【病例学习第23期】Ringworm Infection（癣感染）

From Pharmacy Times(www.pharmacytimes.com)
Thanks to the author Craig I. Coleman, PharmD(Dr. Coleman is an assistant professor of pharmacy practice and director of the pharmacoeconomics and outcomes studies group at the University of Connecticut School of Pharmacy.)

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Ringworm Infection

RW is a 32-year-old woman who comes to the pharmacy counter to ask the pharmacist for his advice. She tells the pharmacist that she has a ringworm (tinea) infection and wants to purchase a suitable OTC, topical antifungal agent to treat it. RW is otherwise healthy and takes no other prescription or OTC medications.

How should the pharmacist respond?

ANSWER

Before the pharmacist can recommend a treatment for RW's tinea infection, he must know the location on her body where the infection has occurred. Tinea infections of the feet, thighs, buttocks, or body can be treated with the application of an OTC, topical antifungal cream for up to 4 weeks. Nail (tinea unguium) and scalp (tinea capitis) infections are more difficult to treat and typically require treatment with prescription oral agents (-azoles, griseofulvin, terbinafine). Upon questioning, RW admits to having an infection of her toenails. Consequently, the pharmacist should tell RW that an OTC product is probably not sufficient to treat her tinea infection and should recommend that she see her physician to get a prescription for terbinafine (a highly lipophilic, oral antifungal drug that penetrates and accumulates in the nail bed).


癣感染
RW是一位32岁的老年妇女，到药店向药师咨询。她告诉药师她感染了癣病。准备买合适的非处方药，局部抗真菌制剂治疗癣病。RW在其他方面健康，不服用处方和非处方药。
药师应如何回答？
回答
在药师可为RW 癣感染提供建议之前，他必须知道RW身体上发生癣感染的位置。其足部、大腿、臀部的癣感染可以用一种非处方药，局部的抗真菌膏剂，一直使用四周。甲癣和头癣更加难以治疗，典型地需要口服处方制剂治疗（唑类、灰黄霉素、特比奈酚）。经询问，RW自述长了趾癣。因此，药师应告知RW非处方药可能不足以治疗其癣症，并要建议她去看医生，开来特比奈酚的处方（一种高脂溶性的能够渗透和聚集在甲板的口服抗真菌药）。

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癣感染
RW是一位32岁的老年妇女，到药店向药师咨询。她告诉药师她感染了癣病。准备买合适的非处方药，局部抗真菌制剂治疗癣病。RW在其他方面健康，不服用处方和非处方药。
药师应如何回答？
回答
在药师可为RW 癣感染提供建议之前，他必须知道RW身体上发生癣感染的位置。其足部、大腿、臀部的癣感染可以用一种非处方药，局部的抗真菌膏剂，一直使用四周。甲癣和头癣更加难以治疗，典型地需要口服处方制剂治疗（唑类、灰黄霉素、特比奈酚）。经询问，RW自述长了趾癣。因此，药师应告知RW非处方药可能不足以治疗其癣症，并要建议她去看医生，开来特比奈酚的处方（一种高脂溶性的能够渗透和聚集在甲板的口服抗真菌药）。