Generic Name : nystatin Brand Name: Oral, oral suspensions, oral troche: Candistatin (CAN), Mycostatin, Nilstat, PMS

Nystatin (CAN), ratioNystatin (CAN) Vaginal preparations: Mycostatin Topical application: Mycostatin, Nilstat Therapeutic actions: Nystatin, a polyene antifungal, binds to ergosterol in the fungal cell membrane. This binding affects the cell wall permeability allowing leakage of cellular contents. Indications Oral: Treatment of oropharyngeal candidiasis Oral suspension, troche: Treatment of oral candidiasis Vaginal: Local treatment of vaginal candidiasis (moniliasis) Topical applications: Treatment of cutaneous or mucocutaneous mycotic infections caused by Candida albicans and other Candida species Adverse effects Diarrhea, GI distress, nausea and vomiting. vaginal pessaries/cream: May damage latex contraceptives (e.g. diaphragms, condoms), additional contraceptive measures should be taken. Topical application: Irritation. Contraindications: Hypersensitivity. Nursing considerations Assessment History: Allergy to nystatin or components used in preparation, pregnancy, lactation Physical: Skin color, lesions, area around lesions; bowel sounds; culture of area involved Interventions

Culture fungus before therapy. Have patient retain oral suspension in mouth as long as possible before swallowing. Paint suspension on each side of the mouth. Continue local treatment for at least 48 hr after clinical improvement is noted. Prepare nystatin in the form of frozen flavored popsicles to improve oral retention of the drug for local application. Administer nystatin troche orally for the treatment of oral candidiasis; have patient dissolve 12 tablets in mouth. Insert vaginal suppositories high into the vagina. Have patient remain recumbent for 1015 min after insertion. Provide sanitary napkin to protect clothing from stains. Cleanse affected area before topical application unless otherwise indicated. Monitor response to drug therapy. If no response is noted, arrange for further cultures to determine causative organism. Ensure that patient receives the full course of therapy to eradicate the fungus and to prevent recurrence. Discontinue topical or vaginal administration if rash or sensitivity occurs.

Teaching points

Take the full course of drug therapy even if symptoms improve. Continue during menstrual period if vaginal route is being used. Long-term use of the drug may be needed; beneficial effects may not be seen for several weeks. Vaginal suppositories should be inserted high into the vagina. Use appropriate hygiene measures to prevent reinfection or spread of infection. This drug is for the fungus being treated; do not self-medicate other problems. Refrain from sexual intercourse or advise partner to use a condom to avoid reinfection; use a sanitary napkin to prevent staining of clothing with vaginal use. You may experience these side effects: Nausea, vomiting, diarrhea (oral use); irritation, burning, stinging (local use). Report worsening of condition; local irritation, burning (topical application); rash, irritation, pelvic pain (vaginal use); nausea, GI distress (oral administration).