释义 |
DictionarySeeclotrimazoleMycelex
clotrimazole (oral) (kloe-trim-a-zole) clotrimazoleoral, Mycelex (trade name) Classification Therapeutic: antifungals Pregnancy Category: C
IndicationsTreatment of oropharyngeal candidiasis.Prevention of oropharyngeal candidiasis in immunocompromised patients (receiving chemotherapy or radiation for cancer or corticosteroids for cancer or transplant).ActionAffects the permeability of the fungal cell wall, allowing leakage of cellular contents.Therapeutic effectsDecrease in or prevention of symptoms of oropharyngeal candidiasis.PharmacokineticsAbsorption: Minimal systemic absorption.Distribution: Inhibitory concentrations remain in saliva for up to 3 hr after troche dissolves.Metabolism and Excretion: Metabolized by liver; <1% excreted unchanged in urine.Half-life: 24 hr.Time/action profile ROUTE | ONSET | PEAK | DURATION |
---|
PO | unknown | unknown | up to 3 hr |
Contraindications/PrecautionsContraindicated in: Hypersensitivity to clotrimazole or other components of formulation; Systemic candidiasis.Use Cautiously in: Hepatic impairment; Obstetric: Use only if potential benefit justifies potential risk to fetus; Pediatric: Children <3 yr (safety and effectiveness not established).Adverse Reactions/Side EffectsGastrointestinal- abnormal mouth sensations
- ↑ liver function tests
- nausea
- vomiting
DermatologicInteractionsDrug-Drug interactionMay ↓ metabolism and ↑ risk of toxicity from CYP3A4 substrates, includingcyclosporine, HMG-CoA reductase inhibitors, some benzodiazepines (alprazolam, midazolam, triazolam ), calcium channel blockers, colchicine, fentanyl, tacrolimus, and warfarin..Route/DosageOral (Adults and Children ≥3 yr) Treatment—One troche 5 times daily for 14 days; Prophylaxis—One troche 3 times daily for the duration of chemotherapy or until steroid doses are reduced to maintenance levels.Availability (generic available)Troche: 10 mg Nursing implicationsNursing assessment- Assess oropharnyngeal mucosa prior to and periodically during therapy.
- Lab Test Considerations: Monitor hepatic function prior to and periodically during therapy. May cause ↑AST.
Potential Nursing DiagnosesImpairedoral mucous membrane (Indications)
Implementation- Oral: Allow each troche to dissolve slowly in mouth to achieve maximum effect.
Patient/Family Teaching- Instruct patient to take clotrimazole as directed. Allow each troche to slowly dissolve in mouth.
Evaluation/Desired Outcomes- Decrease in or prevention of symptoms of oropharyngeal candidiasis.
Mycelex (mī′sə-lĕks′) A trademark for the drug clotrimazole.Mycelex® Clotrimazole, see there. |