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INTRODUCTION

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clotrimazole (topical) (kloe-try-ma-zole)

Image not available.Canesten, Image not available.Clotrimaderm, Cruex, Image not available.Lotriderm, Lotrimin

clotrimazole (vaginal) (kloe-try-ma-zole) Image not available.Canesten, Image not available.Clotrimaderm, Gyne-Lotrimin-3, Mycelex-7, Image not available.Trivagizole-3

Classification

Therapeutic: antifungals (topical, vaginal)

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Indications
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Treatment of a variety of cutaneous fungal infections, including cutaneous candidiasis, tinea pedis (athlete's foot), tinea cruris (jock itch), tinea corporis (ringworm), and tinea versicolor. Treatment of vulvovaginal candidiasis.

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Action
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Affects the permeability of the fungal cell wall, allowing leakage of cellular contents. Therapeutic Effects: Decrease in symptoms of fungal infection.

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Adverse Reactions/Side Effects
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Local: burning, itching, local hypersensitivity reactions, redness, stinging.

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PHYSICAL THERAPY IMPLICATIONS

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Examination and Evaluation
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  • Monitor symptoms and healing of skin lesions to help document drug effectiveness.

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Interventions
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  • Avoid contact with cutaneous lesions when treating patient.

  • Always wash hands thoroughly and disinfect equipment (whirlpools, electrotherapeutic devices, treatment tables, and so forth) to help prevent the spread of infection.

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Patient/Client-Related Instruction
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  • Advise patient to report any increased local sensitivity to this drug (pain, burning, swelling).

  • Instruct patient about proper hygiene; e.g., thoroughly wash and dry the affected area, wear clean socks and ventilated shoes for tinea pedis, and so forth.

  • Advise patient to apply the drug as directed for the full course of treatment even if feeling better.

  • Inform patient that early relief of cutaneous symptoms may be seen in 2–3 days. Full therapeutic response may take 2 wk for cutaneous candidiasis, tinea cruris, and tinea corporis and 3–4 wk for tinea pedis.

  • Vaginal infections: therapeutic response is usually seen after 1 wk. Therapy should be continued during menstrual period.

  • Advise patient to seek medical help if infections persist or recur after the full treatment. Recurrent fungal infections may be a sign of systemic illness.

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Pharmacokinetics
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Absorption: Absorption through intact skin is minimal.

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Distribution: Distribution after topical administration is primarily local.

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Metabolism and Excretion: Systemic metabolism and excretion is negligible with local application.

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Half-life: Not applicable.

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TIME/ACTION PROFILE

ROUTE ONSET PEAK DURATION
topical unknown unknown unknown
vaginal cream unknown 8–24 hr unknown
vaginal tablet unknown 1–2 days unknown

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Contraindications/Precautions
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Contraindicated in: Hypersensitivity to active ingredients, additives, preservatives, or bases.

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Use Cautiously in: Nail and scalp infections (may require additional systemic therapy); patients with recurrent vulvovaginal yeast infections. OB/Lactation: Safety not established.

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Interactions
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Drug-Drug: Not known.

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Route/Dosage
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Topical (Adults and Children >3 yr): Apply cream or solution twice daily for 1–4 wk.

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Vag (Adults and Children >12 yr): Vaginal tablets—100 mg at ...

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