Integumentary System Deck 2 Flashcards
Ointments
Water suspended in oil
• Excellent lubrication
• Generally most potent vehicles
• Greasy, not useful in hairy areas
Ointments do what
facilitate heat retention, prevent water loss, semi occlusive.
Ointments apply
two to three times per day to dry,
lichenified lesions, particularly after
moisturizing the skin
cream are
Cosmetically appealing • Semi-solid – emulsions of oil in 20 to 50% water • Same medication, different potency – Ointments > cream formulations > lotions
Lotions
Least potent • Useful in hairy areas and large areas • Powder-in-water – shake container • Evaporate • Cooling and drying effects • Useful for treating – moist dermatoses – pruritis
Solutions
Contain water or non-aqueous • Bath soaks and open wet dressings – provide coolness – aid in drying exudative lesions • Vasoconstriction – results in decreased local blood flow – reduction in local edema
Solutions used in Wet Dressings
Permit the cleansing of exudate
– maintain drainage in infected lesions
Wet dressings should be changed every
6 hours for 2 to 3 days – Prior to determining effectiveness
Closed wet dressings polyurethane plastic
Closed wet dressings polyurethane plastic
– allows heat to be retained
– prevents evaporation
– causes maceration
Gels are
• Oil-in-water emulsion
– alcohol base
– thin, greaseless, non-staining film
Gels benefit and charticteristics
Transparent, colorless, semi-solid emulsions
that liquefy on contact with the skin
• Therapeutic advantage of ointments
• Cosmetic advantages of cream
Gels are great in
hairy areas and acne
Foams are
Gaseous bubbles in a matrix of liquid film
Foams benefits
Spread readily • Easier to apply – inflamed skin – scalp dermatoses • More cosmetically acceptable – lead to high compliance
Topical Calcineurin Inhibitors used for
atopic dermatitis
Topical Calcineurin Inhibitors MOA
Inhibit calcineurin
– Inhibit T cells, Langerhans’ cells, mast cells,
and keratinocytes
Topical Calcineurin Inhibitors are not to be used in
Not to be used in immunocompromised
patients or children under 2.
Topical Calcineurin Inhibitors have a
Black Box warning about long-term safety
because of rare cases of malignancy
Topical Antipsoriasis Agents are used for
the treatment of psoriasis
Topical Antipsoriasis Agents examples
calcipotriene
Coal tar
Tazotene
calcipotriene
– A vitamin D derivative
– Suppresses lymphocyte activity
Coal tar
Enzyme inhibition
Tazarotene
Topical retinoid prodrug
Topical Antipsoriasis Agents ADR
– All cause burning, stinging, erythema, dermatitis
– Calcipotriene should not be prescribed in patients with hypercalcemia;
hypercalcemia occurs if greater than 100 g/week used
Coal tar ADR
may stain hair, fabrics
Tazarotene ADR
worsening of psoriasis may occur
Seborrhea
inflamatory dermitis that results in a yellow greasy scales in the sebaceous glands, external ear, upper trunk area, scalp and face
Topical Antiseborrheic Medications examples
Selenium sulfide Pyrithione zinc Ketoconazole Sulfacetamide sodium Seborrhea and dandruff
Selenium sulfide MOA
Cytostatic effect on cells of epidermis
Pyrithione zinc MOA
Cytostatic effect reduces cell turnover rate
Ketoconazole is a
Antifungal
Sulfacetamide sodium
Antibacterial active against common skin organisms
Seborrhea and dandruff shampoo uses
Apply shampoo to scalp 1 to 2 times per week, rinse well
– Follow label directions
Topical Immunomodulators used to treat
anogenital warts, actinic
keratosis, and some skin cancers
sinecatechin (vergren) used for
external
genital and perianal warts
Imiquimod (aldara, Zyclara, Vyloma) used for
actinic Keratosis, genital and perianal
warts, superficial basal cell carcinoma,
and off-label for cutaneous flat warts
Topical immunomodulators ADR
Local inflamation, photsensitivity, some may result in systemic reactions includign flu like reactions, fever
Keratolytics used for
corns, calluses, lesions, scalling
most common keratolytic
salicylic acid
Salicylic acid
– OTC wart and corn treatment
– OTC products 5% to 17%; patches 40%
– Use per product label
Keratolytic - Lactic acid (12% lotion)
– Xerosis, dry skin, ichthyosis, keratosis pilaris:
apply to affected area twice a day
Topical Anesthetics used for
prep for procedures
Topical Anesthetics examples
Lidocaine-prilocaine (EMLA) • Lidocaine-tetracaine (Synera) • Lidocaine 4% (LMX-4) • Use for topical anesthesia for minor painful procedures
Astringents example and use
Aluminum chloride hexahydrate (Drysol)
– Used for hyperhidrosis (excessive sweating)
– Apply at bedtime, and wash off in morning
