objective 4.5 Flashcards
application of medicines to the skin or
mucous membranes for absorption
* Used on skin, mucous membranes, surfaces of the eye, ear, nose,
mouth, vagina and anus
* Drugs that are administered directly to the site are called “topical
dermatological drugs’
* Come in many forms (Table 56.3), each with unique characteristics
that make them beneficial for particular uses.
percutaneous drugs
what are the types of percutaneous drugs
- Antibacterial
- Antifungal
- Anti-inflammatory
- Antineoplastic
- Antipruritic (To relieve itching)
- Antiviral
- Burn drugs
- Debriding drugs (to promote healing)
- Emollients (moisturizers/soften skin)
- KERATOLYTICS (removes excess
growth of epidermis by loosening and
shredding cells) - LOCAL ANAESTHETICS
- Sunscreen
- Topical vasodilators
what is the purpose of percutaneous drugs
- Cleanse or debride a wound (N/S, silver, honey)
- Hydrate the skin (Cetaphil, Aveeno)
- Reduce inflammation (Hydrocortisone)
- Relieve localized S & S (Calmoseptine, Nystatin)
- Protective barrier (Iles paste, Cavilon)
- Reduce thickening of skin (Dermatrix)-Kerolytics
- Prepare the skin for procedures (Isopropyl alcohol, chlorhexidine)
what affects absorption of topical meds?
- Concentration of the drug
- Length of contact of drug and percutaneous tissue
- Thickness of area
- Condition of skin
what are the MOAs and uses of antibacterials?
Uses:
* Primarily to decrease the number of bacteria on skin surfaces; prevent
superficial infections in minor cuts, abrasions, wounds & minor burns
* Most common skin disorders: Acne, folliculitis, impetigo, furuncles,
carbuncles, papules, pustules, vesicles and cellulitis
MOA : Direct local effect on specific organisms, Can be bacteriostatic or bactericidal
what are the nursing implications of antibacterials?
- Protect clothing during and after application
- Replace soiled labels if needed on containers/dispensers
- Do not keep container at bedside
- Perform hand hygiene and don gloves
- Cleanse and dry area prior to application
is the most common skin infection, and its cause remains
unknown. Contributing factors might include heredity, stress, drug reactions,
hormones and bacterial infections.
acne vulgaris
what are some of the most common topical drugs used to treat acne?
benzoyl peroxide
dalacin
accutane
tretinoin
what are the MOAs, adverse effects, and nursing implications of benzoyl peroxide?
MOA liberates oxygen in the skin that results in antibacterial, antiseptic, drying and
keratolytic actions; making it unfavorable for the anaerobic bacteria to grow
Adverse effects: r/t dose; incudes peeling, reddened skin, warmth sensation
Nursing Implications: education, since overuse is a huge concern; available in many
forms; applied topically TID-QID
what are teh MOAs, uses, adverse effects, and nursing implications of dalacin?
MOA inhibits protein synthesis; bacteriostatic/bactericidal; good effect on gram-pos and anaerobic
bacteria
Uses: to treat inflammatory lesions a/w acne
Adverse effects: usually limited to minor local skin reactions
Nursing implications: comes in many forms; usually applied once or twice daily
what are the MOAs, adverse effects, and nursing implications of accutane?
MOA inhibits sebaceous gland activity and has anti-skin-hardening, along w/ anti-inflammatory
properties
Adverse effects: teratogenic, suicidal ideations/attempts, dry skin and mucous membranes, increase
thirst sensation
Nursing implications: education, safe sex, monitor for mental health changes, labs (esp LFTs and lipids)
what are the MOAs, uses, adverse effects, and nursing implications of tretinoin?
MOA acts as a skin irritant, stimulating turnover of epidermal cells (peeling); at
the same time, free fatty acids of the skin are reduced, and horny cells of the
skins outer layer cannot adhere to one another. This makes it impossible for
pimples to exist.
Uses: repairs sun damaged skin, reduces collagen breakdown
Adverse effects: local inflammatory reactions (reversible when treatment is
stopped)
Nursing implications: many formulations; best if applied in the evening;
treatment usually begins w/ low dose
what are the MOAs, uses, and adverse effects of antifungals?
MOA: Local effect to inhibit growth of fungi
Uses:
* Candida (yeast) infections most often found in warm, moist areas
* superficial mycotic (fungal) infections of hair, skin, nails
* tx of tinea pedis (athletes ft), tinea cruris (jock itch), tinea corporis (ringworm)
Adverse Effects
* Local irritation, pruritus, burning sensation and scaling
* Hypersensitivity (contraindicated w/ known sensitivity)
what are the nursing implications of antifungals?
- Begin and end with hand hygiene
- Therapy may be required for extended time, since fungi are slow growing
- Cleanse skin and dry well; wear gloves
- Follow instructions carefully for application procedures
- Avoid double dosing
- Topical preparations may be in the form of creams, powders, solutions, or aerosol sprays
applied 2-3 times/day as ordered. - Note ulcerations or burns present. These conditions ↑drugs’ absorption & ↑ likelihood of
the occurrence of systemic side effects ie.: nausea, vomiting, & diarrhea. - Avoid inhalation of powders or sprays
- Complete full course of therapy even if symptoms dissipate. This prevents recurrence of
symptoms & development of resistant strains of the organism.
what are the MOAs, and uses of antivirals?
MOA: Inhibits viral replication; best used early in an outbreak
Uses: for the treatment of primary genital herpes, herpes simplex virus in
immunocompromised clients, and HPV
