Search your Drugs Here

Monday, February 7, 2011

miconazole nitrate

Posted by Sampil 5:55 PM, under | No comments

miconazole nitrate
(mi kon' a zole)
Topical:
Breeze Mist Antifungal, Fungoid Tincture, Lotrimin AF, Maximum Strength Desenex Antifungal, Micatin, Monistat Derm Cream (CAN), Tetterine, Ting, Zeasorb-AF
Vaginal suppositories, topical:
Femisol-M, Micozole (CAN), Monistat 1 (CAN), Monistat 3, Monistat 7, Monistat Dual Pak, M-Zole 3, M-Zole 7 Dual Pack

Pregnancy Category B

Drug class
Antifungal

Therapeutic actions
Fungicidal: Alters fungal cell membrane permeability, causing cell death; also may alter fungal cell DNA and RNA metabolism or cause accumulation of toxic peroxides intracellularly.

Indications
·        Vaginal suppositories: Local treatment of vulvovaginal candidiasis (moniliasis)
·        Topical administration: Tinea pedistinea cruristinea corporis caused by Trichophyton rubrumTrichophyton mentagrophytesEpidermophytonfloccosum; cutaneous candidiasis (moniliasis), tinea versicolor

Contraindications and cautions
·        Contraindicated with allergy to miconazole or components used in preparation.
·        Use cautiously with pregnancy, lactation.

Available forms
Vaginal suppositories—100, 200, 1,200 mg; topical cream—2%; vaginal cream—2%; topical powder—2%; topical spray—2%; topical ointment—2%; spray powder or liquid—2%; solution—2%

Dosages
ADULTS
Vaginal suppositories
Monistat 3: Insert 1 suppository intravaginally once daily hs for 3 days. Monistat 7: One applicator cream or 1 suppository in the vagina daily hs for 7 days. Repeat course if needed. Alternatively, one 1,200-mg suppository at hs for 1 dose.
Topical
Cream and lotion: Cover affected areas bid, morning and evening. Powder: Spray or sprinkle powder liberally over affected area in the morning and evening.
PEDIATRIC PATIENTS
Topical
> 2 yr: Use adult dosage.
< 2 yr: Not recommended.

Pharmacokinetics
Route
Onset
Peak
Topical
Rapid
Unknown
Vaginal
Unknown
Unknown

Metabolism: Hepatic; T1/2: 21–24 hr
Distribution: Crosses placenta; may enter breast milk
Excretion: Feces, urine

Adverse effects
Vaginal suppositories
·        Local: Irritation, sensitization or vulvovaginal burning, pelvic cramps
·        Other: Rash, headache
Topical application
·        Local: Irritation, burning, maceration, allergic contact dermatitis

Nursing considerations
Assessment
·        History: Allergy to miconazole or components used in preparation; lactation, pregnancy
·        Physical: Skin color, lesions, area around lesions; T; orientation, affect; culture of area involved

Interventions
·        Culture fungus involved before therapy.
·        Insert vaginal suppositories high into the vagina; have patient remain recumbent for 10–15 min after insertion; provide sanitary napkin to protect clothing from stains.
·        Monitor response; if none is noted, arrange for further cultures to determine causative organism.
·        Apply lotion to intertriginous areas if topical application is required; if cream is used, apply sparingly to avoid maceration of the area.
·        Ensure patient receives the full course of therapy to eradicate the fungus and to prevent recurrence.
·        WARNING: Discontinue topical or vaginal administration if rash or sensitivity occurs.

Teaching points
·        Take the full course of drug therapy even if symptoms improve. Continue during menstrual period even if vaginal route is being used. Long-term use will be needed; beneficial effects may not be seen for several weeks.
·        Insert vaginal suppositories high into the vagina.
·        Use hygiene measures to prevent reinfection or spread of infection.
·        This drug is for the fungus being treated; do not self-medicate other problems with this drug.
·        Refrain from sexual intercourse, or advise partner to use a condom to avoid reinfection; with vaginal form of drug, use a sanitary napkin to prevent staining of clothing.
·        You may experience these side effects: Irritation, burning, stinging.
·        Report local irritation, burning (topical application); rash, irritation, pelvic pain (vaginal use).

Adverse effects in Italic are most common; those in Bold are life-threatening.

0 comments:

Post a Comment

Tags

Blog Archive

Blog Archive