Antifungal Drug - Nystatin

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.

 

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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.