A 38-year-old woman has been taking oral ketoconazole for four weeks. She presents with fatigue, nausea, dark urine, and yellow discoloration of the eyes.
Nephrotoxicity
Cardiotoxicity
Hepatotoxicity
Ototoxicity
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Clinical Scenario 2:
A 30-year-old patient visits a dermatologist with ring-shaped, itchy lesions on the skin. The doctor prescribes ketoconazole cream. Ketoconazole is primarily used to treat:
Bacterial Infection
Viral Infection
Fungal Infection
Parasitic Infection
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The combination of fatigue, nausea, dark urine, and yellow discolouration of the eyes (scleral icterus) are classic presentations of jaundice and liver injury. Oral ketoconazole carries a well-known, black box warning for severe hepatotoxicity (liver damage), which requires routine monitoring of liver function tests (LFTs).
Clinical Scenario 2:
The “ring-shaped, itchy lesions” describe tinea corporis (commonly known as ringworm), which is superficial fungal infection. Ketoconazole belongs to the azole class of medications, which work by inhibiting the synthesis of ergosterol, an essential component of fungal cell membranes.
Great addition to the Drug of the Week series! These two scenarios perfectly illustrate the critical clinical distinction between systemic and localised therapy.
Scenario 1 is exhibiting classic signs of jaundice due to oral ketoconazole-induced Hepatotoxicity.
Scenario 2 highlights its traditional role against superficial Fungal Infections. It’s a classic reminder to always opt for localised topical azoles whenever possible to spare the patient’s liver