Dermatology Case Study
Dermatology Case Study
According to the Centers for Disease Control and Prevention (CDC) (2020), the first-line medication for onychomycosis is terbinafine (lamsil). The course of treatment is 12 weeks for toenails, while fingernails require 6 weeks of treatment (CDC, 2020). Based on the patient’s symptoms and diagnosis, the recommended dosage for Terbinafine is 250 mg, 1 tablet, PO daily, for 12 weeks.
The labs for baseline when prescribing terbinafine include complete blood count (CBC) and platelet count, which are collected if the patient is immunodeficient, serum creatinine, Alanine Aminotransferase (ALT), and Aspartate Aminotransferase. The protocol for monitoring include baseline labs, the CBC should be repeated after 6 weeks of continuous use of the drug if the patient is immunodeficient, and liver function tests (LFT) every 4-6 weeks, if the patient is at the risk of drug-induced liver injury due to use of hepatotoxic medication s or if there are symptoms of liver problems. Baseline laboratory tests are checked before prescribing terbinafine and periodic monitoring of the laboratory results is required for early detection of abnormalities (Stolmeier et al., 2018).
A follow-up would be ordered for E.D. since she has type 2 diabetes mellitus (T2DM). Type 2 diabetes mellitus is associated with the development of nonalcoholic fatty liver disease (Dharmalingam et al., 2018). As such, it would be advisable to do LFT every 4 weeks to 6 weeks on the course of her treatment to monitor her liver function and discontinue the treatment if abnormalities are detected. The follow-up protects the patient from potential harm that could arise from abnormalities.
