Chapter 56: Dermatologic Drugs

What are the topical dermatologic drug formulations?

-Ointments -Creams -Gels -Lotions

What are adverse effects of silver sulfadiazine (Silvadene)?

-Adverse effects: pain, burning, and itching -Do not use in patients who are allergic to sulfonamide drugs

What is cellulitis?

-An acute, diffuse, spreading infection involving the skin, subcutaneous tissue, and sometimes muscle as well. -It is usually caused by infection of a wound with Streptococcus or Staphylococcus species.

What is clindamycin (Cleocin T) used for?

-Antibiotic -Used topically to treat acne

What are the two types of nonmelanoma skin cancer?

-Basal cell carcinoma -Squamous cell carcinoma

Which type of nonmelanoma skin cancer is the most common?

-Basal cell carcinoma is the most common and is rarely fatal, but it can be highly disfiguring -Squamous cell carcinoma, on the other hand, can be fatal, with 2500 deaths reported annually

How does benzalkonium chloride work?

-Benzalkonium chloride is a surface-active drug that works by denaturing the microorganism or essentially destroying its protein.

What are neomycin and polymyxin B used for?

-Broad spectrum antibiotics -Combination of the two is also known as Neosporin (cream formulation) -Neosporin ointment has neomycin, polymyxin B AND bacitracin -Used as topical antiseptics for minor skin wounds

How does chlorhexidine (Hibiclens) work and what is it used for?

-Chlorhexidine acts by disrupting bacterial membranes and inhibiting cell wall synthesis. -It is used primarily as a surgical scrub or hand-washing agent by health care professionals.

What is scabies?

-Common parasitic skin infection caused by the itch mite Sarcoptes scabiei

What kind of teaching do patients receiving isotretinoin need?

-Contraceptive teaching because of the high risk of birth defects -Suicide prevention

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)

-Correct answer: B. acyclovir (Zovirax) -Rationale: Herpes simplex is a viral infection. Acyclovir (Zovirax) and penciclovir (Denavir) are topical antiviral drugs available to treat viral infections such as herpes simplex. Miconazole (Monistat) is a topical antifungal drug. Clotrimazole (Lotrimin, Mycelex-G) is available as a lozenge for the treatment of oropharyngeal candidiasis.

What are adverse effects of aloe?

-Diarrhea -Abdominal pain -Dermatitis

What are nursing implications related to isotretinoin (Amnesteem)?

-Ensure that strict guidelines are in place for monthly pregnancy testing and prescription renewal -Monitor liver function before and during therapy

What are the two layers of the skin?

-Epidermis -Dermis

What is folliculitis?

-Inflammation of a follicle, usually a hair follicle.

What is the most aggressive skin cancer?

-Melanoma -Accounts for only 3% of all skin cancers but is responsible for 75% of deaths associated with skin cancer

What pregnancy category is tretinoin (retinoic acid, vitamin A acid) (Renova, Retin-A)?

-Pregnancy category C

What are the most common bacteria that infect the skin?

-Streptococcus pyogenes -Staphylococcus aureus

What is isotretinoin (Amnesteem, Claravis, Sotret) used for?

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

What is aloe used for?

-Used for wound healing

What are topical wound care drugs used for?

-Used to prepare wound bed for healing -Remove nonviable tissue (debridement) -Antibacterial

What are examples of wound care drugs?

-Vitamin C (ascorbic acid) -Zinc -Topical wound care drugs

What drugs are used to treat acne?

-benzoyl peroxide -erythromycin -tetracycline -isotretinoin (Amnesteem) -clindamycin (Cleocin T) -tretinoin (Renova, Retin-A) -Oral contraceptives (for female patients with acne)

What are examples of immunomodulators?

-pimecrolimus (Elidel) -Imiquimod (Aldara)

What are examples of antipsoriatic drugs?

-tazarotene (Tazorac) -anthralin (Anthra-derm) -calcipotriene (Dovonex)

A patient is prescribed bacitracin topical ointment. What does the nurse suspect as the possible diagnosis based on the medication prescribed?

Bacterial infection Bacitracin is a polypeptide antibiotic that is applied topically for the treatment or prevention of local skin infections caused by susceptible aerobic and anaerobic gram-positive organisms such as staphylococci, streptococci, anaerobic cocci, corynebacteria, and clostridia.

Which medication is useful in the prevention and treatment of topical infections caused by burns and surgery?

Povidone-iodine Povidone-iodine is an antiseptic medication. It is useful for the treatment and prevention of bacterial, viral, and fungal infections that are caused by burns and surgeries.

A teenage female patient is going to be prescribed isotretinoin for acne. Which information is most important for the nurse to include in the education of the patient?

The patient must use at least two forms of contraception while taking this medication.

What are psoriasis flare-ups triggered by?

-Changes in climate -Infection -Stress -Excessive alcohol intake -Dry skin

The nurse is caring for a child who reports pain following an insect bite. What class of drug should be included in the treatment plan?

Topical anesthetics Topical anesthetics such as lidocaine are used for the treatment of pain associated with an insect bite. It numbs the skin, thereby reducing or eliminating pain.

What are nursing implications of dermatologic drugs?

-Assess for presence of contraindications, especially drug allergies -Do not apply antiinfective drugs until culture and sensitivity testing (if ordered) are completed -Assess area affected thoroughly before applying medication -Keep in mind that systemic absorption is higher in the very young and very old because the skin may be more permeable -Follow specific manufacturer's guidelines for administration techniques -Cleanse the area thoroughly to remove debris and residual medication; follow specific recommendations -Wear gloves when applying topical drugs -Apply dressings (e.g., wet, wet-to-dry, occlusive) as prescribed -Protect affected area from sunlight -Do not double up on dose if a dose is missed -Ensure proper disposal of contaminated dressings

What is the difference between bactericidal and bacteriostatic?

-Bactericidal: kills the bacteria -Bacteriostatic: prevents further growth of bacteria

What are the newest drugs approved for lice treatment?

-Benzyl alcohol 5% (Ulesfia): works by suffocating the lice -Spinosad (Natroba): indicated for children 4 years of age and older and offers the benefit of not requiring nit combing as do the other treatments

What are 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

How does benzoyl peroxide work?

-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 -Produces improvement in 4 to 6 weeks

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 should 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."

-Correct answer: A. "Call your prescriber immediately if you experience any signs of depression." -Rationale: There have been case reports of suicide and suicide attempts in patients receiving this medication. Educate patients to report any signs of depression immediately to their prescribers. Isotretinoin is one of relatively few medications that are classified as pregnancy category X drugs. This means that it is a proven human teratogen. It is imperative that female patients of childbearing age be counseled and agree not to become pregnant during use of the drug. It is now officially required that at least two reliable contraceptive methods be used by sexually active women during therapy with isotretinoin and for 1 month after completion of therapy. Isotretinoin is available only for oral use.

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. Stop the isotretinoin immediately. -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.

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."

-Correct answer: C -Rationale: Overuse of this drug and also of tretinoin is common in teenage patients who are attempting to cure their acne quickly. The result can be painful, reddened skin, which usually resolves on return to use of these medications as prescribed. Benzoyl peroxide generally produces signs of improvement within 4 to 6 weeks. Benzoyl peroxide is available in multiple topical dosage forms. Blistering or swelling of the skin is generally considered an allergic reaction to the product and is an indication to stop treatment.

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. mupirocin (Bactroban) -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.

What are ectoparasites?

-Insects that live on the outer surface of the body (lice and scabies)

Why are topically administered corticosteroids favored?

-Many of the undesirable systemic adverse effects associated with the use of the systemically administered corticosteroids are avoided

What are adverse effects of benzoyl peroxide?

-May cause peeling skin, redness, or sensation of warmth

What is the itching associated with scabies due to?

-Mite causes irritation and itching by boring into the horny layers of skin located in cracks and folds. -Itching seems to occur most commonly in the evening.

What are carbuncles?

-Necrotizing infections of skin and subcutaneous tissue caused by multiple furuncles (boils). -They are usually caused by the bacterium Staphylococcus aureus.

Which topical corticosteroid has the lowest potency?

-OTC hydrocortisone -Prescription corticosteroids have a higher potency: triamcinolone 0.1% (lower); triamcinolone 0.5% (moderate)

What is the most classic type of psoriasis?

-Plaque psoriasis -Typically manifests as large, dry, erythematous scaling patches of the skin that are often white or silver on top

What is povidone-iodine (Betadine) used for?

-Povidone-iodine (Betadine) is an antiseptic that kills bacteria, fungi, and viruses. -It is used for the prevention or treatment of topical infections associated with surgery, burns, and minor cuts and scrapes, and for relief of minor vaginal infections. -It is the most widely used antiseptic, but patients should be screened for iodine or shellfish allergies before using it

What is the most common form of cancer?

-Skin cancer

What are vesicles?

-Small sacs containing liquid - often seen in patients with poison ivy/oak and are often in a linear pattern

What are papules?

-Small, circumscribed, superficial, solid elevations of the skin that are usually pink and less than 0.5 to 1 cm in diameter - these are also called a rash

What is miconazole (Monistat) used for?

-Topical cream -Vaginal suppository or cream -Used for treatment of athlete's foot, jock itch, ringworm & other susceptible fungal infections

What are topical ectoparasiticidal drugs used to treat?

-Topical ectoparasiticidal drugs to treat pediculosis (Phthirus pubis, Pediculus humanus corporis, Pediculus humanus capitis) and scabies (Sarcoptes scabiei)

What does imiquimod (Aldara) treat?

-Treats actinic keratosis, basal cell carcinoma, and anogenital warts

What does pimecrolimus (Elidel) treat?

-Treats atopic dermatitis -Pimecrolimus (Elidel) mechanism of action is similar to that of the anti-transplant-rejection drug tacrolimus (Prograf), which was discussed in Chapter 48.

What is bacitracin used for?

-Used in local skin infections caused by susceptible aerobic and anaerobic gram-positive organisms (e.g. staphylococci, streptococci -Can be either bactericidal or bacteriostatic

What are topical anesthetic drugs used for?

-Used to reduce pain or pruritus associated with: -Insect bites -Sunburn -Poison ivy exposure -Also used to numb the skin before a painful injection

What is tretinoin (retinoic acid, vitamin A acid) (Renova, Retin-A) used for?

-Used to treat acne -Used to help with reduce the dermatologic changes associated with age (e.g. fine wrinkling, hyperpigmentation, roughness) -Also used to reduce dermatologic changes associated with sun damage -Stimulates the turnover of epithelial cells, resulting in skin peeling -Derivative of vitamin A

What is mupirocin (Bactroban) used for?

-Used topically for Staph and Strep impetigo -Intranasal form for methicillin-resistant S. aureus (MRSA) - to prevent nasal colonization -Available by prescription only

What are pustules?

-Visible collections of pus or fluid within or beneath the epidermis - these vary in size

What are the most common antibacterial drugs?

-bacitracin -neomycin -polymyxin B -neomycin and polymyxin B (Neosporin) -mupirocin (Bactroban)

What is an example of a topical antineoplastic drug?

-fluorouracil (Efudex) -Treats basal cell carcinoma and actinic keratosis

The nurse is assessing a patient who reports a burning and itching sensation on the skin. The nurse finds that the patient's skin is dry and peeling because of a medication that was prescribed for the treatment of acne vulgaris. What medication was prescribed for the patient?

Clindamycin

The nurse is assessing the skin of a patient who has been using benzoyl peroxide for the treatment of acne for 2 weeks. The nurse finds that the patient has inflammation and blistering on the skin. Which medication is the best choice to replace benzoyl peroxide to provide effective treatment?

Isotretinoin Benzoyl peroxide is used in the treatment of acne. Inflammation and blistering or swelling of the skin is generally considered to be an allergic reaction to the product and is an indication to stop treatment. In such cases, isotretinoin is prescribed, because it is an effective acne medication with minimal side effects.

What are the types of topical antipruritic drugs?

-Antihistamines -Corticosteroids

What are the effects of topical corticosteroids?

-Antiinflammatory effects -Antipruritic effects -Vasoconstrictor actions

What is atopic dermatitis caused by?

-Atopic dermatitis is caused by a hereditary susceptibility to pruritus and is often associated with allergic rhinitis, hay fever, and asthma (called atopic triad because these three travel together).

What is Ela-max?

-Lidocaine

What drugs interact with aloe?

-digoxin -antidysrhythmics -diuretics

What are examples of skin preparation drugs?

-isopropyl alcohol (70%) -povidone-iodine (Betadine) -chlorhexidine (Hibiclens) -benzalkonium chloride (Zephiran)

What is an example of a topical ectoparasiticidal drug?

-lindane (Kwell) -Chlorinated hydrocarbon originally developed as an agricultural insecticide

What is the main function of melanin?

Absorb radiation Melanin is a color pigment in the skin that is produced by melanocytes and absorbs radiation, thus giving protection. Connective tissue strengthens the skin. Eccrine glands regulate body temperature. Melanin has no role in growth, so it does not increase the amount of blood vessels.

Isotretinoin and tretinoin are common dermatologic drugs used to treat

Acne Isotretinoin and tretinoin are effective topical treatments for acne vulgaris. Isotretinoin inhibits sebaceous gland activity, and tretinoin stimulates the turnover of epidermal cells, resulting in skin peeling.

What is EMLA?

-A lidocaine/prilocaine combination

What is acne caused by?

-Acne is caused by Propionibacterium acnes

Topical anesthetic drugs come in which forms?

-Ointments -Creams -Sprays -Liquids -Jellies

What is silver sulfadiazine (Silvadene) used for?

-Topical antiinfective -Used to prevent or treat infection at the site of second- and third-degree burns

How is scabies transmitted?

-Scabies is transmitted from person to person by close contact, such as by sleeping next to an infested person.

The nurse is assessing a patient with scabies. What should the nurse suggest to the patient's family for providing effective care?

"Avoid direct contact, and do not use personal articles of the patient." Scabies is caused by Sarcoptes scabiei. It is a communicable disease and is transmitted by direct contact with the patient. The nurse should inform the patient's family to avoid sleeping beside the patient and using the personal articles of the patient to prevent the spread of infection.

The nurse is caring for a patient with vulvovaginal candidiasis who has been prescribed miconazole. Which instruction will the nurse expect the primary health care provider to give?

"Insert a 200-mg vaginal suppository once daily at bedtime for 3 days."

A child with head lice has been prescribed lindane shampoo. What instruction should the nurse give to the child's parent to ensure proper use of the shampoo?

"Leave it on the hair for 4 minutes before rinsing." The most appropriate instruction given by the nurse to the child's parent is to leave the shampoo on the hair for 4 minutes before rinsing.

What is pediculosis?

-A parasitic infestation on the skin with lice

The nurse is caring for a patient with actinic keratosis who has been prescribed fluorouracil. Which instruction should the nurse include in the discharge instructions for this patient?

"Use sunscreen and wear protective clothing when outdoors." Photosensitivity is an adverse effect of fluorouracil, and exposure to the sun can cause severe burns. Therefore, the patient should be instructed to use sunscreen and wear protective clothing when going outdoors.

The nurse finds that a patient has been drinking aloe vera juice for 9 months and is using it topically. What will the nurse suggest that the patient discuss with the provider? Select all that apply.

"You should get an electrocardiogram." "You should increase your intake of fluids." "You should get your blood and urine tested."

The nurse is assessing a patient with acne who has been prescribed isotretinoin. Which instruction should the nurse give to the patient to ensure safe administration of this medication?

"You should not become pregnant while using this drug." Isotretinoin is categorized as a pregnancy category X drug. It causes birth defects because of its close resemblance to retinoic acid, a natural vitamin A derivative that controls normal embryonic development. The nurse should inform the patient to avoid becoming pregnant while using this medication to prevent the teratogenic effects of the drug.

What is impetigo?

-A pus-generating, contagious superficial skin infection, usually caused by Staphylococci or Streptococci. It generally occurs on the face and is most commonly seen in children; may be recognized by honey-colored crusts.

Which form of topical drugs is the most penetrating?

-Ointments are generally the most penetrating and therefore should be used only in small areas -Gels, creams, and lotions are less penetrating

What is psoriasis?

-A common skin condition in which areas of the skin become thick, reddened, and covered with silvery scales -Result of a disordered immune system -Believed to involve polygenic inheritance -Fluctuating patterns of recurrence and remission

What are furuncles?

-Painful skin nodules caused by Staphylococcus organisms that enter the skin through the hair follicles -also called a boil.

What is dermatophytosis?

-Ringworm

Which one of the following drugs would you anticipate the provider ordering for a patient who has sustained a second degree burn to her thigh? A. Benzoyl peroxide B. Neomycin C. mupirocin (Bactroban) D. silver sulfadiazine (Silvadene)

D. silver sulfadiazine (Silvadene)

The nurse is caring for a patient with sunburns. Which action is important in the care of this patient?

Giving adequate fluids to prevent dehydration A patient who experiences sunburn is especially prone to dehydration; therefore, increasing fluid intake is very important.

The nurse is caring for a patient with acne who has been prescribed benzoyl peroxide. The patient reports blistering and swelling of the skin. What nursing action is a priority?

Instruct the patient to immediately consult the primary health care provider. The nurse instructs the patient to immediately consult the primary health care provider, because blistering or swelling of the skin is generally considered an allergic reaction to the product.

The nurse is caring for a patient with minor wounds on the hand who has been prescribed an antibacterial medication for preventing infections. Which medication should the nurse expect to find in the patient's prescription?

Neomycin, polymixin B, and bacitracin The primary health care provider would prescribe Neosporin ointment, which is a triple antibiotic combination of neomycin, polymixin B, and bacitracin. This has a faster therapeutic effect.

Which is an example of sebaceous glands?

Oil glands Sebaceous glands contain large lipid cells that produce oil that covers the epidermis of the skin; therefore, these are oil glands.

What are the physiologic functions of the skin? Select all that apply.

Sensation, protection, absorption

When planning care for a burn patient, the nurse would anticipate applying which topical medication?

Silver sulfadiazine Silver sulfadiazine is a topical antiinfective drug used to treat and prevent infection in second- and third-degree burns.

The nurse is assessing a patient who has inflammation and a burning sensation in the lower back. During the assessment, the nurse finds the presence of sharply demarcated, scaling plaques. What may the nurse suspect based on these findings?

The patient has psoriasis. Psoriasis is characterized by the presence of lesions that are covered with silvery white scales. These lesions are symmetrically distributed and commonly occur on the scalp, elbows, nails, and lower back. Nail dystrophies and pitting occur in some patients.

What are adverse effects of topically administered corticosteroids?

-Acne eruptions, allergic contact dermatitis, burning sensations, dryness, itching, skin fragility, hypopigmentation, purpura, hirsutism (usually facial), folliculitis, round and swollen face, and alopecia (usually of the scalp). -Opportunistic overgrowth of bacteria, fungi, or viruses as a result of the immunosuppressive effects of this class of drugs. -Tachyphylaxis (weakening of drug effect over time) may also occur with these drugs, especially with long-term use or overuse.

What is tinea pedis?

-Athlete's foot

What are the functions of the skin?

-Protective barrier for the internal organs -Senses changes in temperature, pressure, or pain -Regulates body temperature -Excretes fluid and electrolytes -Stores fat -Synthesizes vitamin D -Provides a site for drug absorption -Part of this protection includes the skin's ability to maintain a surface pH of 4.5 to 5.5. This weakly acidic environment discourages the growth of microorganisms that thrive at a more alkaline environment

How long is typical fungal infection therapy?

-Several weeks to 1 year

What should you document when administering a dermatologic drug?

-Site of application -Drainage (color, amount) -Swelling, temperature -Odor, color, pain, or other sensations -Type of treatment given -Patient's response -Size of lesion

Which one of the following is NOT a common adverse effect of tretinoin (retinoic acid, Vitamin A acid)? A. Folliculitis B. Red and edematous blisters C. Temporary alterations in skin pigmentation D. Crusted skin

A. Folliculitis

Which one of the following is used to treat actinic keratosis, superficial basal cell carcinoma and anogenital warts? A. pimecrolimus (Elidel) B. lindane (Kwell) C. imiquimod (Aldara) D. anthralin (Anthra-Derm)

C. imiquimod (Aldara)

What are adverse effects of bacitracin?

-Adverse reactions are minimal but can occur such as skin rash to allergic anaphylactoid reactions

What are adverse effects of clindamycin (Cleocin T)?

-Adverse reactions are usually limited to minor local skin reactions, including burning, itching, dryness, oiliness, and peeling

What are types of topical dermatologic drugs?

-Antimicrobial drugs: Antibacterial drugs, Antifungal drugs, Antiviral drugs -Antiinflammatory drugs -Antineoplastic drugs -Antipruritic drugs (for itching) -Burn drugs -Emollients (soften skin) -Keratolytics (cause softening and peeling of the stratum corneum) -Local anesthetics -Topical vasodilators -Débriding drugs (promote wound healing) -Sunscreens

Antihistamines should not be used to treat which conditions and why?

-Chickenpox -Widespread poison ivy lesions -Other lesions involving large body surface areas -Can cause systemic absorption and subsequent toxicity

What can bacterial skin infections cause?

-Folliculitis -Impetigo -Furuncles -Carbuncles -Cellulitis -Pustules -Vesicles -Papules

What pregnancy category is isotretinoin?

-Isotretinoin is one of relatively few medications that are classified as pregnancy category X drugs. -This means that it is a proven human teratogen, or a chemical that is known to induce birth defects.

What is clotrimazole (Lotrimin, Mycelex-G) used for?

-Lozenge for oral candidiasis (thrush) -Vaginal suppository or cream for yeast infections -Other forms used for other fungal infections (e.g. powder, lotion)

What are adverse effects of antiacne drugs?

-Main adverse effects are local inflammatory reactions, which are reversible when therapy is discontinued -Common adverse effects are excessively red and edematous blisters, crusted skin, and temporary alterations in skin pigmentation

A patient who is prescribed the drug miconazole, a topical antifungal, has most likely been diagnosed with which condition?

Candidiasis Miconazole is used in the treatment of candidiasis, which is commonly known as a yeast infection.

A primary health care provider prescribes tazarotene for a patient with plaque psoriasis. Which action should the nurse follow while administering the medication to the patient?

Check the patient's pregnancy test before administering the drug. Tazarotene is prescribed for the treatment of plaque psoriasis. It is classified as a pregnancy category X drug. Therefore, a negative pregnancy test 2 weeks before starting therapy is required for female patients because the drug can result in birth defects.

The nurse is assessing a patient with a skin infection who has been taking aloe for many years. What will the nurse expect after knowing this?

The patient may have increased risk of renal failure. The patient who takes aloe may have increased risk of renal failure because aloe causes nephritis. Therefore, it is contraindicated in patients with renal diseases.

The primary health care provider has prescribed topical antibiotics instead of systemic antibiotics to prevent infection in a patient with burns. What is the reason for prescribing topical antibiotics to the patient?

Topical antibiotics reach the desired site of action faster. Topical antibiotics are mostly prescribed for the prevention and treatment of infection in patients with burns. These antibiotics can reach the site of action quickly and exert their therapeutic effect.