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Nystatin.

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Generic and proprietary names

- Nystatin.

- Nystan.

- Nystaform.

- Tinaderm. 

There are also several products that contain nystatin in combination with other agents.

Action

- An antifungal drug named after the New York State Institute of Health, where it was developed in the 1950s.

- It interferes with fungal DNA replication.

Classification

- Antifungal.

Indications

- Candidiasis. 

- Candidal fungal skin infections.

- Oral and perioral candidal fungal infections.

- Candidal fungal vaginal infections.

Contraindications

- Hypersensitivity. 

Cautions

- Pregnancy.

Common side-effects

- Nausea.

- Vomiting.

- Diarrhoea at high oral doses.

- Local irritation.

- Local sensitisation.

- Rash.

Rare side-effects

- Stevens-Johnson syndrome.

Administration

- Tablet.

- Oral suspension.

- Lozenge (pastille).

- Vaginal pessary.

- Vaginal cream.

- Topical ointment.

- Topical cream.

Nursing considerations

- Recurrent vaginal infection can be associated with courses of antibacterial medication, diabetes, pregnancy, oral contraception and reinfection from a sexual partner.

- Good oral hygiene, including proper care of dentures, is important for the cure of mouth infections.

- Evaluate therapeutic response. 

Patient teaching

- Warn women using vaginal preparations that this medication can stain clothing yellow and that they should avoid using tampons because they will absorb the drug.

- Advise patients to continue to use nystatin lozenges for at least 48 hours after symptoms of infection disappear.

- Lozenges should be allowed to dissolve slowly in the mouth and not chewed or swallowed whole.

- Advise patients using nystatin suspension to shake the bottle well before each use to mix the medication evenly.

- For mouth infections half the dose should be placed in each side of the mouth and swished throughout the mouth for several minutes before swallowing.

- For intestinal infections the suspension can simply be swallowed.

- Advise patients using nystatin skin ointment or cream that it should be kept out of the eyes.

- For cream and ointment application a small amount should be gently and thoroughly massaged into the skin.

Nurses should refer to manufacturer’s summary of product characteristics and to appropriate local guidelines

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