Home Drug Guide Nystatin

Drug Guide

Generic Name

Nystatin

Brand Names Candex, Nilstat, Nysert, Mycostatin, Korostatin, Mykinac, Barstatin 100, Nystex, Nystop

Classification

Therapeutic: Antifungal

Pharmacological: Polyene antifungal

FDA Approved Indications

  • Superficial candidiasis
  • Oral and oesophageal candidiasis
  • Cutaneous and mucocutaneous candidiasis

Mechanism of Action

Nystatin binds to ergosterol in fungal cell membranes, creating pores that increase membrane permeability, leading to cell death.

Dosage and Administration

Adult: Dosing varies based on formulation and site of infection; typically, for oral candidiasis, 100,000 to 400,000 units daily in divided doses.

Pediatric: Similar dosing as adults, tailored to weight and age; consult specific formulation instructions.

Geriatric: Dosing adjustments generally not required, but monitor for renal function and adverse effects.

Renal Impairment: Use with caution; adjust dose if necessary and monitor for toxicity.

Hepatic Impairment: No specific adjustment recommended.

Pharmacokinetics

Absorption: Poorly absorbed from gastrointestinal (GI) tract when administered orally.

Distribution: Distributed mainly in the GI tract; minimal systemic absorption when used topically.

Metabolism: Not significantly metabolized; remains largely unabsorbed when taken orally.

Excretion: Excreted in feces.

Half Life: Not applicable due to minimal systemic absorption.

Contraindications

  • Hypersensitivity to nystatin or other polyene antifungals

Precautions

  • Use with caution in patients with mucosal or cutaneous damage; monitor for hypersensitivity reactions.

Adverse Reactions - Common

  • Gastrointestinal upset (nausea, vomiting, diarrhea) (Common)
  • Skin irritation at application site (Common)

Adverse Reactions - Serious

  • Hypersensitivity reactions including rash, itching, swelling, dizziness (Rare)

Drug-Drug Interactions

  • None well-documented; usually topical and minimal systemic absorption limits interactions.

Drug-Food Interactions

  • None significant.

Drug-Herb Interactions

  • Limited data; caution with herbal products that may alter absorption or efficacy.

Nursing Implications

Assessment: Assess for signs of fungal infection; monitor for adverse reactions.

Diagnoses:

  • Impaired skin integrity
  • Ineffective tissue perfusion related to infection.

Implementation: Administer as prescribed; topical or oral, with attention to site and formulation.

Evaluation: Monitor resolution of infection and side effects.

Patient/Family Teaching

  • Complete prescribed course.
  • Report any allergic reactions or side effects.
  • Maintain good hygiene to assist in infection control.

Special Considerations

Black Box Warnings:

  • No black box warnings for nystatin.

Genetic Factors: None established.

Lab Test Interference: None significant.

Overdose Management

Signs/Symptoms: Gastrointestinal disturbances, nausea, vomiting.

Treatment: Supportive care; no specific antidote due to low systemic absorption.

Storage and Handling

Storage: Store at room temperature, protected from moisture.

Stability: Stable under recommended conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.