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Nystatin
Action:
Binds with sterols in fungal cell membrane allowing intercellular contents to leak out resulting in death.
Uses:
To treat cutaneous, vaginal, intestinal, or oral infections caused by Candida.
Adverse Effect:
PO-none
High doses can cause nausea & vomiting, diarrhea.
Topical - skin irritation
Vaginal - vaginal irritation.
Nursing Implications:
Topical:
- Keep area clean & dry
- Rub well into affected areas
- Inspect mucus membranes for irritation.
- Remove and soak the client's dentures.
Vaginal:
- Insert high in the vagina
- Continue during menses - do not use tampons
- See physician regarding sexual intercourse.
Patient Teaching
Do not miss the doses
Notify doctor if nausea, vomiting, diarrhea develops.
Physiology of Fungal Growth
- Fungi can be separated into 2 groups - Yeast, and mold.
- Normally the body has yeast colonies of candida on the skin, mucous membranes, and GI tract.
- Intact immune mechanisms and competition for nutrients, provided by the body's normal bacterial flora, ordinarily keep colonizing fungal overgrowth and opportunistic infections.
Mycotic Infections by Candida
In the mouth - Oral candidiasis or thrush
- At risk: newborn infants, immunocompromised patients, patients on antibiotics
- Characterized by painless, white plaques that adhere to the oral and pharyngeal mucosa.
Vulvovaginal candidas.
- "yeast infection"
- At risk: pregnancy, diabetes mellitus, oral contraceptives, antibiotics.
- Thick, white vaginal discharge, inflammation of the perineal area and spread to buttocks and thighs.
Skin candidiasis
- At risk: patients with continuously moist skin folds or moist surgical dressings.
- Also called "diaper rash"
- Skin lesions are red and macerated.
Interstinal candidiasis
- Occurs after prolonged broad-spectrum antibiotic use.
- Symptoms include bloating, diarrhea, anal itching.
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