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INTRODUCTION

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butenafine (byoo-ten-a-feen)

Lotrimin Ultra, Mentax

Classification

Therapeutic: antifungals (topical)

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Indications
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Treatment of a variety of cutaneous fungal infections, including tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (ringworm), and tinea versicolor.

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Action
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Affects the synthesis of the fungal cell wall. Therapeutic Effects: Decrease in symptoms of fungal infection.

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Adverse Reactions/Side Effects
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Local: burning, itching, local hypersensitivity reactions, redness, stinging.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Assess healing of skin lesions to help document drug effectiveness.

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Interventions
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  • Avoid contact with cutaneous lesions when treating patient.

  • Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection.

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Patient/Client-Related Instruction
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  • Advise patient to report any increased local sensitivity to this drug (pain, burning, itching, swelling).

  • Instruct patient about proper hygiene, e.g., thoroughly wash and dry the affected area, wear clean socks and ventilated shoes for tinea pedis, and so forth.

  • Advise patient to apply the drug as directed for the full course of treatment even if feeling better.

  • Inform patient that early relief of cutaneous symptoms may be seen in 2–3 days. Full therapeutic response may take 2 wk for tinea cruris, tinea corporis, and tinea versicolor and 4 weeks for tinea pedis.

  • Advise patient to seek medical help if infections persist or recur after the full treatment. Recurrent fungal infections may be a sign of systemic illness.

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Pharmacokinetics
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Absorption: Absorption through intact skin is minimal.

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Distribution: Distribution after topical administration is primarily local.

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Metabolism and Excretion: Hepatic via hydroxylation.

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Half-life: 35 hr.

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TIME/ACTION PROFILE

ROUTE ONSET PEAK DURATION
topical unknown up to 4 wk unknown

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity to active ingredients, additives, preservatives, or bases; Some products contain alcohol or bisulfites and should be avoided in patients with known intolerance.

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Use Cautiously in: Nail and scalp infections (may require additional systemic therapy); OB/Lactation: Safety not established.

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Interactions
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Drug-Drug: None significant.

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Route/Dosage
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Topical (Adults and Children >12 yr): Apply once daily for 2 wk for patients with tinea corporis, tinea cruris, or tinea versicolor. Apply once daily for 4 wk or twice daily for 7 days for patients with tinea pedis.

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Availability
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Cream: 1% Rx, OTC.

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