Home Drug Guide Terconazole

Drug Guide

Generic Name

Terconazole

Brand Names Terazol 7, Terazol 3

Classification

Therapeutic: Antifungal

Pharmacological: Azole antifungal

FDA Approved Indications

  • Treatment of vulvovaginal candidiasis (yeast infection) caused by susceptible Candida species

Mechanism of Action

Terconazole inhibits the fungal cytochrome P450 enzyme 14α-sterol demethylase, leading to decreased synthesis of ergosterol, an essential component of fungal cell membranes. This results in increased membrane permeability and cell death.

Dosage and Administration

Adult: Typically, 0.4% vaginal cream or suppository once daily at bedtime for 3 to 7 days.

Pediatric: Use is not well established; consult pediatric guidelines or specialist.

Geriatric: No specific adjustments proposed; use with caution, monitor for adverse effects.

Renal Impairment: No specific dosage adjustments recommended; use with caution.

Hepatic Impairment: No specific adjustments; caution advised. Use only if the benefits outweigh potential risks.

Pharmacokinetics

Absorption: Minimal systemic absorption when used vaginally.

Distribution: Limited data; presumed to stay localized in vaginal tissues.

Metabolism: Metabolized minimally systemically; mostly remains in vaginal tissues.

Excretion: Limited systemic absorption; excretion details mostly unknown.

Half Life: Data not available; primarily localized action.

Contraindications

  • Hypersensitivity to terconazole or other azole antifungals.

Precautions

  • Use with caution in patients with a history of sensitivity to azole antifungals; caution in pregnancy, particularly in the first trimester; monitor for hypersensitivity reactions.

Adverse Reactions - Common

  • Vaginal burning or stinging (Common)
  • Vaginal irritation or itching (Common)
  • Vaginal discomfort or dryness (Common)

Adverse Reactions - Serious

  • Hypersensitivity reactions (Rare)
  • Contact dermatitis (Rare)

Drug-Drug Interactions

  • Caution with concomitant use of drugs that are metabolized by CYP450 enzymes; systemic absorption is minimal, so interactions are unlikely.

Drug-Food Interactions

  • No significant food interactions noted.

Drug-Herb Interactions

  • Limited data; exercise caution with herbal products affecting CYP enzymes or causing allergic reactions.

Nursing Implications

Assessment: Monitor for signs of fungal infection resolution and adverse reactions.

Diagnoses:

  • Impaired skin integrity r/t fungal infection.
  • Risk of allergic reaction.

Implementation: Administer as prescribed, typically at bedtime for 3-7 days. Educate about ointment/application techniques.

Evaluation: Assess for relief of symptoms and absence of adverse effects.

Patient/Family Teaching

  • Complete full course of therapy even if symptoms resolve early.
  • Report any signs of hypersensitivity, increased irritation, or allergic reactions.
  • Maintain proper vulvovaginal hygiene.
  • Warn about possible local irritation but emphasize the importance of completing therapy.

Special Considerations

Black Box Warnings:

  • None for vaginal terconazole.

Genetic Factors: Limited data; no known genetic contraindications.

Lab Test Interference: Unlikely to interfere with laboratory tests.

Overdose Management

Signs/Symptoms: Overdose is unlikely due to localized application and minimal systemic absorption.

Treatment: Supportive care if accidental ingestion or unusual exposure occurs.

Storage and Handling

Storage: Store at room temperature away from moisture and heat.

Stability: Stable until expiration date on packaging.

🛡️ 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.