane Nishioka1,2, Shuji Ando13, Keisuke Ejima14, Yoshiki Koizumi15, Tomohiro Tanaka16, Shin Aoki16,17, Kouji Kuramochi2, Tadaki Suzuki18, Katsumi Maenaka19, Tetsuro Matano5,6, Masamichi Muramatsu1, Masayuki Saijo13, Kazuyuki Aihara20, Shingo Iwami4,7,21,22,23, Makoto Takeda24, Jane A. McKeating25, Takaji Wakita1 1Department of Virology II, National Institute of Infectious Diseases, Tokyo 162-8640, Japan, 2Department of Applied Biological Science, Tokyo University of Science, Noda 278-8510, Japan, 3Institute for Frontier Life and Medical Sciences, Kyoto University, Kyoto 606-8507, Japan, 4MIRAI, JST, Saitama 332-0012, Japan, 5The Institute of Medical Science, The University of Tokyo, Tokyo 108-8639, Japan, 6AIDS Research Center, National Institute of Infectious Diseases, Tokyo 162-8640, Japan, 7Department of Biology, Faculty of Sciences, Kyushu University, Fukuoka 812-8581, Japan, 8Cellular and Molecular Biotechnology Research Institute, National Institute of Advanced Industrial Science and Technology, Tokyo 135-0064, Japan, 9Division of Biomedical Science, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan, 10Transborder Medical Research Center, University of Tsukuba, Tsukuba 305-8575, Japan, 11Faculty of Bioscience, Nagahama Institute
    [Show full text]
  • Vr Meds Ex01 3B 0825S Coding Manual Supplement Page 1
    vr_meds_ex01_3b_0825s Coding Manual Supplement MEDNAME OTHER_CODE ATC_CODE SYSTEM THER_GP PHRM_GP CHEM_GP SODIUM FLUORIDE A12CD01 A01AA01 A A01 A01A A01AA SODIUM MONOFLUOROPHOSPHATE A12CD02 A01AA02 A A01 A01A A01AA HYDROGEN PEROXIDE D08AX01 A01AB02 A A01 A01A A01AB HYDROGEN PEROXIDE S02AA06 A01AB02 A A01 A01A A01AB CHLORHEXIDINE B05CA02 A01AB03 A A01 A01A A01AB CHLORHEXIDINE D08AC02 A01AB03 A A01 A01A A01AB CHLORHEXIDINE D09AA12 A01AB03 A A01 A01A A01AB CHLORHEXIDINE R02AA05 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S01AX09 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S02AA09 A01AB03 A A01 A01A A01AB CHLORHEXIDINE S03AA04 A01AB03 A A01 A01A A01AB AMPHOTERICIN B A07AA07 A01AB04 A A01 A01A A01AB AMPHOTERICIN B G01AA03 A01AB04 A A01 A01A A01AB AMPHOTERICIN B J02AA01 A01AB04 A A01 A01A A01AB POLYNOXYLIN D01AE05 A01AB05 A A01 A01A A01AB OXYQUINOLINE D08AH03 A01AB07 A A01 A01A A01AB OXYQUINOLINE G01AC30 A01AB07 A A01 A01A A01AB OXYQUINOLINE R02AA14 A01AB07 A A01 A01A A01AB NEOMYCIN A07AA01 A01AB08 A A01 A01A A01AB NEOMYCIN B05CA09 A01AB08 A A01 A01A A01AB NEOMYCIN D06AX04 A01AB08 A A01 A01A A01AB NEOMYCIN J01GB05 A01AB08 A A01 A01A A01AB NEOMYCIN R02AB01 A01AB08 A A01 A01A A01AB NEOMYCIN S01AA03 A01AB08 A A01 A01A A01AB NEOMYCIN S02AA07 A01AB08 A A01 A01A A01AB NEOMYCIN S03AA01 A01AB08 A A01 A01A A01AB MICONAZOLE A07AC01 A01AB09 A A01 A01A A01AB MICONAZOLE D01AC02 A01AB09 A A01 A01A A01AB MICONAZOLE G01AF04 A01AB09 A A01 A01A A01AB MICONAZOLE J02AB01 A01AB09 A A01 A01A A01AB MICONAZOLE S02AA13 A01AB09 A A01 A01A A01AB NATAMYCIN A07AA03 A01AB10 A A01
    [Show full text]
  • Clinical Policy: Topical Agents: Anti-Fungals Reference Number: OH.PHAR.PPA.90 Effective Date: 01/01/2020 Revision Log Last Review Date: Line of Business: Medicaid
    Clinical Policy: Topical Agents: Anti-Fungals Reference Number: OH.PHAR.PPA.90 Effective Date: 01/01/2020 Revision Log Last Review Date: Line of Business: Medicaid See Important Reminder at the end of this policy for important regulatory and legal information. Description NO PA REQUIRED “PREFERRED” PA REQUIRED “NON-PREFERRED” CICLOPIROX cream, gel, topical suspension, shampoo CICLOPIROX kit (generic of CNL® Nail lacquer kit) (generic of Loprox®) ERTACZO® (sertaconazole) CICLOPIROX solution (generic of Penlac®) EXELDERM® (sulconazole) CLOTRIMAZOLE (generic of Lotrimin®) JUBLIA® solution (efinaconazole) CLOTRIMAZOLE/BETAMETHASONE (generic of KERYDIN® solution (tavaborole) Lotrisone®) KETOCONAZOLE foam(generic of Extina®) ECONAZOLE (generic of Spectazole®) LUZU® (luliconazole) KETOCONAZOLE cream & shampoo (generic of Kuric®, MENTAX® (butenafine) Nizoral®) NAFTIFINE CREAM MICONAZOLE NAFTIN® GEL (naftifine) NYSTATIN OXICONAZOLE (generic of OXISTAT®) NYSTATIN/TRIAMCINOLONE PEDIADERM AF® cream (nystatin) TERBINAFINE (generic of Lamisil®) VUSION® ointment (miconazole/zinc) TOLNAFTATE (generic of Tinactin®) FDA approved indication(s) Ciclopirox is indicated for: • Topical treatment of mild to moderate onychomycosis of fingernails and toenails without lunula involvement, due to Trichophyton rubrum in immunocompetent patients (Penlac®, Ciclodan Nail Lacquer®) • Topical treatment of seborrheic dermatitis of the scalp (Loprox®) • Topical treatment of tinea corporis, tinea cruris, or tinea pedis (Epidermophyton floccosum; Microsporum canis; Trichophyton
    [Show full text]