One Peer responses per each discussion total 2. Remember to including the citation no less than 5 year . Discussion Attached

Garcia

Onychomycosis is an infection of the nail that can be caused by a fungi known as dermatophytes. The most frequent culture for onychomycosis is Trichophyton rubrum, which has evolved to become more pathogenic (Piraccini, & Alessandrini, 2015). The treatment of onychomycosis may vary on the clinical type, the degree of involvement, and the thickness of the infected nail plate. Additionally, as health care providers we need to have in consideration that treatment also can be based on the host resistance, genetic susceptibility, and the pathogenicity of the fungal strain help account for a patient’s overall infection severity and helps predict the likelihood of cure. 

The standard gold treatment for onychomycosis is systemic. The disadvantages for this treatment is that oral treatments are often limited due to drug interactions and potential hepatotoxicity, while topical antifungals have a limited efficacy if medication is used without nail plate debridement. Patient can used a combination of both oral and systemic treatment which is  often the best choice. The most common medication treatment includes griseofulvin, ketoconazole, itraconazole, or terbinafine. Furthermore, topical treatment is usually not effective, with exception of ciclopirox nail lacquer (Del Rosso, 2015). As NP Terbinafine should be prescribed to the patient to take for 12 weeks. 

 

Write her complete prescriptions using the prescription writing format in your textbook. 

Terbinafine 250 mg take one tablet by mouth daily for 12 weeks

What labs for baseline and follow up of therapy would you order for this patient? 

Terbinafine is one of the antifungal medication used to treat fungal infections.This oral and topical active allylamine fungicidal agent is used to treat superficial fungal infections of the skin and nails. Terbinafine has been linked to acute liver injury that can be severe. This drug can induced to liver injury. Liver enzymes and complete blood count should be monitored every six weeks if this treatment lasts longer than six weeks (Elewski &Tavakkol, 2015). 

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Mirabal 

The most appropriate diagnostic techniques for detecting onychomycosis involve a combination of direct microscopy and the development of a fungal culture to increase the accuracy of the diagnosis (Scher et al., 2017). 

 

        Follow Up

           The recurrence of onychomycosis after successful treatment is common among patients. Systemic Terbinafine treatment effectively cures onychomycosis, but the patient should be followed up to ensure the patient does not keep exposed to the predisposing factors. The patient should avoid nail lacquer usage for prophylactic treatment.