griseofulvin and Vomiting

Topics: Griseofulvin; Hair; Headache; Humans; Nails; Nausea; Onychomycosis; Porphyrins; Tinea; Tinea Capitis; Tinea Pedis; Trichophyton; Vomiting

Scopulariopsis brevicaulis is a common non-dermatophyte mould that can cause onychomycosis.. To evaluate the efficacy and safety of the oral antifungal agents griseofulvin, ketoconazole, itraconazole, fluconazole and terbinafine in the treatment of S. brevicaulis.. In a prospective, comparative, parallel-group, single-blinded, randomized, non-industry-sponsored study, patients with toe onychomycosis caused by S. brevicaulis sp. were randomized and treated with one of 5 oral antifungal agents, i.e. griseofulvin, ketoconazole, itraconazole (pulse), fluconazole or terbinafine. The treatment regimens were: griseofulvin 600 mg twice daily for 12 months, ketoconazole 200 mg daily for 4 months, itraconazole pulse therapy given for 3 pulses, with each pulse consisting of 200 mg twice daily for 1 week with 3 weeks off between successive pulses, terbinafine 250 mg daily for 12 weeks and fluconazole 150 mg daily for 12 weeks.. There were 59 patients (48 males, 11 females, mean age 35.6 years, range 25-53 years). All patients had clinical evidence of distal and lateral onychomycosis, with moderate to severe disease of the target nail. Between the treatment groups there was no significant difference in the mean age of the patients or the mean area of involvement with onychomycosis at baseline. The efficacy parameters were clinical cure (CC) and mycological cure (MC). At month 12 after the start of treatment, the response was: griseofulvin, CC 3/11, MC 0/11, CC + MC 0/11; ketoconazole, CC 10/12, MC 8/12, CC + MC 8/12; itraconazole, CC 12/12, MC 12/12, CC + MC 12/12; terbinafine, CC 12/12, MC 11/12, CC + MC 11/12, and fluconazole, CC 8/12, MC 8/12, CC + MC 8/12. Adverse effects consisted of: griseofulvin, gastro-intestinal symptoms, allergic reaction, photodermatitis, hepatic and renal dysfunction in 11 patients with discontinuation of treatment in 3 patients; ketoconazole, hepatic dysfunction but no symptomatic changes in 2 patients; itraconazole, nausea and vomiting in 2 patients; terbinafine, taste disturbance in 2 patients, nausea in 3 patients, and fluconazole, severe gastro-intestinal events in 5 patients. None of the patients receiving ketoconazole, itraconazole, terbinafine or fluconazole discontinued treatment.. Itraconazole and terbinafine demonstrate efficacy against some cases of S. brevicaulis toe onychomycosis. These agents also appear to be safe in the course of therapy for toe onychomycosis. Griseofulvin is ineffective against toe onychomycosis caused by S. brevicaulis. Ketoconazole is not recommended for toe onychomycosis given its potential for adverse effects, particularly with the availability of the newer antifungal agents.

Topics: Adult; Antifungal Agents; Female; Fluconazole; Follow-Up Studies; Foot Dermatoses; Gastrointestinal Diseases; Griseofulvin; Humans; Itraconazole; Male; Middle Aged; Mitosporic Fungi; Naphthalenes; Nausea; Onychomycosis; Photosensitivity Disorders; Prospective Studies; Single-Blind Method; Terbinafine; Treatment Outcome; Vomiting

Drug-alcohol interactions in patients who present to emergency departments with a severe "disulfiram-like" illness (including vomiting, diarrhea, flushing, tachycardia, and hypotension) must be recognized and treated appropriately. We report a case of such an interaction caused by oral griseofulvin and alcohol. Emergency physicians should be aware of this potential interaction.

Topics: Drug Synergism; Ethanol; Flushing; Griseofulvin; Humans; Hypotension; Male; Middle Aged; Onychomycosis; Paresthesia; Tachycardia; Vomiting

Topics: Abnormalities, Drug-Induced; Chemical and Drug Induced Liver Injury; Diarrhea; Down Syndrome; Eczema; Female; Fetus; Griseofulvin; Headache; Humans; Liver; Nausea; Photosensitivity Disorders; Pregnancy; Surveys and Questionnaires; Vomiting

Topics: Adolescent; Adult; Aged; Blood Sedimentation; Child; Child, Preschool; Chronic Disease; Dermatomycoses; Eosinophilia; Feeding and Eating Disorders; Female; Griseofulvin; Headache; Humans; Infant; Leukocytosis; Mycoses; Nausea; Suspensions; Tinea; Tinea Favosa; Vomiting