Lamisil AT/ Lotrimin AF

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nikei3ball

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Can someone please tell me what the abbreviations AT and AF stand for. Also, would anyone have a list of all the abbreviations used in medication names? Thanks.
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nikei3ball said:
Can someone please tell me what the abbreviations AT and AF stand for. Also, would anyone have a list of all the abbreviations used in medication names? Thanks.
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I've looked a few places online, and I can't find it. I'm not sure if the AT or AF are even significant. The significant part is that they are different drugs. The Lamisil AT is [FONT=helvetica,arial][SIZE=-1]terbinafine hydrochloride 1% and the Lamisil AF powder is [/SIZE].tolnaftate 1%.
Maybe people with access to drug information sites can help you more.
I don't know of any cheat sheets for abbreviations. You might find one in a pharmacy technician exam study guide.
 
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Lotrimin is pretty confusing:

Clotrimazole 1% (Lotrimin AF- Cr, Soln, Lotion)
Miconazole 1% (Lotrimin AF- Powders, Liq Spray)
Butenafine 1% (Lotrimin Ultra)
 
BMBiology said:
Lotrimin is pretty confusing:

Clotrimazole 1% (Lotrimin AF- Cr, Soln, Lotion)
Miconazole 1% (Lotrimin AF- Powders, Liq Spray)
Butenafine 1% (Lotrimin Ultra)
Click to expand...


Neither differs much when it comes to topical application. But 5-10% of clotrimazole is absorbed intra-vaginally and only about 1% of miconazole is absorbed by the same route. My noob recommendation to a female with a previous history of yeast infection would be to go with the miconazole. If she's never had a yeast infection before, she's going to the doctor with no recommendation from me.

I've used both preparations for athlete's foot. Both work.

My source is 'clinicalpharmacology.com' up to my noob recommendation and history of athlete's foot. :laugh:
 
twester said:
Neither differs much when it comes to topical application. But 5-10% of clotrimazole is absorbed intra-vaginally and only about 1% of miconazole is absorbed by the same route. My noob recommendation to a female with a previous history of yeast infection would be to go with the miconazole. If she's never had a yeast infection before, she's going to the doctor with no recommendation from me.

I've used both preparations for athlete's foot. Both work.

My source is 'clinicalpharmacology.com' up to my noob recommendation and history of athlete's foot. :laugh:
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Intravaginal absorptions spells trouble....

Fluconazole 150mg PO.
 
Butenafine and terbinafine kill the fungus while clotrimazole and miconazole only stop fungus growth. That's why butenafine and terbinafine relapse rate is lower than clotrimazole and miconazole. This is also why clotrimazole and miconazole require a 4 week treatment while butenafine and terbinafine only require 1-2 week treatment for onychomycosis.
 
Well, let's talk about Fungus.

Drug of choice for Candidiasis used to be Fluconazole. Now we have Candida albican....and non albican candida such as Krusei and glabrata. The latter 2 are known to be slightly more resistant. But how do we know if now generic and cost effective fluconazole IV will work against them? Or should we jump right into using new and expensive echinocandins?

Discussion?
 
twester said:
But 5-10% of clotrimazole is absorbed intra-vaginally and only about 1% of miconazole is absorbed by the same route. My noob recommendation to a female with a previous history of yeast infection would be to go with the miconazole.
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Can you provide a link regarding the intravaginal absorption of clotrimazole? According to the manufacturer, absorption is negligible with clotrimazole.

Also, miconazole is a potent inhibitor of CYP2C9 (even when used topically) so I wouldn't recommend it for patients taking warfarin (cause bleeding). =)
 
ZpackSux said:
Well, let's talk about Fungus.

Drug of choice for Candidiasis used to be Fluconazole. Now we have Candida albican....and non albican candida such as Krusei and glabrata. The latter 2 are known to be slightly more resistant. But how do we know if now generic and cost effective fluconazole IV will work against them? Or should we jump right into using new and expensive echinocandins?

Discussion?
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I think you went over everyone's head.
 
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ZpackSux said:
You think?

I can think of at least 1 person who may respond... :)
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Nein! We do not need to use "expensive echinocandins".

Zpack, what would the cost of those per dosage be? Surely, not something as cost effective as something like, perhaps:

flamethrower-754684.JPG


I mean, a lighter -> $1.... some hairspray ->$5... so for just $6/dose you get guaranteed eradication of all things molecular? yay!
 
ZpackSux said:
Well, let's talk about Fungus.

Drug of choice for Candidiasis used to be Fluconazole. Now we have Candida albican....and non albican candida such as Krusei and glabrata. The latter 2 are known to be slightly more resistant. But how do we know if now generic and cost effective fluconazole IV will work against them? Or should we jump right into using new and expensive echinocandins?

Discussion?
Click to expand...

Tall glass of bourbon whiskey, a nice smelling candle and some nice sounding music. It cures all I tell ya!
 
Requiem said:
Nein! We do not need to use "expensive echinocandins".

Zpack, what would the cost of those per dosage be? Surely, not something as cost effective as something like, perhaps:

flamethrower-754684.JPG


I mean, a lighter -> $1.... some hairspray ->$5... so for just $6/dose you get guaranteed eradication of all things molecular? yay!
Click to expand...


Ehh... we in the US like the minimize the effect of Adverse Reaction due to treatment... it's good to rid of yeast....but we hate to spend more on Silvadene cream..
 
acetyl said:
Tall glass of bourbon whiskey, a nice smelling candle and some nice sounding music. It cures all I tell ya!
Click to expand...

That doesn't cure...that's how you can get yeast..
 
ZpackSux said:
Ehh... we in the US like the minimize the effect of Adverse Reaction due to treatment... it's good to rid of yeast....but we hate to spend more on Silvadene cream..
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Ohh you minimize adverse reactions? interesting... see we cause maximal reaction so we get more $$ to fund our governments universal health care :D:D
 
Requiem said:
Ohh you minimize adverse reactions? interesting... see we cause maximal reaction so we get more $$ to fund our governments universal health care :D:D
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Let me make sure I don't ask for yeast treatment when in Canada unless I'm traveling with my firesuit.
 
ZpackSux said:
Let me make sure I don't ask for yeast treatment when in Canada unless I'm traveling with my firesuit.
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Dems fightin words. We couldnt use the flamethrower on you, since youre fresh out of america there'd be a layer of grease caked in from the air with all the fast food joints around, it'd be all too combustible... hard to manage. ;)

To keep these semi-related, my friend wrote Lamisil as the #1 treatment for tinea pedia on an exam, it was in the notes too but apparently it is Rx only, they almost made him retake the exam. It was an "OTC therapeutics" course. I wonder why Rx drugs were in the notes for that course, but I digress
 
I'm surprised you use a flamethrower at all. I would think most people up there would be worried about their crop being burned down. Canada is such a weird place, especially B.C., because all the houses have street lights inside their house.
 
acetyl said:
I'm surprised you use a flamethrower at all. I would think most people up there would be worried about their crop being burned down. Canada is such a weird place, especially B.C., because all the houses have street lights inside their house.
Click to expand...

No, that's actually a common misconception. Don't fret. The hesistation about flamethrowers isn't about crops -although thats legitimate- it's about our igloos melting!
 
ZpackSux said:
Well, let's talk about Fungus.

Drug of choice for Candidiasis used to be Fluconazole. Now we have Candida albican....and non albican candida such as Krusei and glabrata. The latter 2 are known to be slightly more resistant. But how do we know if now generic and cost effective fluconazole IV will work against them? Or should we jump right into using new and expensive echinocandins?

Discussion?
Click to expand...

Great question!

We'd want to get cultures...but as we know it takes longer to grow fungus than bacteria. So that leaves to the question, what do we emipirically cover with in the mean time? C. glabrata is known to have high resistance to fluconazole. First we'd want to take in account the clinical state of the patient...fever, immunocomp, previous infections, potentials for toxicities. Then we go from there...

We could start coverage with fluconazole and see how the patient reacts while we wait for cultures... Is the patient improving clinically or getting worse? If the patient was not improving we could then switch to an echinocandin. This is the more cost effective.

We could just start the echinocandin and wait for cultures....if it is candida albicans just switch to fluconazole and if not then keep the echinocandin on board. This is the one I see most often happen in the hospitals I've been to and my experience is that physicains will generally not switch to fluconazole if anything other than c. albicans grows out.
 
KARM12 said:
Great question!

We'd want to get cultures...but as we know it takes longer to grow fungus than bacteria. So that leaves to the question, what do we emipirically cover with in the mean time? C. glabrata is known to have high resistance to fluconazole. First we'd want to take in account the clinical state of the patient...fever, immunocomp, previous infections, potentials for toxicities. Then we go from there...

We could start coverage with fluconazole and see how the patient reacts while we wait for cultures... Is the patient improving clinically or getting worse? If the patient was not improving we could then switch to an echinocandin. This is the more cost effective.

We could just start the echinocandin and wait for cultures....if it is candida albicans just switch to fluconazole and if not then keep the echinocandin on board. This is the one I see most often happen in the hospitals I've been to and my experience is that physicains will generally not switch to fluconazole if anything other than c. albicans grows out.
Click to expand...

Great Answer.... spoken...I mean typed like a true PharmD candidate about to matriculate.

Glabrata isn't as resistant as we think... and MIC of 32 can be considered susceptible to fluconazole. But you're absolutely right... Candida susceptibility test takes a long time and there aren't many places that can do the test.

Krusei tends to be more resistant. So here we are as clinicians... what to do? It boils down to exactly what you described. Monitor the patient on fluconazole... or echinocandin is a sure thing.
 
BMBiology said:
Can you provide a link regarding the intravaginal absorption of clotrimazole? According to the manufacturer, absorption is negligible with clotrimazole.

Also, miconazole is a potent inhibitor of CYP2C9 (even when used topically) so I wouldn't recommend it for patients taking warfarin (cause bleeding). =)
Click to expand...

I did. Check the original post. If you don't have a subscription, then check the source for which you do.
 
Z, my oscillator lady was growing albicans and glabrata. we went with the expensive cancidas after some empiric stabs in a few other directions.
she seems to have responded, she's off the oscillator.
 
tussionex said:
Z, my oscillator lady was growing albicans and glabrata. we went with the expensive cancidas after some empiric stabs in a few other directions.
she seems to have responded, she's off the oscillator.
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Coolness!!
 
I should have said that's for clotrimazole. Thanks for the citation. =)
 
ZpackSux said:
Great Answer.... spoken...I mean typed like a true PharmD candidate about to matriculate.

Glabrata isn't as resistant as we think... and MIC of 32 can be considered susceptible to fluconazole. But you're absolutely right... Candida susceptibility test takes a long time and there aren't many places that can do the test.

Krusei tends to be more resistant. So here we are as clinicians... what to do? It boils down to exactly what you described. Monitor the patient on fluconazole... or echinocandin is a sure thing.
Click to expand...

There was a recent article published in NEJM that compared fluconazole to the new echinocandin in June. I believe the conclusion that the echinocandin was as effective as fluconazole, but never said that it was better.
 
ZpackSux said:
Well, let's talk about Fungus.

Drug of choice for Candidiasis used to be Fluconazole. Now we have Candida albican....and non albican candida such as Krusei and glabrata. The latter 2 are known to be slightly more resistant. But how do we know if now generic and cost effective fluconazole IV will work against them? Or should we jump right into using new and expensive echinocandins?

Discussion?
Click to expand...
I thought vori- and itra-conazole still had activity against the non-albicans Candida species. They would be cheaper the the echinocandins, and come PO in case we want to send the patient home.
 
KARM12 said:
There was a recent article published in NEJM that compared fluconazole to the new echinocandin in June. I believe the conclusion that the echinocandin was as effective as fluconazole, but never said that it was better.
Click to expand...

I don't believe that study was powered to determine the superiority of candins over fluconazole. I read it. I will need to download and save it to my archive.
 
DrugDealer said:
I thought vori- and itra-conazole still had activity against the non-albicans Candida species. They would be cheaper the the echinocandins, and come PO in case we want to send the patient home.
Click to expand...

Yes, triazoles have activity against non albicans and certainly against aspergillus. But Voriconazole studies in candedemia is little weak... there is a study comparing Vfend against AmphoB ... similar outcome but the clinical success rate against glabrata and krusei were less than stellar...33 percent and 25 percent.
 
ZpackSux said:
Yes, triazoles have activity against non albicans and certainly against aspergillus. But Voriconazole studies in candedemia is little weak... there is a study comparing Vfend against AmphoB ... similar outcome but the clinical success rate against glabrata and krusei were less than stellar...33 percent and 25 percent.
Click to expand...

Do you have a photographic memory or something? How do you know/remember so much? Daily application of information? What do I need to do to be where I should be in terms of what I need to know? I'm half-way done with school (haven't taken therapeutics yet) but I feel like I am nowhere NEAR knowing half of what many pharmacists (specifically people I work with) know. :confused: :mad:
 
trx said:
Do you have a photographic memory or something? How do you know/remember so much? Daily application of information? What do I need to do to be where I should be in terms of what I need to know? I'm half-way done with school (haven't taken therapeutics yet) but I feel like I am nowhere NEAR knowing half of what many pharmacists (specifically people I work with) know. :confused: :mad:
Click to expand...

LOL...no I do not have a photographic memory...but maybe a selective one.
I don't remember everthing I read. Just the things I want to remember.

But knowing this stuff is a part of my job and that is what I do. I probably spend a lot more time reading and researching than most pharmacists. I can't imagine how a retail pharmacist can keep up with it.

But when it comes to antimicrobials and hematopoietics, I do try to keep up with the latest info. Like I said before, it is a part of my job and it's what I do.

Ask me about hormone replacement therapy and I'll be scratching my head.
 
what do you need to do? well, you have to decide where your expertise will be in. Then delve into it. My P1 year, I decided antimicrobials were the most interesting drugs of all. Unlike other drugs that control disease symptoms, most antibiotics were a cure. I liked that.

By the end of P2, I had a solid grasp of antimicrobials. It didn't hurt that I interned at a Childrens Hospital with a large Heme/Onc unit with Bone Marrow transplant unit where we saw many neutropenic patients on heavy abx therapy.

My understanding of hematopoietics came by as a default. Because it's a class which levies a heavy burden on pharmacy financials, I needed to know how to control the usage. To prevent financial toxicity in the pharmacy, you must have a full clinical grasp of that particular class of medication.

Some of my collegues are spew off things about anesthesia gas and neuro muscular blockers which makes me dizzy. Then there are other who can talk about ISMP and the Joint Commission Regs.. where I give a blank stare.

Then there is SDN1977 who can talk about everything and write a chapter about.
 
trx said:
Do you have a photographic memory or something? How do you know/remember so much? Daily application of information? What do I need to do to be where I should be in terms of what I need to know? I'm half-way done with school (haven't taken therapeutics yet) but I feel like I am nowhere NEAR knowing half of what many pharmacists (specifically people I work with) know. :confused: :mad:
Click to expand...


also, you know how Z said he was going to download a study and place in his archives? do that. always know where you keep info that you dont need all the time, but you can find it quickly.

you dont have to know everything, but you have to know where to look!:thumbup:
 
tussionex said:
also, you know how Z said he was going to download a study and place in his archives? do that. always know where you keep info that you dont need all the time, but you can find it quickly.

you dont have to know everything, but you have to know where to look!:thumbup:
Click to expand...

Actually I have 2 external hard drives, 250GB and 80GB. The 80GB is portable which I take with me on business trips. Then I back up the 80GB HD to 250GB HD weekly. I also have all my picture files in the 250GB...which I should back up to another drive....:smuggrin:

So when I'm not emailing my files to DOPs and clinical coordinators, when on site I will stick my HD directly into their port and they can download all they can handle... :smuggrin::smuggrin::smuggrin: that just didn't sound right..
 
WOW, I have a lot to learn!:eek:
 
ehh...golf is much harder than pharmacy...
 
you're a perv, zpak...

i need an external HD, esp for photos...they are just clogging my machine
 
ZpackSux said:
I don't believe that study was powered to determine the superiority of candins over fluconazole. I read it. I will need to download and save it to my archive.
Click to expand...

No it wasn't powered to detect a difference.
 
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