Pharm Ch. 56 PPT

Benzol Peroxide (Antiacne)

-Causes death of the anaerobic P. acnes bacteria by slowly releasing oxygen -Antibacterial, antiseptic, drying, and keratolytic actions -Keratolytic: softens scales and loosens the outer layer of the skin

Topical Antifungal Drugs

-Clotrimazole (Lotrimin, Mycelex-G) -Lozenge for oral candidiasis (thrush) -Vaginal suppository or cream for yeast infections -Other forms used for other fungal infections -Miconazole (Monistat) -Topical cream -Vaginal suppository or cream

Topical Dermatologic Drugs

-Antimicrobial drugs -Antibacterial drugs -Antifungal drugs -Antiviral drugs -Antiinflammatory drugs -Antineoplastic drugs -Antipruritic drugs (for itching) -Burn drugs -Antibacterial drugs -Antifungal drugs -Antiviral drugs

Nursing Implications

-Assess for presence of contraindications, especially drug allergies. -Do not apply antiinfective drugs until culture and sensitivity testing (if ordered) are completed. -Wear gloves when applying topical drugs. -Apply dressings (e.g., wet, wet-to-dry, occlusive) as prescribed -Document

Antibacterial Drugs: Most Common

-Bacitracin -Neomycin -Polymyxin -Neomycin and polymyxin B (Neosporin) -Mupirocin (Bactroban) -Unfortunately, because of the high incidence of infection with methicillin-resistant S. aureus (MRSA), mupirocin is now becoming resistant.

Topical Fungal Infections

-Difficult to eradicate -Therapy may be prolonged -Several weeks to 1 year -Topical fungal infections caused by -Candida albicans: a yeastlike opportunistic fungus present in the normal flora of the mouth, vagina, and intestinal tract -Dermatophytes; tinea or ringworm infections

Skin Prep Drugs

-Isopropyl alcohol -Povidone-iodine (Betadine) -Chlorhexidine (Hibiclens) -Benzalkonium chloride (Zephiran)

Isotretinoin (Amnesteem, Claravis, Sotret)

-Treatment of severe recalcitrant cystic acne -Inhibits sebaceous gland activity and has antikeratinizing (anti-skin hardening) and antiinflammatory effects

Topical Anesthetic Drugs

-Used to reduce pain or pruritus associated with -Insect bites -Sunburn -Poison ivy exposure -Also used to numb the skin before a painful injection -Ointments, creams, sprays, liquids, jellies -EMLA: lidocaine/prilocaine combination -Ela-max: lidocaine -Antihistamines -Corticosteroids -Antiinflammatory effects -Antipruritic effects -Vasoconstrictor actions

Drugs used to treat acne

-benzoyl peroxide -erythromycin -tetracycline -isotretinoin -clindamycin -vitamin A acid: retinoic acid

Systemic hair growth drug

-finasteride (Propecia) -Finasteride is classified as a pregnancy category X drug. -Women are not to handle this drug without gloves or crush this drug, thereby making it airborne.

A few months later, it is determined that Jane is not responding to treatment and is now prescribed isotretinoin. Which statement will the nurse include when teaching Jane about isotretinoin therapy? A."Call your prescriber immediately if you experience any signs of depression." B."If you become pregnant, the dose of isotretinoin will be cut in half." C."Isotretinoin is administered by subcutaneous injection directly into the acne areas." D. "Isotretinoin should not be used with any form of birth control"

A

Silver sulfadiazine (Silvadene)

Antibacterial -Topical antiinfective -Used to prevent or treat infection at the site of second- and third-degree burns -Adverse effects: pain, burning, and itching -Do not use in patients who are allergic to sulfonamide drugs.

Mupirocin (Bactroban)

Antibiotic -Used topically for Staphylococcus and Streptococcus impetigo -Intranasal form for MRSA -Available by prescription

During a regular follow-up visit, Jane points out a sore that she has developed on her mouth. She is diagnosed with herpes simplex. Which medication does the nurse anticipate Jane will receive? A. miconazole (Monistat) B. acyclovir (Zovirax) C. clotrimazole (Lotrimin) D. anthralin (Anthra-Derm)

B

Acyclovir (Zovirax) and penciclovir (Denavir)

Both used to treat initial and recurrent herpes simplex 1 and 2 and human papillomavirus infections

Jane is a 17-year-old patient who is being seen in the dermatology clinic for treatment of acne vulgaris. The nurse practitioner prescribes benzoyl peroxide topically four times a day. Jane tells the nurse that she wants take the drug more frequently so the acne will go away quickly. What information will the nurse provide to Jane? A."Improvement is usually seen in 1 week." B."If you want faster results, a pill form of benzoyl peroxide will be used." C."Overuse of this drug can result in painful, reddened skin." D."Benzoyl peroxide causes the skin to blister or swell to clear the acne."

C

A woman who is taking isotretinoin calls the office to say that she thinks she may be pregnant. What will the nurse instruct the patient to do first? A. Stop the isotretinoin immediately. B. Reduce the dosage of the isotretinoin to every other day. C. Switch to tretinoin (retinoic acid). D. Consult an obstetrician.

Correct answer: A Rationale: While she will need to consult an obstetrician to verify her pregnancy, if she suspects that she is pregnant, she must stop the medication immediately because it is a pregnancy category X drug and a known teratogen.

The nurse is assessing a patient who has been diagnosed with MRSA on the right arm. The nurse anticipates use of which medication to treat the MRSA? A. bacitracin B. neomycin C. polymyxin B D. mupirocin (Bactroban)

Correct answer: D Rationale: Mupirocin (Bactroban) is an antibacterial product available only by prescription. It is used on the skin for treatment of staphylococcal and streptococcal impetigo. It is used topically and intranasally to treat nasal colonization with MRSA. The drug is applied topically three times daily and intranasally twice daily to treat MRSA colonization. Adverse reactions are usually limited to local burning, itching, or minor pain.

Acnes is caused by ________________ ______

Propionibacterium acnes

_____________ ___________ have been shown to be better for controlling viral skin conditions

Systemic drugs

Topical hair growth drug

minoxidil (Rogaine) For men and women

Do topical antiviral drugs cure skin infections?

no; but may reduce healing time and pain