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INTRODUCTION

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nystatin (topical) (nye-stat-in)

Mycostatin, Image not available.Nyaderm, Nystop

nystatin (oral/local) (nye-stat-in)

Mycostatin, Image not available.Nadostine, Nilstat, Nystex, Image not available.PMS-Nystatin

nystatin (vaginal) (nye-stat-in)

Mycostatin

Classification

Therapeutic: antifungals

Pharmacologic: polyenes

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Indications
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Cream, powder: 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. Lozenges, oral suspension: Local treatment of oropharyngeal candidiasis. Treatment of intestinal candidiasis.

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Vaginal tablets: 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: Decreased symptoms of fungal infection.

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Adverse Reactions/Side Effects
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Local: burning, itching, local hypersensitivity reactions, redness, stinging. GI: diarrhea, nausea, stomach pain (large doses), vomiting. Derm: contact dermatitis, Stevens-Johnson syndrome. GU: irritation, sensitization.

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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.

  • Notify physician immediately of severe rashes or dermatitis because certain conditions may indicate serious hypersensitivity reactions (e.g., Stevens-Johnson syndrome).

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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, itching, 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, tinea versicolor, and tinea corporis, and 6 wk for tinea pedis.

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

  • Instruct patient to notify physician of severe or prolonged GI effects (nausea, vomiting, diarrhea) during oral administration.

  • 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 (resolution of symptoms/lesions)

ROUTE ONSET PEAK DURATION
topical unknown unknown unknown
topical/oral rapid unknown 2 hr*
intravaginal unknown unknown unknown

*Maintenance of saliva levels required to inhibit growth of Candida...

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