Chapter 196 - Other Topical Medications Flashcards
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Topical Antimicrobials and Astringents
What group does Chlorhexidine belong to?
Bisbiguanide
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Topical Antimicrobials and Astringents
What group does Gentian violet belong to?
Dye
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Topical Antimicrobials and Astringents
What group does Brilliant green belong to?
Dye
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Topical Antimicrobials and Astringents
What group does Hydrogen peroxide belong to?
Peroxide
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Topical Antimicrobials and Astringents
What group does Povidone-iodine belong to?
Iodophor
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Topical Antimicrobials and Astringents
What group does Clioquinol belong to?
Iodophor
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Topical Antimicrobials and Astringents
What group does Metronidazole belong to?
Imidazole
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Topical Antimicrobials and Astringents
What group does Mupirocin belong to?
Fermentation product of Pseudomonas fluorescens
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Topical Antimicrobials and Astringents
What group does Retapamulin belong to?
Pleuromutilin
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Topical Antimicrobials and Astringents
What group does Azelaic acid belong to?
Dicarboxylic acid
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Topical Antimicrobials and Astringents
What group does Benzoyl
peroxide belong to?
Peroxide
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Topical Antimicrobials and Astringents
What group does Aluminum salts belong to?
Astringent
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Topical Antimicrobials and Astringents
What group does Potassium
permanganate belong to?
Astringent
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Topical Antimicrobials and Astringents
What group does Silver nitrate belong to?
Astringent
TABLE 196-1
Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
(1) Binds to negatively charged bacterial cell wall and cytoplasmic components leading to altered osmotic equilibrium
(2) Precipitation of cytoplasmic components
Chlorhexidine
TABLE 196-1
Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Unknown
- Gentian violet
- Brilliant green
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Oxidizes microbial molecules
- Hydrogen peroxide
- Benzoyl peroxide
- Potassium permanganate
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Oxidation and release of free iodine
Povidone-iodine
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Oxidation and release of free iodine; chelates bacterial surface and trace metals needed for bacterial growth
Clioquinol
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Creation of reduced intermediate compounds and free radicals
Metronidazole
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Inhibits bacterial isoleucyl-tRNA synthetase
Mupirocin
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Inhibits 50S subunit of prokaryotic ribosome
Retapamulin
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Possibly through inhibition of microbial respiratory chain
Azelaic acid
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Coagulation of proteins
Aluminum salts
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Topical Antimicrobials and Astringents
ANTIBACTERIAL MECHANISM
Precipitation of bacterial proteins by free silver ions
Silver nitrate
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Gram-positive, Gram-negative bacteria, enveloped viruses, and fungi
Chlorhexidine
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Some vegetative Gram-positive bacteria (eg, Staphylococcus sp.) and yeast
- Gentian violet
- Brilliant green
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Broad-spectrum antimicrobial
- Hydrogen peroxide
- Benzoyl peroxide
- Aluminum salts
- Potassium permanganate
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Gram-positive, Gram-negative, enveloped viruses, fungi, sporicidal, Mycobacterium tuberculosis
- Povidone-iodine
- Clioquinol
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Anaerobes, protozoa, and microaerophilic bacteria
Metronidazole
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Gram-positive, some Gram-negative, spares normal flora
Mupirocin
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Gram-positive
Retapamulin
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Propionibacterium acnes and Staphylococcus epidermidis
Azelaic acid
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Topical Antimicrobials and Astringents
ANTIMICROBIAL SPECTRUM
Gram-positive and Gram-negative bacteria
Silver nitrate
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Keratitis, ototoxicity
Chlorhexidine
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Potential skin necrosis at high concentrations or when occluded; stains skin and clothing; tattooing when applied over granulation tissue; mutagenic
Gentian violet
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Potential skin necrosis; stains skin and clothing
Brilliant green
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Avoid in abscesses; bleaches hair
Hydrogen peroxide
TABLE 196-1
Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Caution in patients with thyroid disorders; potential systemic toxicity in neonates or when applied to large body surface area; neutralized by blood, serum proteins, and sputum
Povidone-iodine
TABLE 196-1
Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Possible irreversible optic atrophy and peripheral neuropathy (oral); contraindicated in children <2 years of age; contraindicated for diaper rash; stains skin yellow; neutralized by blood, serum proteins, and sputum
Clioquinol
TABLE 196-1
Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Contraindicated during first trimester of pregnancy
Metronidazole
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Potentially toxic amounts of polyethylene glycol contained in vehicle may be absorbed in patients with extensive burns or open wounds
Mupirocin
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Allergic contact dermatitis
Retapamulin
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Hypopigmentation
Azelaic acid
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Bleaches dark clothing
Benzoyl peroxide
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Do not use under impervious material to prevent evaporation
Aluminum salts
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Skin discoloration; caustic at high concentrations or with contact of undissolved crystals
Potassium permanganate
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Topical Antimicrobials and Astringents
MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Black skin discoloration, caustic at high concentrations; potential methemoglobinemia
Silver nitrate
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Topical Antimicrobials and Astringents
USE
Antiseptic surgical hand scrub and surgical site preparation
Chlorhexidine
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Topical Antimicrobials and Astringents
USE
Impetiginized eczema; mycotic skin infections; oral candidiasis; superficial skin infections
- Gentian violet
- Brilliant green
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Topical Antimicrobials and Astringents
USE
Cleansing of wounds, suppurating ulcers, and local infections
Hydrogen peroxide
TABLE 196-1
Topical Antimicrobials and Astringents
USE
Antiseptic surgical hand scrub, prevention or treatment of topical site infection associated with surgery, burns, minor cuts/scrapes
Povidone-iodine