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Snapshot
  • A 25-year-old woman presents to the urgent care clinic for vaginal itching and discharge. She recently completed a course of antibiotics for the treatment of urinary tract infection. On physical exam, there is white discharge with erythema and swelling of the vulva. She requests a topical agent, as she did not want to take any medications by mouth. She is instructed to use a topical cream. (Vaginal candidiasis)
Introduction
  • Drugs
    • nystatin
      • topical use only
      • side effects are too toxic to be given systemically
  • Mechanism of action
    • binds to ergosterol, a key component of the cell membrane, which forms pores that allow for leakage of cellular contents
  • Clinical use
    • candidiasis
      • cutaneous (intertrigo and diaper rash)
      • mucocutaneous (oral thrush and vaginal candidiasis)
  • Adverse effects
    • skin irritation or hypersensitivity
 

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