Nursing Teaching on Side Effects of Ketoconazole Use

Nurse educated the patient and caregiver on the side effects of using Ketoconazole as follows:

  1. Cardiac arrhythmias: Ketoconazole can precipitate irregular heartbeats, life-threatening ventricular arrhythmias in individuals with history of cardiac arrhythmias. Individuals with history of chronic disturbance in serum magnesium and potassium ions are also at increased risk for arrhythmias with Ketoconazole. Also, individuals taking Lasix are at increased risk for losing potassium, thus setting the ground for life-threatening arrhythmias, upon taking Ketoconazole.
  2. Nausea and vomiting: This is the most common side effect of Ketoconazole. Taking the antibiotic with some food and water can minimize the effects of nausea and vomiting.
  3. Central nervous system findings: Ketoconazole use can sometimes result in severe dizziness, confusion, hallucinations, tremors, and seizures.
  4. Diarrhea: Ketoconazole can cause irritation of the intestinal mucosa and diarrhea.
  5. Anaphylaxis: A rare, but serious anaphylactic response can occur for Ketoconazole. Patients can present with extreme itching and rash, swelling of the face and throat, dizziness, bronchoconstriction, and difficulty breathing. This is an emergency and medical attention should be sought immediately, without any delay.
  6. Hepatic damage: Long term Ketoconazole intake can lead to severe hepatic injury, thus compromising liver function. Hepatic injury and altered liver function can result in increased bilirubin levels in the body, resulting in itching, jaundice with yellowing of skin and sclera, dark urine, altered metabolism with nausea and vomiting, pain in the right upper abdominal quadrant, and fatigue.
  7. Skin rash: Ketoconazole intake can result in skin rash ranging between mild to severe exfoliating rash, blisters, easy bleeding, and bruising.