Running head: ADVANCE PHARMACOLOGY
According to the signs and symptoms exhibited by the 38-year-old Caucasian female patient as well as the physical examination and lab tests, the patient is suffering from a fungal infection of the nail known as onychomycosis. This condition comprises of a fungal infection of either the toenails or fingernails. It is usually caused by dermatophytes such as Candida albicans, which tend to penetrate inside the nails, thus causing an infection and the patient’s symptoms. There are some risk factors that increase the chances of being infected by the nail fungus. In this case, the patient has diabetes type II and is, therefore, more likely to show these symptoms. She is also a little old, which means that her nails have grown thicker than usual, thus creating optimum conditions for the increase of the infection. The patient is experiencing a yellow color on her right great toe, itchiness, and inflammation, which are consistent with this condition, especially when left untreated for a long time (Lipner & Scher, 2019).
This condition is best treated through the prescription of antifungal medications. As per the guidelines from AAFP/CDC, for this condition, the best treatment is Itraconazole and Terbinafine. A strict following of Terbinafine’s oral therapy would be very effective in fighting against the dermatophytes that are the root causes of most onychomycosis conditions. With the same adherence to the use of Itraconazole prescription, this is a very safe and successful therapy for a short period of time. In addition, this gives a reliable, convenient, and affordable medication. The best dosage for the utilization of Terbinafine prescription entails intake of 250 mg each day for a time frame of 12 weeks for the toenail infections. In case of an infection of the fingernail, the same dosage should be taken but for a time frame of six weeks. On the other hand, Itraconazole should be taken in a dosage of 200 mg daily for either toe or fingernail infections for 12 weeks and six weeks, respectively. The prescription below would be the best recommendation for this specific patient:
Disp: 250 mg capsules
PO: Orally once a day
Notes: Take with food
Disp: 200 mg capsules
PO: orally once a day
Notes: Take with food
Patients who conduct a thorough follow up of the above prescription for these antifungal medications can get treated for onychomycosis as well as other related complications (Lipner & Scher, 2019).
Before the initiation of any treatment with antifungal therapy for onychomycosis, it would be crucial to get a differential diagnosis to remove any other possible condition, particularly due to the accompanying side effects related to this pharmacological treatment. The administered antifungal agents would be the basis for my choice of the labs for baseline and follow up therapy for this Caucasian female. After choosing what would be used in the treatment plan, I would order two different tests. They would be inclusive of live blood tests as well as a total blood count test to find the levels of AST and ALT. In the process of therapy, these tests would be done every four to six weeks. Moreover, the same tests would be carried out for the utilization of Itraconazole is the antifungal agent. The main significance of the above lab tests would be to ensure proper monitoring of how effective the prescribed antifungal agents have been in association with the treatment of onychomycosis and other related conditions (Lipner & Scher, 2019).
Lipner, S. R., & Scher, R. K. (2019). Onychomycosis: clinical overview and diagnosis. Journal of the American Academy of Dermatology, 80(4), 835-851.
Lipner, S. R., & Scher, R. K. (2019). Onychomycosis: Treatment and prevention of recurrence. Journal of the American Academy of Dermatology, 80(4), 853-867