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TOPICAL MEDS
- - Contraindicated in Patients with known hypersensitivity (allergic reaction)
- - No significant food or Drug interactions
- - Keep out of eyes
- - Caution with Pregnancy and lactation
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APPLICATION OF TOPICAL MEDS
- - Wash hands before and after*
- - Wash skin with mild soap and water*
- - Remove old cream prior to application of new*
- - Pat Dry*
- - Nurse wears gloves*
- Teach Patients to wear glove to apply .. to avoid spread of lesions such as herpes*
- - Follow directionson label instructions.. generally apply thin layer and rub into area*
- - Apply to lesions only*
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ORAL MUCOUS MEMBRANES
- Instruct patient to wait 60 minutes before eating and drinking after application*
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ABSORPTION OF MEDS
- - Systemic absorption when applied to areas where skin is thinnest
- -- Genital Area*
- -- Mucous membranes
- -- Axilla
- -- Groin
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TOPICAL ANTISEPTICS AND GERMICIDES
- - Reduce the number of Bacteria on the skin surface*
- - May be used preoperatively*
- - The action is dependent on the strength of the preparation*
- - Used on Minor cuts and abrasions
- - Antiseptic slows or prevents growth
- - Germicide kills bacteria
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ADVERSE REACTIONS
- - Burning, Itching, Redness, Rash, on skin*
- - Superinfection.. Overgrowth of Bacteria (becomes resistant)
- -- Develop when an antibiotic alters the normal flora*
- - Ringing in the ears can occur with salicylic acid*
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TOPICAL ANTIBIOTICS
- - Azelaic Acid (Azelex): often used to treat ACNE*
- - Mupirocin (Bactroban): MRSA of the nose*
- - Chlorhexidine (Hibiclens): Superficial wound infections*
- - Benzoyl Peroxide: Acne
- - Clindamycin: Acne
- - Erythromycin: Acne
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ANTIFUNGALS
- - Miconazole Niteate (Micatin*): Tinea infections Cutaneous Candidiasis
- - Nystatin (Mycostatin): Candida albicans causing repeated vaginal infections*
- - Clotimazole (Cruex): Superficial fungal skin infections.. tinea infections*
- - Terbinafine HCL (Lamisil): tinea infections
- - Tolnaflate ( Tinactin): tinea infections
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ANTIVIRALS
- - Acyclovir (Zovirax): Initial episode of genital herpes and herpes simplex in immunocompromised patients
- - Docosanol (Abreva): Herpes Simplex 1 & 2
- - Penciclovir* (Denavir): Recurrent genital herpes*
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CORTICOSTEROIDS
- - Anti-inflammatory effect to treat various allergic/immunologic skin problems
- - Reduce inflammation and itching*
- - Used to Treat
- -- Psoriasis
- -- Dermatitis
- -- Rashes
- -- Insect bites
- -- Eczema
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CORTICOSTEROIDS - given for inflammation and Itching
- - Amcinonide (Cyclocort)
- - Dexoximetasone (Topicort)
- - Dexamethasone (Decadron Phosphate)
- - Hydrocortisone (Locoid)*
- - Triamcinolone acetonide (Kenalog)
- - Flucinolone Acetonide (Synalar): Actopic Dermatitis*
- -- Thin Layer*
- -- Rub in thoroughly*
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ANTIPSORIATICS
- - Help remove the plaques associated with psoriasis
- - Anthralin ( Anthraderm)
- -- Can cause burns.. apply only on psoriatic lesions*
- -- May cause discoloration of hair and fingernails
- -- Use cautiously in pregnancy
- - Calcipotriene (Dovonex)*
- -- Used cautiously in pregnancy
- -- Caution in Older adults
- - Selenium sulfide (head and shoulders, selsun blue)
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ENZYMES
- - Used to debride necrotic tissue*
- - Have proteolytic action*
- -- Reduction or digestion proteins
- - Used on:
- -- Deep partial thickness and full thickness burns
- -- Pressure ulcers
- -- Peripheral Vascular ulcers
- - Not used in Major body cavities or on exposed nerves
- - Collagenase (Santyl)*
- -- Can be inactivated by washing the affected area with Povidone-Iodine*
- - Accuzyme*
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KERATOLYTICS
- - Removes excess growth of the epidermis
- -- Warts*
- -- Calluses*
- -- Corns
- -- Seborrheic keratosis*
- - Contraindicated for use on:
- -- Moles
- -- Birthmarks*
- -- Warts with Hair
- -- Warts on Mucous membranes
- -- Infected skin
- -- Used Cautiously in diabetics or impaired circulation
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KERATOLYTICS
- - Masoprocol (Actinex)
- - Salicylic acid (doufilm, Wart Remover, Foster)
- -- Toxicity with prolonged used: dizziness, tinnitus*, impaired hearing, sweating , Kussmaul respirations, tachycardia, confusions, drowsiness, respiratory depression
- -- Interacts with:
- --- Blood thinners.. potentiate effect
- --- NSAIDS.. increase serum levels
- --- Antacids.. decrease effect
- --- Activated Charcoal.. blocks absorption
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TOPICAL ANESTHETICS
- - May be applied to skin or mucous membranes
- - Temporarily inhibits the conduction from sensory nerves
- - May be used to relieve itching and pain
- - Occasional local irritation, rash, burning, stinging
- - Used cautiously in patients receiving class I antiarrythmics due to synergistic effects
- - Instruct patient to not eat or drink for 1 hour after oral application*.. may impair ability to swallow
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TOPICAL ANESTHETICS
- - Benzocaine (Lanacane): local skin disorders
- - Dibucaine* (Nupercainal): local skin disorders and mucous membranes
- - Viscous Lidocaine* (Xylocaine): local skin disorders and mucous membranes
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