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PEER RESPONSE NUMBER 1
Discussion Board Module 2
Daniela DXXX
St Thomas University
NUR 600 Advance Clinical Pharmacology
September 1st, 2022
1. Briefly describe the therapeutic actions of Clotrimazole (Lotrimin).
Clotrimazole is a broad-spectrum antifungal drug used to treat dermatological and
gynecological fungal infections. It acts mainly by blocking the biosynthesis of the
major sterol of fungal membranes, ergosterol, by interacting with 14-alpha
demethylase, which leads to the alteration of the fungal cell membrane and the
inhibition of fungal growth. In case ergosterol synthesis is blocked, a cell is unable to
build an intact and functional cell membrane that serves as a selective barrier, which
ultimately leads to the loss of potassium and other cellular contents (Khatter & Khan,
2022). Moreover, since ergosterol directly supports the growth of fungal cells in a
hormonelike manner, the initiation of the foregoing processes leads to the dosedependent inhibition of fungal growth (Khatter & Khan, 2022). Furthermore,
clotrimazole has other therapeutic actions like the inhibition of Ca2+-ATPase and the
depletion of intracellular calcium stores that account for other effects of this medicine
that are different from its antimycotic actions.
2. Describe antifungal drug uses and side effects.
Clotrimazole is helpful for the treatment of different types of fungal infections of
the body and skin. Some of these infections are tinea pedis, tinea cruris,
dermatophytosis, and yeast infections. In addition, clinicians prescribe clotrimazole to
treat tinea versicolor, a fungal infection in which flaky discolored patches appear on
the neck, chest, arms, or legs. The medication treats fungal infections directly and
helps relieve the symptoms after three days. Most people using this medication do not
experience any unwanted effects at all. The most frequently reported side effect of
clotrimazole is the irritation of the area of the skin where a patient spread the cream.
Notifying a provider or pharmacist is necessary if this effect persists or worsens.
Moreover, the patient should seek medical attention immediately if blistering, oozing,
open sores or symptoms of a serious allergic reaction occur. While these serious side
effects are unlikely, some people may develop them.
3. Develop a teaching plan for Ms. Jones including age-appropriate
considerations for Sam.
The teaching plan for Ms. Jones would include patient education about the
treatment and prevention of diaper Candida/a yeast infection. First, it is necessary to
inform Ms. Jones that to use topical clotrimazole, she should first wash her hands and
the affected area and dry it thoroughly but gently. Then, it is essential to tell her that
she should apply a thin layer of the cream to the affected area of the skin with diaper
changes. Symptoms will start to fade and disappear after three days, however, yeast
overgrowth may still be present, so it is critical to use the medication for 14 days to
ensure that rashes do not occur again. After the clearance of the infection, it is
possible to use barrier ointments like Bepanthen to help avoid recurrence as it
provides a breathable and waterproof barrier and prevents the skin from rubbing. In
addition, it is vital to inform Ms. Jones about the ways of avoiding rashes in the diaper
area in the future. One of the ways is changing dirty diapers as soon as possible and
leaving a diaper off for as long as possible to let fresh air affect the skin. This
minimizes the amount of moisture on the skin, which could create perfect conditions
for fungi and might inflame a rash (Blume-Peytavi & Kanti, 2018). Moreover, it is
important to check whether Sam’s diaper is of a proper size because if it is too tight, it
can cause irritation, and if it is too loose, a diaper will not properly absorb urine.
Finally, it is not recommended to use talcum powder, soap, bubble baths, or lotions
because they may contain fragrances and ingredients irritating the baby’s skin.
Overall, it is easier to prevent diaper Candida/a yeast infection than to treat them, and
therefore, Ms. Jones should prioritize hygiene and cleanliness when it comes to
changing diapers.
References
Blume-Peytavi, U., & Kanti, V. (2018). Prevention and treatment of diaper
dermatitis. Pediatric Dermatology, 35(S1), s19–
s23. https://doi.org/10.1111/pde.13495
Khatter, N. J., & Khan, M. A. B. (2022). Clotrimazole. StatPearls
Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560643/
PEER RESPONSE NUMBER 2
Module 2 Discussion
Alexis J. XXX
Nur-600-AP3
Fungus can be described as spore producing organisms that can affect different
areas of the skin. People at risk for fungus can include those
who have a family history, a compromised immune system, and those who are subject
to environments that are warm, dark, and moist (Arcangelo et
al., 2017). Antifungal medications are the line of treatment for fungal infections.
Antifungal medications can be divided into topical and systemic. The
decision for typical or systemic medication is based on the site of the fungal infection.
Furthermore, antifungals can further be classified into the
following groups such as: azole, polyenes, allylamines, and echinocandins. These
medications should be avoided in those who are pregnant or who
are breastfeeding. Side effects include rash, hives, blisters, burning, itching, peeling,
redness, swelling, pain, or other signs of skin irritation (Khatter &
Khan, 2021).
Clotrimazole is classified as an azole antifungal medication. It is a topical
medication that is commonly used to treat fungal infections. It works
by preventing the spread and growth of the infection by attacking the cell membrane
of the fungus. It does this by inhibiting Ergosterol synthesis, as
Ergosterol directly promotes the growth of fungal cells in a hormone-like fashion
(Khatter & Khan, 2021). The medication can be in the form of an
ointment or powder, and is applied to the affected and surrounding skin area.
Clotrimazole can be purchased over the counter, without a prescription
from the healthcare provider. Common uses or indications for Clotrimazole includes
Tinea Corporis (ringworm), Tinea Cruris (jock itch), Tinea Pedis
(athlete’s foot), Tinea Manus (hand infection), Tinea Unguium (nail infections), as
well as Candidiasis (Arcangelo et al., 2017). In this case study, Sam
has been diagnosed with Candidiasis, which is commonly associated in the diaper
region, known as Diaper Dermatitis. Signs and symptoms of Diaper
Dermatitis include lesions that can sometimes have exudate, pruritus, and erythema.
The teaching plan for Ms. Jones includes washing her hands before and after
diaper changes. This promotes the growth of healthy bacteria. In
addition, keeping Sam’s peri area clean and dry by changing soiled diapers
immediately. Sam’s soiled diapers allow his skin to be moist and promote a
dark environment, which is ideal for the growth of Candida (Arcangelo et al., 2017).
She can also be instructed to leave the diaper off for a few
minutes in between changes to allow airflow and drying to the affected area. After
sufficient drying, she should be instructed to apply the topical
Clotrimazole TID for 14 days. However, Ms. Jones should monitor adverse reactions
with Sam such as increasing rash, blisters, swelling, or increased
crying and to notify the provider as the treatment plan may need to be adjusted.
Complementary and Alternative Medicine (CAM) education can be
provided to Ms. Jones. For example, the use of plain yogurt without sugars and
flavoring can be used to heal diaper rash. The probiotics present on
plain yogurt can keep the growth of fungi in check by producing lactic acid
(Arcangelo et al., 2017).
References
Arcangelo, P. V., Peterson, M. A., Wilbur, V., & Reinhold, A. J.
(2017). Pharmacotherapeutics for Advanced Practice: A Practical Approach (4th
Ed.). Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins
American. ISBN: 9781496319968
Khatter N.J., & Khan, M.A.B. (2021). Clotrimazole. StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing; 2022 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK560643
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