tract mucosa. Phenazopyridine is excreted in the
urine where it exerts a topical anesthetic effect on
the mucosa of the urinary tract. It is contrain-
dicated where renal insufficiency exists.
Phenazopyridine imparts a bright red or orange
color to the urine and the patient should be made
aware of this fact.
USUAL DOSE. 200 mg three times daily
ACTION AND USE. This bactericide is ef-
fective against a wide variety of organisms. Its
mode of action is the inhibition of bacterial cell
wall synthesis. It is not effective against most
aerobic gram-negative bacilli and is employed
locally by topical application in ointment form.
Antifungal agents inhibit or suppress the
growth systems of fungi, dermatophytes, or
Candida. Antifungal have not been developed
to the same degree as antibacterial agents. Most
fungi are completely resistant to the action of
chemicals at concentrations that can be tolerated
by the human cell. Since there are only a few
available for internal use, most antifungal agents
are topical. The agents that are available for
systemic use generally produce hepatic or renal
dysfunction or other serious side effects; because
of this, systemic antifungal should be limited to
serious or potentially fatal conditions. When using
oral or parenteral antifungal agents, provide con-
comitant therapy with topical preparations.
ACTION AND USE. Nystatin is primarily
used in the treatment of candidal infections. It
is fungicidal and fungistatic against a wide variety
of yeasts and yeast-like fungi and most often used
in the treatment of candidiasis. It is sometimes
used concurrently with tetracycline to suppress the
overgrowth of Candida in the bowel.
USUAL DOSE. Nystatin is available as a
cream, powder, oral tablets, vaginal tablets, or
oral suspension. The cream or powder should be
applied two or three times daily as indicated by
clinical response; one or two oral tablets three
times daily until 48 hours after clinical cure;
vaginal tablets one daily for 2 weeks; and the oral
suspension 2 to 4 ml four times daily held in the
mouth for as long as possible before swallowing.
Griseofulvin (Gris-Peg, Fulvicin)
ACTION AND USE. Griseofulvin is a
fungistatic agent used in the treatment of fungal
infections of the nails, hair, and skin. It is gen-
erally reserved for chronic infections that have not
responded to topical therapy alone. Because treat-
ment may last for several months, the patient
should be instructed to follow the treatment
regimen even though symptoms may abate. In-
clusion of topical therapy is a must for effective
elimination of the infection. Griseofulvin is not
indicated for the treatment of superficial fungal
infections that can be controlled by topical anti-
fungal. Because of its toxicity, patients should
have periodic evaluations of hepatic and renal
function. Griseofulvin is contraindicated in pa-
tients with hepatic dysfunction.
USUAL DOSE. 500 mg to 1 g daily as either
a single dose or two equally divided doses.
Miconazole Nitrate (Monistat)
ACTION AND USE. Miconazole nitrate is
a synthetic antifungal that inhibits the growth of
common dermatophytes. Is is indicated for the
treatment of cutaneous fungal infections and
USUAL DOSE. For topical preparations,
the cream should be applied to the affected area
twice daily. For vaginal infections, either the
cream or the suppository should be inserted daily
at bedtime for 7 days.
Undecylenic Acid (Desenex)
ACTION AND USE. This is a fatty acid
antifungal, available in ointment, dusting powder,
solution, and spray. It is used primarily in the
treatment and prevention of tinea pedis (athletes
foot) and is often compounded with zinc to act
as an astringent.
FOR TOPICAL USE. Apply two to four
times daily between the toes and on the affected