Tolnaftate (Tinactin, Aftate)
ACTION AND USE.— Tolnaftate was the first fungicide synthesized. It is effective in the treatment of superficial fungal infections of the skin. It is indicated for the topical treatment of tinca pedis (athlete’s foot), tinca corporis (body ringworm), tines capitis (fungus infection of the scalp), and tines versicolor.
USUAL DOSE.— It is for topical use only and is available in cream, gel, powder, and solution. Only small quantities are required for effective treatment. Apply twice daily to the affected area for 2 to 3 weeks.
Clotrimazole (Lotrimin, Mycelex)
ACTION AND USE.— This is a broadspectrum antifungal that inhibits the growth of pathogenic dermatophytes, yeasts, and other types of fungus growth, including Candida albicans. It is indicated for the treatment of tinea pedis, tinea cruris, tines corporis, and candidiasis.
USUAL DOSE.— It is for topical use only. It is available in cream and solution. It is also available in a vaginal cream for the treatment of vulvovaginal candidiasis. Apply twice daily to the affected area for two weeks. A single daily vaginal application for two weeks is generally sufficient for cure.
ANTIPARASITICS
Parasitic infections or infestations account for the largest number of chronic disabling diseases known. They are especially prevalent in the tropics or subtropics and in lesser developed countries where overcrowding and poor sanitation exist. Parasitic infections include protozoal infections, i.e., malaria, amebiasis, and to a lesser extent, trichomoniasis; helminthic infections (intestinal worms), and ectoparasites. Ectoparasites, although not disabling, are considered a nuisance and can transmit disease.
Lindane (Kwell) (Old name: Gamma Benzene Hexachloride)
ACTION AND USE.— Lindane is a pediculocide used in the treatment of Pediadosis capitis (head lice) and Phthirus pubis (crab lice). It is also indicated for scabies. Use with caution, especially in infants, children, and pregnant women, since it penetrates human skin and has the potential for systemic poisoning. This drug is irritating to the eyes and should be discontinued immediately if local irritation occurs.
USUAL DOSE.— As a 1 percent cream, lotion, or shampoo, it is for topical use only. A single application is usually sufficient to kill parasites and their eggs, but it may be repeated in 7 days.
Crotamiton (Eurax)
ACTION AND USE.— This is a scabicide indicated for the treatment of scabies (Sarcoptes scabiei); it also has an antipruitic effect. Keep away from the eyes and mouth, and do not apply to inflamed skin.
USUAL DOSE.— For topical use only, it is available in a 10 percent cream or lotion. Thoroughly massage into the skin of the whole body from the chin down for scabies treatment. A second application is often advisable in 24 hours.
Metronidazole (Flagyl)
ACTION AND USE.— Metronidazole is effective in the treatment of all forms of amebiasis. It is also used as a trichomonacide.
USUAL DOSE.— For amebiasis, give 500 to 750 mg three times daily for 5 to 10 days. For trichomoniasis, give 2 g as a single dose or 250 mg three times daily for 7 days. Take with food or milk. NOTE: DO NOT DRINK ANY ALCOHOLIC BEVERAGES; IT MAY CAUSE A “DISULFRAM” REACTION. Metronidazole is contraindicated in pregnant women during the first trimester.
Chloroquine Phosphate (Aralen)
ACTION AND USE.— Chloroquine phosphate is the drug of choice in the treatment of acute malarial attacks and severe disease and in the prevention and suppression of malaria in endemic areas.
USUAL DOSE.— It is generally administered once a week while in an endemic area as a prophylactic agent.