CH 5 The Integumentary System Flashcards
The Integumentary System
largest organ system in the body which includes the skin, hair, and nails
skin cancer is caused by
UVA and UVB radiation
Photosensitivity
Abnormal sensitivity to light which may increase risk for phototoxicity
May be more prone to sunburns, blistering, rash, or peeling
drugs that may cause Photosensitivity
N.D.A.C.C.
NSAIDs including ibuprofen
Diphenhydramine
All ACE inhibitors
Certain antibiotics, antidepressants or antipsychotics
Certain chemotherapies including MTX, 5-FU
Topical Agents for Sun-Damaged Skin
s.h.l.b generic end in -ne
silver sulfadiazine (SSD, Silvadene)
hydrocortisone (Cortizone, Cortaid)
lidocaine (Topicaine, Xylocaine, Lidoderm)
benzocaine (HurriCaine, Anacaine, Dermoplast)
age for benzocaine
2 years and up due to risk of methemoglobinemia
methemoglobinemia
a life-threatening condition in which oxygen-carrying capacity of hemoglobin is diminished and leads to tissue hypoxemia
acne
overproduction of sebum
prevented by bid cleansing face
mild acne treated with OTC products
severe acne types are…
nodular acne and acne vulgaris
Topical antibiotics used for acne, wrinkles, and rosacea
b.e.d.m.c.
benzoyl peroxide (Clearasil, Benzac, Brevoxyl)
erythromycin (Erygel)
dapsone (Aczone)
metro nidazole (MetroGel, MetroCream)
clindamycin (Cleocin-T)
Retinoids used for acne, wrinkles, and rosacea
t.a.i.t.
tretinoin (Renova, Retin-A)
adapalene (Differin)
isotretinoin (Accutane, Claravis, Zenatane)
tazarotene (Avage, Fabior, Tazorac)
Miscellaneous antibiotic agents
salicylic acid (Clearasil, Neutrogena products)
sodium sulfacetamide (Avar Cleanser, Plexion)
Retinoids are made of…
Vitamin A derivatives for acne, wrinkles, rosacea,
Topical agents of Retinoids are used for
acne, photoaging, or psoriasis
Oral agents of retinoids are used for
severe acne, psoriasis, cutaneous T-cell lymphoma
retinoids side effects *Topical agents
burning, dry skin, itching, peeling, or redness
Oral retinoids side effects
Agents…………………………………
teratogenicity (birth defects), hypertriglyceridemia, N/V (nausea, vomiting) fatigue, and hepatotoxicity
tretinoin (Altreno, Atralin, Renova)
topical retinoid for acne treatment and photodamaged skin
tretinoin admin
avoid sun exposure
Should not be used on areas of skin that are infected, red, irritated, or open wounds
Avoid applying close to eyes or mouth
tretinoin side effects
Burning, dry skin, itching, peeling, redness, and photosensitivity
rare but teratogenic (birth defects)
isotretinoin (Accutane, Claravis, Zenatane)
oral retinoid used as a last resort for severe acne
must enroll in iPLEDGE program
taken with a full glass of water to prevent capsule from dissolving in esophagus
avoid sun exposure
isotretinoin BBW
teratogenic (birth defects)
isotretinoin side effects
Depression, myalgias, hypertriglyceridemia, pancreatitis, hepatotoxicity, decreased bone mineral density, visual disturbances, psychiatric effects or hypersensitivity
iPLEDGE program
REMS (Risk Evaluation and Mitigation Strategy) program
all patients must agree to use birth control
females must do routine pregnancy tests
Miscellaneous Skin Conditions
Dermatitis
Contact Dermatitis
Seborrheic dermatitis
atopic dermatitis
psoriaris
Topical Calcineurin Inhibitors are used to
treat severe forms of eczema or psoriasis that don’t respond to topical corticosteroids
Reduces itching and inflammation
Topical Calcineurin Inhibitors are
end in “crolimus”
Pimecrolimus (Elidel)
tacrolimus (Protopic)
Tacrolimus 0.03% 2 - 15 yrs old
Tacrolimus 0.1% adults
Topical Calcineurin Inhibitors’ side effects
Burning, itching, acne, redness, headache, muscle aches, or flu-like symptoms
May increase risk for malignancy (skin cancer or lymphoma)
use for short period of time to minimize side effects
dandruff is treated with
selenium sulfide (Head and Shoulders)
pyrithione zinc (Denorex Dandruff Shampoo)
topical corticosteroids
Topical Corticosteroids are used for
contact dermatitis, eczema, psoriasis, and allergic reactions
relieve redness, swelling, itching and pain in the dermal layer of the skin
used for limited time only
Topical Corticosteroid side effects
Hyperglycemia, thinning of skin, fluid retention and HTN (hypertension, high bp), weight gain, changes in appetite, psychosis or insomnia, or fat redistribution
Low Potency Topical Corticosteroid
generics end in “sone”
DRUG LIST
h.a.
hydrocortisone 0.5 or 1% (OTC; Dermarest, Instacort, Lanacort)
hydrocortisone 2.5% (Rx; Ala-Cort, Instacort, Cortaid)
alclometasone (Aclovate)
hydrocortisone butyrate (Locoid)
hydrocortisone acetate (Cortaid, Lanacort)
High Potency Topical Corticosteroid
some generics end in “sone” “one”
DRUG LIST
b.b.f.f.h.m.t
betamethasone dipropionate (Diprolene)
betamethasone valerate(Apexicon, Psorcon)
fluocinolone (Capex, Synalar)
fluocinonide (Lidex, Vanos)
hydrocortisone valerate (Instacort, Locoid, Pandel)
mometasone furoate (Elocon)
triamcinolone (Kenalog, Triderm)
Very High Potency Topical Corticosteroid
DRUG LIST
b.c.h.a.d.
_ - propionate
betamethasone dipropionate (augmented formulation)
clobetasol propionate (Clobex, Clodan)
halobetasol propionate (Lexette, Ultravate)
amcinonide
desonide (DesOwen, Tridesilon)
Bacitracin/neomycin/polymyxin B
(Neosporin)
Topical triple antibiotic used to prevent superficial skin infections on minor cuts, abrasions, and burn wounds
OTC ointment
Bacitracin/neomycin/polymyxin B
(Neosporin)
Side Effects
Hypersensitivity, pain or stinging around the site of application, erythema, edema
Bacitracin/neomycin/polymyxin B (Neosporin)
DOSING
apply 1 to 3 times per day or 8x qd for burn wounds
Topical Antibiotics
end in “in”
b.m.r.
bacitracin
bacitracin-neomycin-polymyxin B (Neosporin)
mupirocin (Bactroban, Centany)
retapamulin (Altabax)
Terbinafine (Lamisil)
Topical antifungal to treat athlete’s foot
OTC and Rx topical cream
oral formulation for onychomycosis
Terbinafine (Lamisil)
DOSING
bid for 1-2 wk
Terbinafine (Lamisil)
SIDE EFFECTS
Hypersensitivity, skin irritation, application site burning, pruritus, xerosis
Systemic absorption of topical terbinafine is 37 times lower than oral administration
Topical Antifungals DRUG LIST
some end in -“zole” and “ine”
c.k.s.m.b.t.t.c
clotrimazole (Lotrimin AF)
ketoconazole (Nizoral)
sertaconazole (Ertaczo)
miconazole (Desenex, Lotrimin AF)
butenafine (Lotrimin)
terbinafine (Lamisil)
tolnaftate (Lamisil AF)
ciclopirox (Ciclodan)
Docosanol (Abreva)
OTC Topical cream for acute episodes of herpes labialis (cold sores)
Docosanol (Abreva)
DOSING
5x qd directly on lesion
Docosanol (Abreva)
SIDE EFFECTS
Hypersensitivity, skin irritation, application site burning, pruritus, xerosis
Topical Antivirals DRUG LIST
d.a
docosanol (Abreva)
acyclovir (Zovirax)
permethrin OTC topical agent
treats
scabies
lice
May cause redness, rash, or skin irritation
Ivermectin (Sklice, Soolantra)
Rx topical product treats
headlice and topical lesions of rosacea in adults
may cause skin irritation, rash, dandruff or dry skin
Benzalkonium chloride (Viroxyn)
used as
pre-operative skin disinfectant
Instruments and hospital utensils stored in solution of benzalkonium chloride
Pyrethrin (Licide, RID)
OTC topical shampoo for
headlice
Apply to wet hair/scalp for 10 minutes then rinsed off, treatment is repeated in 1 week
Hydrogen peroxide
Strong disinfecting, cleansing, and bleaching agent used to prepare dental surfaces before filling or to clean wounds
Sodium hypochlorite (Clorox)
Disinfects and deodorizes most germs and odor
Common household cleaning product
Isopropyl alcohol
70 to 90% concentrations remove and kill bacteria by denaturing proteins
stinging sensation when applied to cuts or open wounds
Must dry and be left on wound for ~ 2 minutes for maximum effect
Povidone iodine (Aplicare, Betadine)
aqueous solution used against bacteria, fungi, viruses, protozoans, and yeasts
little discomfort to open wounds
Often used in surgical procedures to prevent infection
Diaper rash
irritation and redness
May lead to skin infection if left untreated
Common ingredients in diaper rash products
balsam of Peru
camphor or menthol
eucalyptus oil
talc or kaolin
zinc oxide
balsam of Peru
Promotes wound healing and tissue repair
(used in diaper rash products)
camphor or menthol
Local anesthetic that relieves pain and itching
(used in diaper rash products)
eucalyptus oil
Has antimicrobial activity
(used in diaper rash products)
talc or kaolin
Promotes moisture absorption
(used in diaper rash products)
zinc oxide
mild astringent to promote drying
(used in diaper rash products)
Aloe Vera Gel
Complementary and Alternative Therapies
soothing, antibacterial, antifungal, and wound-healing properties
pain-inducing speeds up healing of burns/sunburns
