Dermatologic Pharmacology (Part 2) Flashcards
what can be said about repeated use of antiseptic wash solutions?
repeated use of dilute iodine, chlorhexidine, or hydrogen peroxide is generally not necessary- they have a minimal lasting action against bacteria and they potentially impede wound healing through toxic effects on normal tissue
what are the exceptions to antiseptic and antibiotic use in wound treatment?
cadexomer iodine and silver–> reduces bacterial load
what 3 things are super important to consider in a patient’s wound healing process?
their glycemic control, adequate oxygenation, and nutrition
what are the usually reasons that cause inadequate oxygenation during wound healing?
blood volume deficit, unrelieved pain, and hypothermia lead to sympathetic overactivity which causes local vasoconstriction
why does removing dead tissue and debris promote wound healing?
it decreases protease production which conserves local resources needed for healing
what are the 4 different types of wound debridement?
low-pressure irrigation with normal saline; surgical debridement; enzymatic debridement; biological debridement
which wound debridement is routine?
low-pressure irrigation with normal saline
what is an example of a growth factor used for wound healing?
becaplermin: a platelet-derived growth factor that promotes cell proliferation and angiogenesis; it is the only agent approved for treatment of chronic diabetic foot ulcers
what is the black box warning on becaplermin?
for malignancy: use of more than 3 tubes increases risk of malignant complications x4
what are the general principals associated with wound dressings?
woulds should be kept moist and should not be exposed to air
why should wounds not be exposed to air?
occluded wounds heal 40% faster and have less scarring; wounds are then exposed to their own fluid, a mix of metalloproteases and cytokines
there are different recommendations for wound dressings at different stages of the wound healing process. What are these recommendations?
hydrogels should be used for the debridement stage; foam and low-adherence dressing should be used for the granulation stage; hydrocolloid and low-adherence dressing should be used for the epithelialization stage
topical antibacterial agents are not often needed, but they have been around for a long time. What is in these agents?
bacitracin, neomycin, and polymixin B
what is bacitracin?
it is a peptide antibiotic that is active against gram positive organisms; poorly absorbed through the skin
what is neomycin?
aminoglycoside antibiotic that binds to the 30S ribosomal subunit; active against gram negative organisms; poorly absorbed
