College of Our Lady of Mt.

Carmel
Bachelor of Science in Nursing Department

COLLEGE DEPARTMENT
College of Our Lady of Mt. Carmel
Bachelor of Science in Nursing
S.Y 2022-2023

PHARMACOLOGY

Submitted by:
De Jesus, Fatima Kate M.
BSN 2

Submitted to:

Mr. Rogelio Canlas Jr.

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 College of Our Lady of Mt. Carmel
Bachelor of Science in Nursing Department

DRUG STUDY
Terbinafine is an antifungal drug. It is used to treat fungal (yeast) skin infections
such athlete's foot, fungal nail infections, ringworm, jock itch (also known as
dhobie itch, an infection in the groin area), and pityriasis versicolor (this causes
small patches of scaly and discoloured skin, often on your back, chest, upper arms,
neck and tummy). For the treatment of jock itch, athlete's foot, ringworm, and
pityriasis versicolor, terbinafine is available as a cream, gel, or spray. A liquid
(solution) is also available for athlete's foot. These are available at a drugstore or a
grocery store.

Additionally, it is available in tablet form to treat various fungal diseases and nail
fungus. If your doctor believes that creams, gels, sprays, or solutions are not likely
to be effective, they may suggest pills.

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 College of Our Lady of Mt. Carmel
Bachelor of Science in Nursing Department

GENERIC NAME:
Terbinafine

BRAND NAME:
Lamisil

CLASSIFICATION:
PHARMACOTHERAPEUTIC: Synthetic allylamine derivative.
CLINICAL: Antifungal.

PREGNANCY CATEGORY:

Category B

INDICATIONS:
Do not confuse LamISIL with LaMICtal, or terbinafine with terbutaline.

ACTION:

Inhibits the enzyme squalene epoxidase, thereby interfering with fungal

biosynthesis.
Therapeutic Effect: Results in death of fungal cells.
PHARMACOKINETICS
Well absorbed following PO administration. Protein binding: 99%.
Metabolized in liver. Primarily excreted in urine; minimal excretion in
feces. Half-life: PO, 36 hrs; topical, 22–26 hrs. Lifespan considerations

Pregnancy/Lactation:
Distributed in breast milk. Children: Safety and efficacy not established in
children younger than 4 yrs of age. Elderly: Age-related renal impairment

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 College of Our Lady of Mt. Carmel
Bachelor of Science in Nursing Department

may require dosage adjustment.

CONTRAINDICATION/PRECAUTION:
Contraindications: Hypersensitivity to terbinafine. Chronic or active
hepatic disease.
Cautions: Preexisting hepatic or renal impairment (CrCl 50 mL/min or
less), sensitivity to allylamine antifungals (e.g., butenafine). Not
recommended in pts with active or chronic hepatic disease

ADVERSE REACTION/SIDE EFFECTS:

Side effects: Frequent (13%): PO: Headache. Occasional (6%–3%): PO:
Abdominal pain, flatulence, urticaria, visual disturbance. Rare: PO:
Diarrhea, rash, dyspepsia, pruritus, altered taste, nausea. Topical: Irritation,
burning, pruritus, dryness.
Adverse effects: Hepatobiliary dysfunction (including cholestatic
hepatitis), serious skin reactions, severe neutropenia occur rarely. Ocular
lens, retinal changes have been noted.

INTERACTIONS:
DRUG: Alcohol, other hepatotoxic medications (e.g., acetaminophen,
amiodarone, ketoconazole, isoniazid) may increase risk of hepatotoxicity.
CYP3A inducers (e.g., carBAMazepine, phenytoin, rifAMPin) may
increase clearance. CYP3A inhibitors (e.g., clarithromycin, ketoconazole,
ritonavir) may decrease clearance. HERBAL: None significant. FOOD:
None known. LAB VALUES: May increase serum ALT, AST
DOSAGE:
Tinea Pedis
o Topical: ADULTS, ELDERLY, CHILDREN 12 YRS AND

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 College of Our Lady of Mt. Carmel
Bachelor of Science in Nursing Department

OLDER: (Cream): Apply once or twice daily for at least 1 wk.

(Gel/Solution): Apply once daily for at least 1 wk. Tinea Cruris,
Tinea Corporis
o Topical: ADULTS, ELDERLY, CHILDREN 12 YRS AND
OLDER: Apply once daily for at least 1 wk until signs/symptoms
significantly improve; not to exceed 4 wks.
Onychomycosis
o Note: Continue for 6 wks. PO: ADULTS, ELDERLY,
CHILDREN 12 YRS AND OLDER: 250 mg/day for 6 wks
(fingernails) or 12 wks (toenails).
Tinea Versicolor
o Topical Solution: ADULTS, ELDERLY: Apply to the affected area
once or twice daily for 7 days.
Tinea Capitis
o Note: Continue for 6 wks. PO:ADULTS, ELDERLY: 250 mg once
daily. CHILDREN 4 YRS AND OLDER: (Use granules).
WEIGHING GREATER THAN 35 KG: 250 mg once daily.
WEIGHING 25–35 KG: 187.5 mg once daily. WEIGHING LESS
THAN 25 KG: 125 mg once daily.
Dosage in Renal Impairment
o No dose adjustment.
Dosage in Hepatic Impairment
o Not recommended in pts with active or chronic hepatic disease.

ROUTE:
Terbinafine is formulated as a 250 mg tablet to be taken (PO) by mouth.
Terbinafine is applied to the skin to treat: ringworm of the body.

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 College of Our Lady of Mt. Carmel
Bachelor of Science in Nursing Department

NURSING CONSIDERATION
Baseline assessment
Serum LFT should be obtained in pts receiving treatment for longer than 6
wks.

Intervention/evaluation
Check for therapeutic response. Discontinue medication, notify physician if
local reaction occurs (irritation, redness, swelling, pruritus, oozing,
blistering, burning). Monitor LFT in pts receiving treatment for longer than
6 wks.

Patient/family teaching
Keep areas clean, dry; wear light clothing to promote ventilation.
Avoid topical cream contact with eyes, nose, mouth, other mucous
membranes.
Rub well into affected, surrounding area.
Do not cover with occlusive dressing.
Report rash, dark urine, abdominal pain, anorexia, yellowing of skin.

POSSIBLE NURSING DIAGNOSIS:

Risk for impared skin integrity R/T treatment of variety of cutaneous fungal
infections.

REFERENCES:
SAUNDERS NURSING DRUG HAND BOOK 2019
http://repo.stikesperintis.ac.id/1035/1/78%20SAUNDERS%20NURSING%20DRU
G%20HANDBOOK%202019.pdf

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