Antifungals - Topical: Nursing pharmacology

Topical antifungals are medications used to treat cutaneous fungal infections, which are conditions that affect the skin, hair, and nails, and can be caused by a variety of fungi, such as Candida albicans or dermatophytes.

The most commonly used topical antifungals include nystatin, tavaborole, ciclopirox, and azoles like ketoconazole, miconazole, econazole, and efinaconazole. These medications are applied topically on the affected skin, in the form of ointments, creams, gels, or foams.

Once administered, topical antifungals work by disrupting and damaging the fungal cell membranes, ultimately resulting in a fungistatic action, meaning that they stop fungal growth, or a fungicidal action, meaning they kill the fungi.

As far as side effects go, topical administration of antifungals can cause the development of a skin rash, as well as itching, and burning of the skin area.

Additionally, some clients may present with serious hypersensitivity reactions, such as Stevens-Johnson syndrome. Fortunately, there are no major contraindications for the use of topical antifungals.

Alright, when caring for a client that is prescribed a topical antifungal medication like ketoconazole, first assess the affected skin area, making note of the presence of moist, red patches, papules, pustules, and discharge, as well as itching, burning, and pain. Then, review recent laboratory test results, including results from skin scrapings.

Next, be sure to teach your client how the prescribed medication can help treat their cutaneous fungal infection. Remind them that the medication is for topical use only, and not for ophthalmic, oral, or vaginal use.