NATAMYCIN

NATAMYCIN
(na-ta-mye'sin)
Natacyn
Classifications: antifungal agent;
Therapeutic: antifungal

Prototype: Amphotericin B
Pregnancy Category: C

Availability

5% suspension

Action

Mechanism of action simulates that of amphotericin B and nystatin by binding to sterols in the fungal cell membrane resulting in cell death of fungi.

Therapeutic Effect

Effective against many yeasts and filamentous fungi including Candida, Aspergillus, Cephalosporium, Fusarium, and Penicillium. Limited activity in vivo against Trichomonas vaginalis.

Uses

Blepharitis, conjunctivitis, and keratitis caused by susceptible fungi. Drug of choice for Fusarium solani keratitis.

Unlabeled Uses

Oral, cutaneous, and vaginal candidiasis; intranasal treatment of pulmonary aspergillosis.

Contraindications

Concomitant administration of a corticosteroid.

Cautious Use

Pregnancy (category C) or lactation. Safety and efficacy in children are not established.

Route & Dosage

Fungal Keratitis
Adult: Ophthalmic 1 drop in conjunctival sac of infected eye q1–2h for 3–4 d, then decrease to 1 drop q6–8h, then gradually decrease to 1 drop q4–7d

Administration

Instillation
  • Wash hands thoroughly before and after treatment. Infection is easily transferred from infected to noninfected eye and to other individuals.
  • Shake well before using.
  • Store at 2°–24° C (36°–75° F).

Adverse Effects (≥1%)

Special Senses: Blurred vision, photophobia, eye pain. Uneven adherence of suspension to epithelial ulcerations or in fornices.

Interactions

Drug: No clinically significant interactions established.

Pharmacokinetics

Absorption: Drug adheres to ulcerated surface of the cornea and is retained in conjunctival fornices. Does not appear to be systemically absorbed.

Nursing Implications

Assessment & Drug Effects

  • Inspect eye for response and tolerance at least twice weekly.
  • Note: Lack of improvement in keratitis within 7–10 d suggests that causative organisms may not be susceptible to natamycin. Reevaluation is indicated and possibly a change in therapy.

Patient & Family Education

  • Learn appropriate technique for application of eye drops.
  • Expect temporary light sensitivity. Be prepared to wear sunglasses outdoors after drug administration and perhaps for a few hours indoors.
  • Return to ophthalmologist for reevaluation of eye problem if you experience symptoms of conjunctivitis: pain, discharge, itching, scratching "foreign body sensation," changes in vision.
  • Do not share facecloths and hand towels; this will help prevent transmission of the fungal infection.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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