Pharmacy Practice II

1
Pharmacy Practice II

• Interviewing
• Dermatitis, Scaly Dermatoses

2
Common Dermatological Conditions

• Seven Attributes
• Appearance!
• History
• Conditions
• Medications
• Could it be drug related?
• Referral
• Corticosteroids

3
Skin Structure Function

• Barrier
• Moisture
• Epidermis
• Stratum Corneum
• Lipophilic
• Overturn rate
• Water content
• Keratin
• Hygroscopic substances

4
Dry Skin

• Roughness, scaling, loss of flexibility,
  fissures, inflammation, pruritis
• Environmental, occupational, elderly
• Differential
• Nondrug treatments
• fluid intake
• decrease frequency and length of bathing
• tepid water
• nonsoap cleansers

5
Dry Skin

• Pharmacological
• Bath products oatmeal , oils
• Emollients petrolatum, lanolin, mineral oil,
  silicones
• Humectants glycerin, propylene glycol,
  phospholipids
• Keratin softeners urea, lactic acid, allantoin,
  ammonium lactate

6
Atopic Dermatitis (eczema)

• Location, symmetry
• Infants, children, young adults
• allergic
• pruritic
• exacerbating factors
• phases

7
Atopic Dermatitis Treatments

• When to refer
• Nonpharmacological
• Hydration
• Pruritis
• weeping
• astringents
• Hydrocortisone

8
Contact Dermatitis

• Allergic
• nickel
• rubber/latex
• poison oak/ivy
• Irritant
• alkalis, acids
• solvents
• fiberglass

9
Contact Dermatitis

• remove agent gently wash
• if wet-dry it
• aluminum acetate (Burows solution)
• witch hazel
• cool wet compresses
• hydrocortisone
• antihistamines ?
• protectants
• topical anesthetics

10
Dandruff

• Excessive scaling of scalp epidermis (2x)
• 20-50 of population
• non-inflammatory
• diffuse
• tiny white/gray scales
• Pityrosporum ovale

11
Dandruff Treatments

• Shampoo frequency
• Cytostatic agents
• pyrithione zn, selenium sulfide, coal tar
• appropriate use-contact time
• Keratolytic agents
• salicylic acid, sulfur
• Ketoconazole

12
Seborrheic dermatitis

• Scalp, face, other areas
• epidermal proliferation, sebaceous gland
• yellow, oily scales
• inflammation, pruritis
• patchy
• triggers
• cradle cap

13
Seborrhea Treatment

• Decrease cell turnover rate
• similar to dandruff treatments
• Inflammation
• hydrocortisone lotion
• rx corticosteroids

14
Psoriasis

• Various forms
• inflammation
• patchy
• silvery scales
• Auspitz sign
• pruritic

15
Psoriasis Treatments

• Referral
• OTCs
• emollients lubricants
• cytostatic agents
• keratolytic agents
• anti-inflammatory agents

16
Formulation Considerations

• Ointments
• Water-in-oil
• Oil-in-water
• Creams
• Lotions
• Gels
• Solutions
• Sprays