AlAbleg Clinical Dermatology channel اشراف د. محمد عثمان أستشاري الجلدية

Meeting No. 5
Dr Nadia Hassanein
Demodicosis

Mycetoma with Prof. Ahmed Alfahal video lecture

https://drive.google.com/file/d/1FQVrwK68MP4NLB8D2MeiNGeser8yFo6W/view?usp=drivesdk

Meeting No. 3
Erectile Dysfunction

Meeting No 2
HIV challenging cases

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Itraconazole is an antifungal medication commonly used to treat various fungal infections, including onychomycosis, histoplasmosis, and aspergillosis. While it is generally effective, it can have several potential complications and side effects, particularly with long-term use or in patients with certain risk factors.

Common Side Effects:
1. Gastrointestinal Issues:
- Nausea, vomiting, diarrhea, and abdominal pain are relatively common side effects.

2. Headache and Dizziness:
- Some patients may experience headaches or dizziness, which are usually mild but can affect daily activities.

3. Rash:
- Skin rashes can occur, which may indicate a hypersensitivity reaction.

Serious Complications:
1. Hepatotoxicity:**
- Itraconazole can cause liver damage, leading to elevated liver enzymes, jaundice, or even severe hepatic failure. Liver function should be monitored regularly during treatment.

2. Cardiac Effects:
- Itraconazole has been associated with negative inotropic effects, which can worsen heart failure. It is contraindicated in patients with congestive heart failure or left ventricular dysfunction.

3. Drug Interactions:
- Itraconazole is a potent inhibitor of cytochrome P450 3A4 (CYP3A4), which can lead to significant drug interactions. It can increase the plasma levels of drugs metabolized by CYP3A4, such as certain statins, benzodiazepines, and calcium channel blockers, potentially leading to toxicity.

4. Peripheral Neuropathy:
- Long-term use of itraconazole has been associated with peripheral neuropathy, characterized by tingling, numbness, or pain in the extremities.

5. Hypokalemia:
- Itraconazole can cause low potassium levels (hypokalemia), which may require monitoring and supplementation.

6. Endocrine Effects:
- There have been reports of itraconazole affecting the adrenal glands, leading to adrenal insufficiency, particularly in patients receiving long-term therapy.

7. QT Prolongation:
- Itraconazole can prolong the QT interval on an ECG, which can increase the risk of arrhythmias like Torsades de Pointes.

Monitoring:
- Liver Function Tests (LFTs):
Regular monitoring is recommended to detect hepatotoxicity early.
- Electrolytes and ECG:
Monitoring potassium levels and ECGs may be necessary in patients at risk of QT prolongation or cardiac issues.
- Drug Levels:
In some cases, itraconazole levels may be monitored to ensure therapeutic but not toxic levels, especially when used with other medications that interact with CYP3A4.

Precautions:
- Itraconazole should be used cautiously in patients with existing liver disease, heart failure, or those on multiple medications with potential drug interactions.