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Dermatology Case No5. Tinea Cruris

A 60 years male patient presents with itching in groin.

D) What’s your Rx plan?

Answer is:-

Dx . Tinea cruris

Rx.

1.Cream. Clotrimazole

Use 2 times for 1 month

Tab. Cetirizine 10 mg

0+0+1 for 15 days

 Fluconazole Orally

0+0+1 for 15 days

Or

Dx . Tinea cruris

Oral Itracoanzole and topical Luliconazole will be effective in this case.

Antihistamine for itching.

Management Index:-

  Clotrimazole (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations).

Cream 1:-Clarizol 1%  10gm tube For Use 2 times for 1 month .

Oral Itracoanzole (AS A Itraconazole AS a Drugs for subcutaneous and mycoses). 

2.Tablet:-Itra 200mg Use For 15 Days 2 time .

OR

topical Luliconazole (AS A Luliconazole AS A Miscellaneous topical agents).

Cream 3.Lucazol 1% 10/20gm For Use 2 times for 1 month.

OR Topical Terbinafine Hydrochloride (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations).

Cream 4.Derbicil 1% 5gm tube For Use 2 times for 1 month.

Fluconazole Orally (As a Fluconazole AS A Drugs for subcutaneous and mycoses).

Capsule 5.Flugal 200mg  Use 2 times for 15 Days.

Antihistamin.

Tablet6. Cetirizine 10 mg (AS A Cetirizine Hydrochloride As a Sedating Anti-histamine).

Use 2 times for 15 Days.

A) what is the Tinea Cruris ?

Answer Is:- পায়ের দাদ (ল্যাটিন: টিনিয়া ক্রুরিস) বা জক ইচ হলো একধরনের ছত্রাক সংক্রমণ যা ঊরুর ভেতরের ত্বক, কুঁচকি এবং নিতম্বকে ক্ষতিগ্রস্ত করে। এই কারণে শরীরের এইসব উষ্ণ, আর্দ্র জায়গায় লালচে হয়ে যেতে পারে, ফাটতে পারে, কখনও রিঙের মতন দাগ হয়। এটা সাধারণত স্যাঁতস্যাঁতে ও গরম আবহাওয়ায় হয়। স্বাভাবিকের থেকে বেশি ওজনের লোকদের এটা আরও বেশি হয়।

জক ইচ (টিনিয়া ক্রুরিস)

জক ইচ হল একটি সংক্রামক ছত্রাক সংক্রমণ যা আপনার কুঁচকির এলাকায় বিভিন্ন চুলকানি ত্বকের সমস্যা সৃষ্টি করে। সংক্রামিত ত্বকে চুলকানি, দমকা, জ্বলন্ত ফুসকুড়ি তৈরি হয়। চিকিত্সা ছত্রাক ছড়িয়ে পড়া বন্ধ করতে পারে এবং এটি পরিষ্কার করতে পারে।

জক চুলকানি কি?

জক ইচ হল একটি সাধারণ ছত্রাক (একটি ছত্রাক দ্বারা সৃষ্ট) সংক্রমণ দাদ অনুরূপ। জক ইচ আপনার কুঁচকির চারপাশের ত্বকে চুলকানি, দমকা, জ্বলন্ত ফুসকুড়ি, ভিতরের উরু এবং বাট ফাটল (গ্লুটিয়াল ক্লেফট) সৃষ্টি করে। টিনিয়া ক্রুরিস জক ইচের অপর নাম। দাদ এর অপর নাম টিনিয়া, আর ক্রুরিস মানে কুঁচকি।

এই সংক্রমণে, আপনার ত্বক আঁশযুক্ত এবং ফাটল হতে পারে বা বাম্প বা ফোস্কা হতে পারে।

জক চুলকানি দেখতে কেমন?

জক ইচ আপনার কুঁচকির আশেপাশের ত্বক, ভিতরের উরু এবং বাট ফাটলকে প্রভাবিত করতে পারে। আপনার ত্বক খিটখিটে (লাল, বেগুনি, ধূসর, কষা বা সাদা), আঁশযুক্ত বা ফ্ল্যাকি প্রদর্শিত হতে পারে। আপনার ত্বকে ছোট ছোট ফুসকুড়ি বা ফোস্কাও হতে পারে।

জক চুলকানি কে প্রভাবিত করে?

জক ইচ সবাইকে প্রভাবিত করে। যাইহোক, বয়ঃসন্ধিকালের এবং অল্প বয়স্ক পুরুষদের প্রায়ই জক চুলকানি হয়। এটি মহিলাদের মধ্যে অস্বাভাবিক। মহিলাদের তুলনায় পুরুষদের জক ইচ হওয়ার সম্ভাবনা তিনগুণ বেশি। এটি শিশুদের মধ্যে বিরল।

আপনার যদি জক ইচ হওয়ার সম্ভাবনা বেশি থাকে যদি আপনার থাকে:

  • ডায়াবেটিস।
  • স্থূলতা।
  • একটি দুর্বল ইমিউন সিস্টেম।

মহিলাদের জক চুলকানি পেতে পারেন?

মহিলাদের জক ইচ হতে পারে। যাইহোক, এটি সাধারণ নয়। মহিলাদের মধ্যে, জক ইচ কুঁচকির আশেপাশের ত্বক, ভিতরের উরু এবং বাট ফাটলকে প্রভাবিত করে। এটি খুব কমই ভালভা (জননাঙ্গ) প্রভাবিত করে।

প্রতিরোধ

আমি কিভাবে আমার ঝুঁকি কমাতে পারি?

আপনার জক ইচ হওয়ার ঝুঁকি কমানোর অনেক উপায় রয়েছে:

  • অ্যান্টিব্যাকটেরিয়াল সাবান দিয়ে আপনার কুঁচকি ভালোভাবে ধুয়ে নিন।
  • সাঁতার বা স্নানের পরে আপনার কুঁচকি শুকিয়ে নিন।
  • আর্দ্রতা শোষণ করতে আপনার কুঁচকিতে ট্যালকম পাউডার বা অ্যান্টিফাঙ্গাল পাউডার লাগান।
  • ঢিলেঢালা আন্ডারওয়্যার এবং প্যান্ট পরুন যা এলাকাটিকে শ্বাস নিতে দেয়।
  • আর্দ্রতা শোষণ করতে সুতির অন্তর্বাস পরুন বা আর্দ্রতা দূর করতে সিন্থেটিক উপকরণ দিয়ে তৈরি অন্তর্বাস পরুন।
  • ব্যবহার করার পরে আপনার কাপড় ধুয়ে ফেলুন, বিশেষ করে আপনি যে পোশাকগুলি পরিশ্রম করার সময় পরেন।
  • অন্যদের সাথে তোয়ালে বা কাপড় শেয়ার করবেন না।

আমি কিভাবে এটি প্রতিরোধ করতে পারি?

আপনার যদি অ্যাথলিটের পায়ে বা অন্য ধরণের ছত্রাক থাকে তবে জক চুলকানি থেকে নিজেকে আটকানোর অনেক উপায় রয়েছে:

  • অ্যান্টিফাঙ্গাল ক্রিম, মলম, জেল, স্প্রে বা পাউডার দিয়ে আপনার সংক্রমিত এলাকার চিকিৎসা করুন।
  • আপনার সংক্রামিত স্থানগুলি শুকানোর জন্য একটি পৃথক তোয়ালে ব্যবহার করুন বা শেষ পর্যন্ত যে কোনও সংক্রামিত স্থান শুকিয়ে নিন।
  • ড্রেসিং করার সময়, আপনার অন্তর্বাসের আগে আপনার মোজা পরুন।
  • আপনার সংক্রামিত এলাকায় স্ক্র্যাচ এড়িয়ে চলুন. যদি আপনি একটি সংক্রামিত এলাকা আঁচড়ান, পুঙ্খানুপুঙ্খভাবে আপনার শরীরের অন্য কোন অংশ স্পর্শ করার আগে অ্যান্টিব্যাকটেরিয়াল সাবান দিয়ে আপনার হাত ধুয়ে নিন।
  • আপনার মোজা, অন্তর্বাস, তোয়ালে এবং বিছানা গরম জলে ধুয়ে নিন।
  • জক চুলকানি আছে এমন কারও সাথে যৌন যোগাযোগ এড়িয়ে চলুন যতক্ষণ না এটি চলে যায়।
  • জক চুলকানি একটি অপ্রীতিকর অবস্থা। এটা চুলকানি এবং বিরক্তিকর. এটি দংশন বা জ্বলতে পারে। যাইহোক, অ্যান্টিফাঙ্গাল ওষুধ বা ঘরোয়া প্রতিকার আপনাকে জক চুলকানি থেকে মুক্তি পেতে সাহায্য করবে। নিশ্চিত হোন যে আপনি আপনার কুঁচকিতে আঁচড় দেবেন না, কারণ এটি আপনার শরীরের অন্যান্য অংশে ছত্রাক ছড়িয়ে দিতে পারে। আপনার স্বাস্থ্যসেবা প্রদানকারীর চিকিত্সা পরিকল্পনা অনুসরণ করাও গুরুত্বপূর্ণ। আপনি যদি আপনার ওষুধের সম্পূর্ণ কোর্স শেষ না করেন তবে জক ইচ আবার ফিরে আসতে পারে। আপনার স্বাস্থ্যসেবা প্রদানকারীকে জিজ্ঞাসা করুন কিভাবে আপনি জক ইচকে আপনার শরীরের অন্যান্য অংশে বা অন্যান্য লোকে ছড়িয়ে পড়া থেকে রক্ষা করতে পারেন।

লক্ষণ ও কারণ

জক ইচ এর লক্ষণ কি কি?

জক চুলকানি জ্বলতে পারে এবং চুলকানি হতে পারে। আপনার ত্বক খিটখিটে দেখাতে পারে এবং রং পরিবর্তন করতে পারে। এটি আঁশযুক্ত বা ফ্ল্যাকিও দেখা দিতে পারে। ফুসকুড়িটি আংটির মতো দেখতে হতে পারে এবং ফুসকুড়িটির বাইরের দিকে ছোট ছোট ফুসকুড়ি বা ফোস্কা থাকতে পারে।

জক চুলকানির কারণ কি?

একটি ছত্রাক জক চুলকানি কারণ। জক ইচ ফুসকুড়ি হল  । দাদ বৃত্তের মত দেখতে পারে। কিন্তু প্রকৃত কৃমি দাদ সৃষ্টি করে না।

জক চুলকানি কি সংক্রামক?

জক চুলকানি সংক্রামক। জক ইচ হল একটি ছত্রাক যা আপনার ত্বকে বা ত্বকে বৃদ্ধি পায়। ছত্রাক (ছত্রাকের বহুবচন) বৃদ্ধির জন্য উষ্ণ তাপমাত্রা এবং আর্দ্রতা প্রয়োজন। টাইট অন্তর্বাস বা প্যান্ট আপনার কুঁচকির চারপাশে তাপ এবং আর্দ্রতা আটকে রাখে। তাপ এবং আর্দ্রতা জক চুলকানির জন্য উপযুক্ত পরিবেশ তৈরি করে।

কিভাবে জক চুলকানি ছড়ায়?

জক ইচ সাধারণত ত্বক থেকে ত্বকের যোগাযোগ বা সংক্রামিত পৃষ্ঠের সাথে যোগাযোগের মাধ্যমে ছড়িয়ে পড়ে। সংক্রামিত ব্যক্তির সাথে যৌন যোগাযোগের মাধ্যমে আপনি জক ইচ পেতে পারেন। আপনি একজন সংক্রামিত ব্যক্তির সাথে তোয়ালে বা পোশাক ভাগ করেও জক ইচ পেতে পারেন।

কিছু ক্ষেত্রে, আপনার যদি Athlets Foot Tinea Pedis থাকে তবে আপনি জক ইচ পেতে পারেন । আপনি আপনার সংক্রামিত পা স্পর্শ করার পরে আপনার কুঁচকি স্পর্শ করে ছত্রাক ছড়িয়ে দিতে পারেন। আপনি আপনার পোশাকের মাধ্যমে আপনার পা থেকে কুঁচকিতে ছত্রাক ছড়িয়ে দিতে পারেন। পোষাক পরার সময়, আপনার পা থেকে কুঁচকিতে ছত্রাক ছড়ানো প্রতিরোধ করার জন্য আপনার অন্তর্বাসের আগে আপনার মোজা পরা একটি ভাল ধারণা।

জক ইচ নির্ণয়ের জন্য কি পরীক্ষা করা হবে?

কিছু ক্ষেত্রে, আপনার স্বাস্থ্যসেবা প্রদানকারী ত্বকের একটি ছোট টুকরো (বায়োপসি) অপসারণ করতে পারেন এবং এটি একটি ল্যাবে পরীক্ষা করতে পারেন। পটাসিয়াম হাইড্রোক্সাইড (KOH) দ্রবণের বেশ কয়েকটি ফোঁটা ত্বকের কোষগুলিকে দ্রবীভূত করে যাতে শুধুমাত্র ছত্রাকের কোষগুলি দৃশ্যমান হয়।

লক্ষণ

১. উরুর সংযোগস্থল ও নিতম্বে তীব্র চুলকানি ভাব অনুভূত হওয়া

২. লাল বা খয়েরি রঙয়ের র‍্যাশ ও পানি ভর্তি ফুসকুড়ি দেখা দেয়া

৩. চুলকানোর পর এই পানি ভর্তি ফুসকুড়িগুলো ফেটে যাওয়া

৪. আক্রান্ত স্থানে পানি লাগলে জ্বালাপোড়া করা

৫. আক্রান্ত স্থান কালো এবং শুষ্ক হয়ে যাওয়া।

৬. রাতের বেলা বেশি চুলকায়।

৭. বিছানায় গেলেই প্রচুর চুলকায় এবং জ্বালাপোড়া করতে থাকে।

৮. কাপড় পরিবর্তনের সময় চুলকায় , আরাম অনুভব হয় এবং জ্বালাপোড়া করে সাথে রস বের হয়।

ব্যবস্থাপনা ও চিকিৎসা

জক চুলকানি কি নিজে থেকেই চলে যাবে?

জক ইচ সাধারণত নিজে থেকে যায় না। যদি এটি চিকিত্সা না করা হয় তবে এটি আপনার শরীরের অন্যান্য অঞ্চলে ছড়িয়ে পড়তে পারে, যার মধ্যে রয়েছে:

  • নখ : ছত্রাকের নখের সংক্রমণের চিকিৎসা করা আরও কঠিন হতে পারে। তারা প্রায়শই অনেক চিকিত্সার জন্য আরও প্রতিরোধী।
  • হাত : অনুরূপ ছত্রাক সংক্রমণ আপনার হাতে ছড়িয়ে পড়তে পারে। এটি ঘটে যখন আপনি আপনার হাত দিয়ে আপনার সংক্রামিত কুঁচকি আঁচড়ান বা উভয় জায়গা শুকানোর জন্য একই তোয়ালে ব্যবহার করেন।
  • পা : একই ছত্রাক যা জক ইচ সৃষ্টি করে আপনার পায়েও ছড়িয়ে পড়তে পারে। এটি অ্যাথলিটস ফুট নামে একটি অবস্থা। ছত্রাকটি সাধারণত আপনার অন্তর্বাসের মাধ্যমে আপনার কুঁচকি থেকে আপনার পায়ে ছড়িয়ে পড়ে। উভয় জায়গা শুকানোর জন্য একই তোয়ালে ব্যবহার করেও এটি ছড়িয়ে পড়তে পারে।

কিভাবে জক চুলকানি চিকিত্সা করা হয়?

Treatment Management :-

Cream 1:-Clarizol 1% 10gm tube (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations).

Indications of Cream :-Clarizol 1% 10gm tube (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

 

  • All dermatomycoses due to dermatophytes (e.g.Trichophyton species).
  • All dermatomycoses due to yeasts (Candida species).
  • Dermatomycoses due to moulds and other fungi.
  • Skin diseases showing superinfections with these fungi.

Some examples of skin infections included in above points are interdigital mycoses (e.g. athlete’s foot), paronychias (associated with nail mycoses), mycoses in skin folds, Candida vulvitis, Candida balanitis, Pityriasis versicolor, erythrasma.

Description of Cream :-Clarizol 1% 10gm tube (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

Clarizol is a broad-spectrum antifungal agent that is used for the treatment of dermal infections caused by various species of pathogenic dermatophytes, yeasts, moulds and bacteroids. Clarizol is also active against certain gram-positive bacteria especially Staphylococci and Tricomonas. Like other imidazoles, Clarizol alters the permeability of fungal cell walls by interfering with cell wall lipids. At fungi static levels the main effect is inhibition of ergosterol synthesis but at higher concentrations there is an additional mechanism of membrane damage unrelated to sterol synthesis.

Pharmacology of Cream :-Clarizol 1% 10gm tube (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

Clotrimazole acts primarily by damaging the permeability barrier in the cell membrane of fungi. Clotrimazole causes inhibition of ergosterol biosynthesis, an essential constituent of fungal cell membranes. If ergosterol synthesis is either completely or partially inhibited, the cell is no longer able to construct an intact and functional cell membrane. Because ergosterol directly promotes the growth of fungal cells in a hormone‐like fashion, rapid onset of the above events leads to dose-dependent inhibition of fungal growth.

Though decreased ergosterol, due to the inhibition of lanosterol 14-demethylase (also known as CYP51) is accepted to be primarily responsible for the antimycotic properties of clotrimazole, this drug also shows other pharmacological effects. These include the inhibition of sarcoplasmic reticulum Ca2+ ATPase, depletion of intracellular calcium, and blocking of calcium‐dependent potassium channels and voltage‐dependent calcium channels. The action of clotrimazole on these targets accounts for other effects of this drug that are separate from its antimycotic activities.

Dosage & Administration of Cream :-Clarizol 1% 10gm tube (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

Clotrimazole Cream: This should be thinly applied 2-3 times daily to the infected sites and rubbed in. On account of the excellent efficacy, a small amount of cream is usually sufficient for an area about the size of the palm. For the treatment to become a complete success, reliable and sufficiently long-time application of Clotrimazole Cream is important. The duration of treatment varies; it depends among other factors on the extent and localization of the disease.

Recommended duration of treatment-

  • Dermatomycoses: 3-4 weeks
  • Candida vulvitis and Candida balanitis: 1-2 weeks
  • Erythrasma and Pityriasis Versicolor: 3 weeks (approximately)

In fungal infection of the feet, to prevent relapse, treatment should be continued for about 2 weeks beyond the disappearance of all signs of disease. After washing, the feet should be thoroughly dried (particularly spaces between the toes). Clotrimazole Cream is odorless, can be washed off and does not stain clothing.

Clotrimazole topical solution: Apply this sparingly to the affected areas and rub in gently, two or three times daily.

Interaction

No information is available.

Contraindications

Hypersensitivity to Clotrimazole.

Side Effects of Cream :-Clarizol 1% 10gm tube (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

When applied topically, Clarizol is well tolerated.With external application, systemic effects are not observed. Local irritation or burning sensation may occur in a very few cases but these symptoms are not considered harmful.

Pregnancy & Lactation of Cream :-Clarizol 1% 10gm tube (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

It is recommended that Clotrimazole should be used in pregnancy only when considered necessary by the physician.

Therapeutic Class of Cream :-Clarizol 1% 10gm tube (AS A Clotrimazole As a Drugs for subcutaneous and mycoses, Topical Antifungal preparations):-

Drugs for subcutaneous and mycoses, Topical Antifungal preparations

Oral Itracoanzole

2.Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

Indications of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

Itra is used for the treatment of oropharyngeal candidiasis, vulvovaginal candidiasis, pityriasis versicolor, tinea pedis, tinea cruris, tinea corporis, tinea manuum, onychomycosis, histoplasmosis. It is indicated in the treatment of systemic candidiasis, aspergillosis, and cryptococcosis (including cryptococcal meningitis). It is also used for maintenance therapy in AIDS patients to prevent relapse of underlying fungal infections and in the prevention of fungal infection during prolonged neutropenia.

Pharmacology of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

Itraconazole inhibits Cytochrome P-450 dependent enzymes resulting in impairment of the biosynthesis of ergosterol, a major component of the cell membrane of yeast and fungal cells. Being integral to the proper functioning of the cell membrane, inhibition of the synthesis of ergosterol leads to a cascade of abnormalities in permeability, membrane bound enzyme activity, and co-ordination of chitin synthesis leading to inhibition of growth, abnormal cell wall formation and accumulation of intracellular lipids and membranous vesicles.

SUBA (Super Bio-available) technology is a novel technology for enhancing the bioavailability of poorly soluble drugs. This technology utilizes a solid dispersion of drug in a polymer that improves the dissolution of poorly soluble drugs compared to their normal crystalline form. SUBA technology Itraconazole is an orally active triazole antifungal drug that has demonstrated a broad spectrum of activity and favorable pharmacokinetic profile.

Dosage & Administration of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

100 & 200 mg preparation:
For non-systemic fungal disease-

  • Vulvovaginal candidiasis: 200 mg twice daily for 01 day
  • Pityriasis versicolor: 200 mg once daily for 07 days
  • Tinea corporis, tinea cruris: 100 mg once daily for 15 days or 200 mg once daily for 7 days
  • Tinea pedis, tinea manuum: 100 mg once daily for 30 days
  • Oropharyngeal candidiasis: 100 mg once daily for 15 days, Increase dose to 200 mg once daily for 15 days in AIDS or neutropenic patients because of impaired absorption in these groups.
  • Onychomycosis (toenails with or without fingernail involvement): Either 200 mg daily for 3 months or course (pulse) of 200 mg twice daily for 7 days, subsequent courses repeated after 21 days’ interval. Fingernails two courses, toenails three courses.

For systemic fungal disease-

  • Aspergillosis: 200 mg once daily for 2-5 months Increase dose to 200 mg twice daily in case of invasive or disseminated disease
  • Candidiasis: 100-200 mg once daily for 3 weeks-7 months. Increase dose to 200 mg twice daily in case of invasive or disseminated disease
  • Non-meningeal Cryptococcosis: 200 mg once daily for 10 weeks
  • Cryptococcal meningitis: 200 mg twice daily for 2-6 months
  • Histoplasmosis: 200 mg once daily twice daily for 8 months
  • Maintenance in AIDS: 200 mg once daily until immune recovery
  • Prophylaxis in neutropenia: 200 mg once daily until immune recovery

The dose and duration of treatment for systemic antifungal disease should be adjusted depending on the clinical response.

65 mg & 130 mg preparation:
For non-systemic fungal disease-

  • Vulvovaginal candidiasis: 130 mg twice daily for 1 day
  • Pityriasis versicolor: 65 mg twice daily for 7 days
  • Tinea corporis and tinea cruris: 65 mg daily for 15 days OR 65 mg twice daily for 7 days
  • Tinea pedis and tinea manuum: 65 mg once daily for 30 days
  • Oropharyngeal Candidiasis: 65 mg once daily for 15 days, increase dose to 65 mg twice daily for 15 days in AIDS or neutropenic patients because of impaired absorption in these groups.
  • Onychomycosis (toenails with or without fingernail involvement): Either 65 mg twice daily for 3 months or course (pulse) of 130 mg twice daily for 7 days, subsequent courses repeated after 21 days interval. Fingernails two courses, toenails three courses.

For systemic fungal disease-

  • Aspergillosis: 65 mg twice daily for 2-5 months.Increase dose to 130 mg twice daily in case of invasive or disseminated disease
  • Candidiasis: 65-130 mg once daily for 3 weeks-7 months. Increase dose to 65 mg twice daily in case of invasive or disseminated disease
  • Non-meningeal Cryptococcosis: 65 mg twice daily for 10 weeks
  • Cryptococcal meningitis: 130 mg twice daily for 2-6 months
  • Histoplasmosis: 130 mg once daily-twice daily for 8 months
  • Maintenance in AIDS: 65 mg twice daily until immune recovery
  • Prophylaxis in neutropenia: 65 mg twice daily until immune recovery

The dose and duration of treatment for systemic anti-fungal disease should be adjusted depending on the clinical response.

pediatric use: The efficacy and safety of the Itraconazole capsule have not been established in pediatric patients.

Interaction of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

The drugs like terfenadine, astemizole, cisapride, HMG-CoA reductase inhibitors such as simvastatin, oral midazolam or triazolam should not be given concurrently with Itra. Significant interactions also observed during co-administration of rifampin, phenytoin, phenobarbital, digoxin, and calcium channel blockers. There is no experience of overdosage with Itra.

Contraindications of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

Itraconazole is contraindicated in patients with known hypersensitivity to the drug or any ingredient in the formulation. Patients who have severe hepatic disease are not advised to take Itraconazole. It is not advisable to use the drug in patients taking rifampin, which appears to initially inhibit and then enhance the metabolism of Itraconazole.

Side Effects of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

Nausea, abdominal pain, dyspepsia, constipation, headache, dizziness, raised liver enzymes, menstrual disorders, allergic reactions (including pruritus, rash, urticaria and angioedema), hepatitis and cholestatic jaundice, peripheral neuropathy and Stevens-Johnson syndrome reported. On prolonged use hypokalaemia, oedema and hair loss reported.

Pregnancy & Lactation of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

Itraconazole is contraindicated in pregnancy. Breast feeding while receiving Itraconazole is not recommended.

Precautions & Warnings- of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

Absorption is impaired when gastric acidity is reduced. In patients receiving acid neutralizing medicines (e.g. aluminium hydroxide), these should be administered at least 2 hours after the intake of Itra. The drug should be administered after a full meal. Rarely, cases of hepatitis and jaundice have been reported mainly in patients treated for longer than one month. It is therefore, advised to monitor liver function in patients receiving continuous treatment of more than one month.

Therapeutic Class of Tablet:-Itra 200mg (AS A Itraconazole AS a Drugs for subcutaneous and mycoses).

 

Drugs for subcutaneous and mycoses

OR

topical Luliconazole

Cream 3.Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents).

Indications of Cream :-Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents):-

 

Lucazol cream is indicated for the topical treatment of interdigital tinea pedis, tinea cruris and tinea corporis caused by the organisms Trichophyton rubrum and Epidermophyton floccosum.

Pharmacology of Cream :-Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents):-

 

Luliconazole is a topical antifungal agent. It is a broad-spectrum antifungal agent that belongs to the azole group. It acts against fungus by inhibiting the enzyme lanosterol demethylase and blocks ergosterol synthesis which is an important constituent of fungal cell membrane. Thus it exerts strong fungicidal activity both in-vitro and in-vivo against dermatophytes, Candida albicans, Malassezia spp, Trichophyton and Epidermophyton spp.

Dosage & Administration of Cream :-Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents):-

 

Adult & Geriatric:

  • Interdigital tinea pedis: Luliconazole cream should be applied to the affected area and approximately 1 inch of the immediate surrounding area(s) once daily for two weeks.
  • Tinea cruris and Tinea corporis: Luliconazole cream should be applied to the affected area and approximately 1 inch of the immediate surrounding area(s) once daily for one week.

Pediatric: Safety and effectiveness have not been established.

Contraindications of Cream :-Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents):-

 

Luliconazole cream is contraindicated in patients with a history of hypersensitivity to Luliconazole.

Side Effects of Cream :-Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents):-

 

Contact dermatitis and cellulitis may occur. Application site reactions were observed in iess than 1% of subjects in clinical trial.

Pregnancy & Lactation of Cream :-Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents):-

 

There are no adequate and well-controlled studies of Luliconazole cream in pregnant women. Luliconazole cream should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether Luliconazole is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Luliconazole cream is applied to women who are breastfeeding.

Precautions & Warnings of Cream :-Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents):-

 

If there is any unusual allergic reaction with the use of Lucazol, then treatment should be discontinued and appropriate therapy should be instituted. Lucazol is recommended for topical use only. It is not intended for ophthalmic, oral or intravaginal use.

Therapeutic Class of Cream :-Lucazol 1% 10/20gm (AS A Luliconazole AS A Miscellaneous topical agents):-

 

Miscellaneous topical agents

OR Topical Terbinafine Hydrochloride

Cream 4.Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations).

Indications of Cream:-Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations):-

 

Derbicil tablet: This tablet is indicated for the treatment of onychomycosis of the toenail or fingernail due to dermatophytes (tinea unguium).

Derbicil granules: This is indicated in Tinea Capitis.

Derbicil cream: Fungal infection of the skin caused by Trichophyton (e.g. T. rubrum, T. mentagrophytes, T. verrucosum, T. violaceum), Microsporum canis and Epidermophyton floccosum. Yeast infections of the skin, principally those caused by the genus Candida (e.g. C. albicans). Pityriasis (tinea) versicolor due to Pityrosporum orbicular (also known as Malassezia furfur).

Derbicil 1% Spray: This spray is indicated in the treatment of tinea infections of the skin. This spray is also indicated in the treatment of pityriasis (tinea) versicolor due to Malassezia furfur.

Pharmacology of Cream:-Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations):-

 

Terbinafine, an Allylamine antifungal, inhibits biosynthesis of Ergosterol (an essential component of fungai cell membrane) via inhibition of Squalene Epoxidase enzyme. This results in fungal cell death primarily due to the increased membrane permeability mediated by the accumulation of high concentrations of Squalene but not due to Ergosterol deficiency. Depending on the concentration of the drug and the fungal species test in vitro, Terbinafine hydrochloride may be fungicidal. However, the clinical significance of in vitro data is unknown. Terbinafine has been shown to be active against most strains of the following microorganisms both in vitro and in clinical infections: Tricophyton Mentagrophyte, Trichophyton Rubrum.

Dosage & Administration of Cream:-Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations):-

 

Terbinafine tablet:

  • For the treatment of fingernail onychomycosis: Terbinafine 250 mg (one tablet), once daily for 6 weeks.
  • For the treatment of toenail onychomycosis: Terbinafine 250 mg (one tablet), once daily for 12 weeks.
  • The optimal clinical effect is seen some months after mycological cure and cessation of treatment. This is related to the period required for the outgrowth of healthy nail.

Terbinafine granules:

  • Body Weight: <25 kg: 125 mg/day up to 6 weeks
  • Body Weight: 25-35 kg: 187.5 mg/day up to 6 weeks
  • Body Weight: >35 kg: 250 mg/day up to 6 weeks

Terbinafine cream: Terbinafine cream can be applied once or twice daily. Cleanse and dry the affected areas thoroughly before application of the terbinafine cream. Apply the cream to the affected skin and the surrounding area in a thin layer and rub in lightly. In the case of intertriginous infections (submammary, interdigital, intergluteal, inguinal) the application may be covered with a gauze strip, especially at night. The likely durations of treatment are as follows:

  • Tinea corporis, cruris: 1 to 2 weeks
  • Tinea pedis: 1 week
  • Cutaneous candidiasis: 2 weeks
  • Pityriasis versicolor: 2 weeks

Relief of the clinical symptoms usually occurs within a few days. Irregular use or premature discontinuation of treatment carries the risk of recurrence. If there are no signs of improvement after two weeks, the diagnosis should be verified.

Terbinafine 1% Spray: This spray is applied once or twice daily, depending on the indication. The affected areas should be cleansed and dried thoroughly before application of this spray. A sufficient amount of solution should be applied to wet the treatment area(s) thoroughly.

  • Tinea pedis: once a day,1 week
  • Tinea corporis/cruris: once a day,1 week
  • Pityriasis versicolor: twice a day, 1 week

Relief of clinical symptoms usually occurs within a few days. If there are no signs of improvement after two weeks the diagnosis should be verified.

Interaction of Cream:-Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations):-

 

In vivo studies have shown that terbinafine is an inhibitor of the CYP450 2D6 isozyme. Drugs predominantly metabolized by the CYP450 2D6 isozyme include the following drug classes: tricyclic antidepressants, selective serotonin reuptake inhibitors, beta-blockers, antiarrhythmics class 1C (e.g., flecainide and propafenone) and monoamine oxidase inhibitors Type B. Co-administration of terbinafine should be done with careful monitoring and may require a reduction in dose of the 2D6-metabolized drug.

Contraindications of Cream:-Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations):-

 

Terbinafine tablet and cream are contra-indicated in individuals with hypersensitive to terbinafine.

Side Effects of Cream:-Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations):-

 

The adverse events reported encompass gastrointestinal symptoms (including diarrhea, dyspepsia and abdominal pain), liver test abnormalities, rashes, urticaria, pruritus, and taste disturbances. In general, the adverse events were mild, transient, and did not lead to discontinuation. Adverse events, based on worldwide experience with terbinafine use, include: idiosyncratic and symptomatic hepatic injury and more rarely, cases of liver failure, some leading to death or liver transplant, serious skin reactions, severe neutropenia, thrombocytopenia, angioedema and allergic reactions (including anaphylaxis). Other adverse reactions that have been reported include malaise, fatigue, vomiting, arthralgia, myalgia, and hair loss.

Pregnancy & Lactation of Cream:-Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations):-

 

Terbinafine tablet: There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, and because treatment of onychomycosis can be postponed until after pregnancy is completed, it is recommended that terbinafine not be initiated during pregnancy. After oral administration, terbinafine is present in the breast milk of nursing mothers. Treatment with terbinafine is not recommended in nursing mothers.

Terbinafine cream: Foetal toxicity and fertility studies in animals suggest no adverse effects. There is no clinical experience with terbinafine in pregnant women; therefore, unless the potential benefits outweigh any potential risk, terbinafine should not be administered. Terbinafine is excreted in breast milk and therefore mothers should not receive terbinafine treatment whilst breast-feeding.

Therapeutic Class of Cream:-Derbicil 1% 5gm tube  (AS A Terbinafine Hydrochloride AS A Other Antifungal preparations, Topical Antifungal preparations):-

 

Other Antifungal preparations, Topical Antifungal preparations

Fluconazole Orally

Capsule 5.Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses).

Indications of Capsule :-Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses):-

 

Flugal is indicated in-

  • Vaginal Candidiasis
  • Oropharyngeal Candidiasis
  • Esophageal Candidiasis
  • Tinea corporis/Tinea cruris/Tinea pedis/Other Tinea
  • Kerion
  • Pityriasis versicolor
  • Onychomycosis
  • Invasive candidal infections and cryptococcal infections (including meningitis)
  • Prevention of cryptococcal meningitis
  • Prevention of fungal infections in immunocompromised patients
  • Systemic Candidiasis and Cryptococcal infection
  • In Superficial Candidiasis
  • In Systemic Candidiasis & Cryptococcal infection

Other indications-

  • Fungal urinary tract infections
  • Disseminated candidiasis
  • Prophylaxis for fungal infection in neutropenic cancer patients.
  • Acute treatment of other systemic fungal infections such as coccidioidomycosis and histoplasmosis.

Pharmacology of Capsule :-Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses):-

 

Fluconazole is a triazole antifungal agent. It is a potent inhibitor of fungal cytochrome P-450 dependent enzymes. Cytochrome P-450 enzyme system is essential component of fungal cell membrane which is responsible for the synthesis of ergosterol.

Dosage & Administration of Capsule :-Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses):-

 

Adults:

  • Vaginal Candidiasis: 150 mg as a single dose.
  • Oropharyngeal Candidiasis: 200 mg in 1st day followed by 100 mg daily for 14 days.
  • Oesophageal Candidiasis: 200 mg in 1st day followed by 100 mg daily for 14-30 days.
  • Tinea corporis/Tinea cruris/Tinea pedis/Other Tinea: 150 mg weekly for 4-6 weeks.
  • Kerion: 50 mg daily for 20 days.
  • Pityriasis versicolor: 400 mg as a single dose.
  • Onychomycosis: 150 mg weekly for 12 months.
  • Invasive candidal infections and cryptococcal infections (including meningitis): Orally or by IV infusion, 400 mg on first day then 200-400 mg daily.
  • Prevention of cryptococcal meningitis: Orally or by IV infusion 200 mg daily.
  • Prevention of fungal infections in immunocompromised patients: Orally or by IV infusion, 50-400 mg daily.


Child over 1 year-

  • In Superficial Candidiasis: 1-2 mg/kg daily.
  • In Systemic Candidiasis & Cryptococcal infection:3-6 mg/kg daily.

In serious life threatening infections upto 12 mg/kg daily has been given to children aged 5-13 years (Maximum 400 mg daily)

  • 1 year: 9 kg: 1/2 measuring spoonful
  • 1-2 years: 12 kg: 1 measuring spoonful
  • 2-3 years: 14 kg: 1½ measuring spoonful
  • 3-4 years: 16 kg: 2 measuring spoonful
  • 4-6 years: 20 kg: 2½ measuring spoonful


Use in Specific Population-

Elderly patient: The normal dose should be used if there is no evidence of renal impairment.

Renal Impairment: No adjustment in single dose therapy is required. In multiple dose therapy of patients with renal impairment, normal doses should be given on days 1 and 2 of treatment and there after the dosage intervals should be modified as follows:

  • Creatinine clearance (>41 ml/min): Dosage interval (hours) 24
  • Creatinine clearance (21-40 ml/min): Dosage interval (hours) 48
  • Creatinine clearance (10-20 ml/min): Dosage interval (hours) 72
  • Patients receiving regular dialysis: One dose after every dialysis session

Children: Renal clearance in children may be proportionately more rapid than in adults and doses up to 12 mg/kg is recommended.

Interaction of Capsule :-Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses):-

 

In an interaction study, fuconazole increased the prothombin time after warfarin administration in healthy males. Though the magnitude of change was small (12%) careful monitoring of prothombin time in patients receiving coumarin type anticoagulants is recommended.

Flugal has been shown to prolong the serum half-life of concomitantly administed oral sulphonyl ureas (chlorpropamide, gilbenclamide, glipizide and tolbutamide) in healthy volunteers. Flugal and oral sulphonylureas may be co-administered to diabetic patients, but the possibility of a hypoglycemic episode should be borne in mind.

In a kinetic interaction study, co-administration of multiple-dose hydrochlorothiazide to healthy volunteers receiving fuconazole increased plasma concentrations of fuconazole by 40%. An efect of this magnitude should not necessitate a change in the fuconazole dose regimen in subjects recieving concomitant diureties, although the prescribers should bear it in mind.

Concomitant administration of fuconazole and phenytoin may increase the level of phenytoin to a clinically signifcant degree. Administration of fuconazole and rifampicin has resulted in a 25% decrease in the AUC and 20% shorter half-life of fuconazole. Patients recieving concomitant rifampicin, an increase in the fuconazole dose should be considered.

Two kinetic studies with combined oral contraceptive have been performed using muitiple dose of fuconazole. There were no relevant efects on either hormone level in the 50 mg fuconazole study, while at 200 mg daily the AUCs of ethinyl estradiol and levonorgestrel were increased 40% and 4% respectively. Thus multipule dose use of fuconazole at these dose is unlikely to have an efect on the efcacy of the combined oral contraceptives. Flugal 50 mg daily does not afect endogenous steroid levels in females. 200-400 mg daily has no clinically singnifcant efect on endogenous steroid levels or on ACTH stimulated response in healthy male volunteers.

A kinetic study in renal transplant patients found fuconazole 200 mg daily to slowly increase cyclosporin concentrations. However, in another multiple dose study with 100 mg daily, fuconazole did not afect cyclosporin levels in patients with bone marrow transplants. Cyclosporin plasma concentration monitoring in patients receiving fuconazole is recommended.

Interaction studies have shown that when oral fuconazole is co-administered with food. cemetidine, antacids or following total body irradiation for bone marrow transplantation, no clinically signifcant impairment of fuconazole absorption occurs.

In placebo-controlled interaction study, the administration of fuconazole 200mg for 14 days resulted in an 18% decrease, in the mean plasma clearance of theophyline, Patients who are receiving dose of theophyline or who are otherwise at increased risk for theophyline toxicity should be observed for sign of toxicity while receiving fuconazole, and the therapy modifed appropriately if sign of toxicity while receiving fuconazole, and the therapy modifed appropriately if sign of toxicity develop.

Physicians should be aware that drug-drug interaction studies with other medications have not been conducted, but that such interactions may occur.

Contraindications of Capsule :-Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses):-

 

Fluconazole should not be used in patients with known hypersensitivity to Fluconazole or to related triazole compounds.

Side Effects of Capsule :-Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses):-

 

Flugal is generally well tolerated. The commonest side-efects associated Flugal are symptoms associated with the gastrointestinal tract; these include nausea, abdominal discomfort, diarrhoea and fatulence. Other adverse events such as rash are rarely encountered (Incidence less than 1%). In rare cases, as with other azoles, anaphylaxis has been reported.

Pregnancy & Lactation of Capsule :-Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses):-

 

Fluconazole adverse fetal efects have been seen in animals only at dose levels associated with maternal toxicity. These levels are many times in excess of those recommended for therapeutic use. There has been little use during human pregnancy. Accordingly, fuconazole should not be used in pregnancy or in women of child bearing potential unless adequate contraception is employed.

Therapeutic Class of Capsule :-Flugal 200mg (As a Fluconazole AS A Drugs for subcutaneous and mycoses):-

 

Drugs for subcutaneous and mycoses

Antihistamin.

Tablet6. Cetirizine 10 mg (AS A Cetirizine Hydrochloride As a Sedating Anti-histamine).

Indications of Tablet:- Cetirizine 10 mg (AS A Cetirizine Hydrochloride As a Sedating Anti-histamine):-

 

Cetirizine is indicated for the relief of symptoms associated with seasonal & perennial allergic rhinitis. It is also indicated for the treatment of the uncomplicated skin manifestations of chronic idiopathic urticaria and allergen induced asthma.

Pharmacology of Tablet:- Cetirizine 10 mg (AS A Cetirizine Hydrochloride As a Sedating Anti-histamine):-

 

Cetirizine Hydrochloride is a potent H1 receptor antagonist without any significant anticholinergic and antiserotonic effects. At pharmacologically active dose levels, it has almost no drowsiness effect and does not cause behavioral changes. It inhibits the histamine-mediated early phase of the allergic reaction and also reduces the migration of inflammatory cells and the release of mediators associated with the late phase of the allergic reaction.

Pharmacokinetics: Cetirizine 10 mg achieves peak plasma concentrations of 257 mcg/L within one hour of administration (980 mcg/L in children). Food does not affect the extent of absorption, but it may slightly reduce the rate. Peak blood levels 0.3 micrograms/ml are reached between thirty & sixty minutes after administration of 10 mg dose of Cetirizine. Its plasma half-life is approximately 11 hours. Absorption is very consistent from one subject to the next. Its renal clearance is 30 ml/minute and the excretion half-life is approximately nine hours.

Dosage & Administration of Tablet:- Cetirizine 10 mg (AS A Cetirizine Hydrochloride As a Sedating Anti-histamine):-

 

Cetirizine oral dosage form:

  • Adults and Children 6 years and older: 1 tablet or 2 teaspoonfuls daily (or 1 teaspoonful twice daily).
  • Children 2-6 years: 1 teaspoonful once daily or 1/2 teaspoonful twice daily.
  • Children 6 months to 2 years : 1/2 teaspoonful once daily. The dose in children 12-23 months of age can be increased to a maximum dose as 1/2 teaspoonful every 12 hours.

Cetirizine injectable dosage form: Cetirizine is a single use injectable product for intravenous administration only. The recommended dosage regimen is once every 24 hours as needed for treatment of acute urticaria. Administer Cetirizine as an intravenous push over a period of 1 to 2 minutes. Cetirizine is not recommended in pediatric patients less than 6 years of age with impaired renal or hepatic function.

  • Adults and adolescents 12 years of age and older: The recommended dosage is 10 mg administered by intravenous injection.
  • Children 6 to 11 years of age: The recommended dosage is 5 mg or 10 mg depending on symptom severity administered by intravenous injection.
  • Children 6 months to 5 years of age: The recommended dosage is 2.5 mg administered by intravenous injection.

Interaction of Tablet:- Cetirizine 10 mg (AS A Cetirizine Hydrochloride As a Sedating Anti-histamine):-

 

No clinically significant drug interactions have been found with Theophylline, Azithromycin, Pseudoephedrine, Ketoconazole or Erythromycin and with other drugs.

Contraindications

It is contraindicated in patients with a history of hypersensitivity to Cetirizine or hydroxyzine.

Side Effects of Tablet:- Cetirizine 10 mg (AS A Cetirizine Hydrochloride As a Sedating Anti-histamine):-

 

The most common side effects that occurred more frequently on Cetirizine is somnolence.

Pregnancy & Lactation of Tablet:- Cetirizine 10 mg (AS A Cetirizine Hydrochloride As a Sedating Anti-histamine):-

 

US FDA Pregnancy Category of Cetirizine Hydrochloride is B. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed. Cetirizine Hydrochloride has been shown to be excreted in human milk. So, caution should be exercised when Cetirizine Hydrochloride is administered to a nursing woman.

ওভার-দ্য-কাউন্টার (OTC) এবং প্রেসক্রিপশন অ্যান্টিফাঙ্গাল ক্রিম, মলম, জেল, স্প্রে বা গুঁড়ো কার্যকরভাবে জক চুলকানির চিকিৎসা করে। এই পণ্যগুলিতে Clotrimazole, Miconazole , Tolnafatet বা Terbinafineরয়েছে ।

কিছু প্রেসক্রিপশন অ্যান্টিফাঙ্গাল ওষুধ হল বড়ি। এই বড়িগুলিতে Fluconazole , Itraconazole বা টেরবিনাফাইন থাকে।

আপনার ওষুধের সম্পূর্ণ কোর্স শেষ করা গুরুত্বপূর্ণ। আপনি যদি খুব শীঘ্রই বন্ধ করেন, আপনার জক চুলকানি ফিরে আসতে পারে এবং চিকিত্সা করা কঠিন হতে পারে।

প্রতিরোধপা বা নখের যেকোনো ছত্রাক সংক্রমণের চিকিৎসা করুন। কুঁচকি শুকনো রাখুন আঁটসাঁট পোশাক পরিহার করুন মোটা হলে ওজন কমান
ঔষধটপিকাল এন্টিফাঙ্গাল ওষুধগুলি

Raiyyan Tahsan Date:01-01-2024 Wednesday Time:-3-41-45 Pm

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