Health Medical Homework Help

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Jessica Craig.

Discussion Post 2

Cutaneous candidiasis thrives in occluded warm and moist conditions as well as where there is a break in the skin allowing overgrowth. Common presentation of diaper dermatitis is erythema and edema with popular and pustular lesions, erosion and oozing. Possibility of scaling may be seen at the margins of the lesions. When implementing a treatment plan the goal is to restore the mucous membranes to normal. The application of clotrimazole (lotrimin) is an antifungal topical cream used in the treatment of cutaneous candidiasis. (Arcangelo et al., 2016)

Clotrimazole is the generic name for brand name Lotrimin that is a topical antifungal. The exact mechanism of action is unknown; however, it is known to inhibit the 14-alpha demethylase causing a reduction in fungal cell membrane ergosterol synthesis thus increasing the cellular permeability. Meaning the fungal cell wall becomes unstable causing membrane leakage. Half-life of this medication is unknown and is excreted primarily through bile/feces and urine. (Epocrates, 2021)

Pertaining to this case study, patient is six weeks old, presenting with worsening bright red rash to diaper area who has been diagnosed with diaper candida (yeast infection). Treatment plan is for topical clotrimazole (lotrimin) to diaper area three times a day (TID) for 14 days. Patient caregiver education is to include the importance of continuing treatment for the entire 14 days even if the area appears to me healed after several days of application. Completing the course of treatment will increase the likelihood of complete healing and decrease the risks for recurrent infection. Clotrimazole is an antifungal used in the treatment of infections caused by fungus such as yeast infections, jock itch, ring worm and athlete’s foot. Clotrimazole should not be used if allergic to it.

Route of administration is topical (applying to skin of the affected area), do not take by mouth. Wash hands before and after application. Clean and dry the affected area, apply a small amount of cream to diaper area three times a day for 14 days. Keeping the infected area clean and dry when possible, can be beneficial in treatment as well as prevention. Allow for air flow to the affected area as covered, warm and moist conditions allow infection growth. This could include a period where the diaper is removed to allow for air flow to promote healing. Avoid getting the medication in eyes, nose, and mouth. Avoid using other topical creams/ointments to the area, unless otherwise directed. Common reactions to the medication are irritation, burning, stinging, itch, redness, localized swelling, hives, peeling, or blistering. Stop using medication and call the office should any of the following reactions occur:

• severe blistering of treated skin
• swelling, redness, or oozing
• severe burning, itching, or other irritation

Keep medication out of the reach of children. Follow-up in two weeks for evaluation of response to therapy.

References

Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (2016). Pharmacotherapeutics for Advanced Practice: A Practical Approach (4th ed.) [E-book]. Wolters Kluwer Health. https://bookshelf.vitalsource.com/books/9781496374066 (Links to an external site.)

Epocrates (21.5.1). (2021). [Mobile app]. Epocrates, LLC. https://online.epocrates.com/drugs/1210/clotrimazole-topical/Monograp