NUR600- REPLY TO DISCUSSION MARIA

Clotrimazole

The therapeutic actions of Clotrimazole (Lotrimin) include treatment of tinea corporis (ringworm; fungal skin infection that causes a red scaly rash on different parts of the body), tinea cruris (jock itch; fungal infection of the skin in the groin or buttocks), and tinea pedis (athlete’s foot; fungal infection of the skin on the feet and between the toes) (Kumari & Kesavan, 2017).  Clotrimazole is in a class of antifungal medications called imidazoles.  

The essence of its mechanism of functioning is stopping the growth of fungi that cause infection (Kumari & Kesavan, 2017).  It prevents growth of several types of fungi by preventing interfering with the production of the membrane that surrounds fungal cells (Kumari & Kesavan, 2017).  The mechanism of action of clotrimazole is associated with primary fungistatic or fungicidal activity, depending on the concentration of clotrimazole at the site of infection (Woo & Robinson, 2020).  Clotrimazole also disrupts the vital processes in the fungal cell, suppressing the formation of components necessary for building vital cellular structures (proteins, fats, DNA, polysaccharides), damaging nucleic acids and increasing the excretion of potassium.  In addition to the antimycotic activity, clotrimazole also acts on gram-positive microorganisms (streptococci, staphylococci, Gardnerella vaginalis) and gram-negative microorganisms (Bacteroids). 

Topical clotrimazole comes as a cream and liquid to apply to the skin.  It is usually applied twice a day to address the rash problem identified (morning and night) (Woo & Robinson, 2020).  Clotrimazole is poorly absorbed through the skin and mucous membranes, and has practically no systemic effect (Woo & Robinson, 2020).  The duration of treatment depends on the severity of the disease, the localization of pathological changes and the effectiveness of therapy.  If signs of hypersensitivity or irritation appear, treatment is discontinued (Woo & Robinson, 2020).  If there is no effect within 4 weeks, the diagnosis should be confirmed.

Taking into consideration potential threats of using clotrimazole for a 6-week-old baby, Ms. Jones will need to be educated to use the medication strictly according to the treatment plan, because it can cause potential side effects if used unproperly.  Some of the possible side effects are rash; hives; stomach pain; fever; chills; nausea; vomiting; foul-smelling vaginal discharge (Woo & Robinson, 2020).  If anything of these occurs, Ms. Jones is educated to discontinue the medication and call the office (Woo & Robinson, 2020).  Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug.  

Also, prior to use of clotrimazole, it is important to cleanse and thoroughly dry the area.  By all means, it is important to avoid contact of clotrimazole with eyes and application to severely cracked or irritated areas.  Besides, Ms. Jones needs to be warned to return to the office should she notice the signs and symptoms of an allergic reaction to clotrimazole.  When the medication is finished, it is important to dispose it in order to ensure that children and pets do not take it in and cause harm to themselves as a result (Kumari & Kesavan, 2017).  The best way to dispose this medication is through a medicine take-back program.

References

Kumari, B., & Kesavan, K. (2017). Effect of chitosan coating on microemulsion for effective dermal clotrimazole delivery. Pharmaceutical development and technology, 22(4), 617-626. https://doi.org/10.1080/10837450.2016.1230629

Woo, T., & Robinson, M. (2020). Pharmacotherapeutics for advanced practice nurse prescribers. (4th ed.). F.A Davis.