A patient is diagnosed with onychomycosis. The primary care NP ...

[bucstennis@aim.com]

A patient is diagnosed with onychomycosis. The primary care NP notes that the patient takes quinidine. The NP should prescribe:
 
  a. terbinafine (Lamisil).
  b. fluconazole (Diflucan).
  c. itraconazole (Sporanox).
  d. griseofulvin (Gris-PEG).

Question 2

A woman who takes oral contraceptive pills develops vaginal candidiasis. The primary care NP prescribes a single dose of fluconazole. When counseling the patient about this drug, the NP should tell her:
 
  a. that the drug is safe if she were to become pregnant.
  b. that she may consume alcohol while taking this medication.
  c. to use a backup contraceptive method for the next 2 months.
  d. that she may need a lower dose of fluconazole because she takes oral contraceptive pills.

[vish98]

Answer to Question 1

A
Sporanox and terbinafine are both indicated to treat onychomycosis. Sporanox is not indicated in patients taking quinidine because of the risk of cardiac arrhythmias. Fluconazole and griseofulvin are not indicated to treat onychomycosis.

Answer to Question 2

C
Women using oral contraception who take antifungals should be advised to use supplemental contraception during and for 2 months after antifungal therapy. Antifungals have teratogenic effects and are not safe during pregnancy. Patients should not consume alcohol while taking antifungal medications. It is not necessary to lower the antifungal dose in women taking oral contraceptive pills.

[bucstennis@aim.com]

TYSM

[LVPMS]

Gracias!