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Generic Name : nystatin

Brand Name:

Oral, oral suspensions, oral troche: Candistatin (CAN), Mycostatin, Nilstat, PMS Nystatin (CAN), ratio-

Nystatin (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 Candidaalbicans 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 forlocal application.

Administer nystatin troche orally for the treatment of oral candidiasis; have patient dissolve 12tablets in mouth.

Insert vaginal suppositories high into the vagina. Have patient remain recumbent for 1015 minafter 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 preventrecurrence.

Discontinue topical or vaginal administration if rash or sensitivity occurs.

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Teaching points

Take the full course of drug therapy even if symptoms improve. Continue during menstrual periodif vaginal route is being used. Long-term use of the drug may be needed; beneficial effects maynot 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, pelvicpain (vaginal use); nausea, GI distress (oral administration).