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Administering Medications

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Describe the structures and functions of the integumentary system. ... Symptoms include yellow or brownish-grey greasy scales. Treatment: frequent shampooing ... – PowerPoint PPT presentation

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Title: Administering Medications


1
Administering Medications
  • Chapter 9
  • Drugs for the Skin

2
Learning OutcomesAfter studying this chapter,
you should be able to
  • Describe the structures and functions of the
    integumentary system.
  • Describe the major skin disorders and give
    examples of medications to treat them.
  • Explain the process of inflammation, and list and
    define the common symptoms of skin disorders.
  • Describe ways to increase absorption of drugs
    into the skin layers.
  • State the actions and give examples of diseases
    that would be treated by these medication
    categories (topical, oral or both) keratolytics,
    aseptics, protectives, astringents, topical
    anesthetics, antipruritics, anti-inflammatories,
    anti-infectives, antihistamines.

3
Anatomy of the Skin
4
Main Functions of the Integumentary System
  • Integumentary System skin and its appendages
    (hair, nails, and sweat and sebaceous glands)
  • Largest organ of the body
  • Waterproof, protective covering
  • Protects internal organs
  • Barrier for microorganisms
  • Regulates body temperature
  • Senses heat, cold, pressure and pain
  • Secretion and excretion of fluid and electrolytes

5
Inflammation
  • Inflammation is the bodys natural response to
    injury.
  • When cell damage occurs, the capillaries in the
    surrounding area bring in leukocytes (white blood
    cells of the immune system), which destroy
    microorganisms and begin cell repair.

Leukocytes
6
Symptoms of Skin Disorders
  • Pruritus (itching)caused by histamine
  • Erythema (reddening)expansion of the capillaries
    at skin surface
  • Edema (swelling)build-up of fluid in the tissues
  • Scalingan excess of a protein, keratin, in the
    epidermis. When a layer of dead cells builds up
    and becomes hard, the resulting condition is
    called keratosis.
  • Lesionsa superficial growth or patch of the skin
    that does not resemble the area surrounding it.

Scaling
7
Question
  • In the previous slide, there is an example of
    scaling.
  • What other term also describes it?
  • Pruritus
  • Erythema
  • Edema
  • Lesion

8
Symptoms of Skin Disorders, (cont.)
  • Ulcerationsopen lesions that are the result of
    tissue damage that starts below the skin and then
    erupts onto the skin surface
  • Hives or welts (urticaria)raised, irregularly
    shaped skin eruptions that have red margins and
    pale centers. Many causes.

Hives
9
Question
  • What is the difference between a lesion and an
    ulceration?
  • Can a single skin disorder have multiple
    symptoms? Look at the Symptoms of Skin
    Disorders slides and think of situations
    Discuss examples.

10
Types of Drugs for the Skin
  • Before we discuss specific disorders and the
    drugs used to treat them, we should familiarize
    ourselves with types of drugs used for skin
    disorders.
  • Often one type of medication is used to treat
    many different skin disorders.
  • Well look mainly at topical medicines. In
    almost all cases, if the disorder is severe
    enough, drugs may be given orally.

11
Topical Drugs for the Skin
  • Keratolytics (e.g. salicylic acid)
  • Soften and destroy the outer layer of skin so
    that it is sloughed off (shed).
  • Astringents (e.g. Calamine lotion)
  • Shrink local blood vessels and dry up weepy
    lesions.
  • Protectives (e.g. zinc oxide, also an astringent)
  • Form a lasting film on the skin that cools,
    dries, and/or soothes inflamed skin.
  • Antipruritics
  • Relieve itching (corticosteroids and
    anti-histamines are antipruiticssee next slide)

12
Topical Drugs for the Skin (cont.)
  • Corticosteroids
  • have three actions
  • Anti-inflammatory
  • Antipruitic (anti-itch)
  • Vasoconstriction (tightens blood vessels and
    decreases swelling)
  • Anti-histamines
  • Lessen effects of histamine, which decreases
    itching.

13
Topical Drugs for the Skin (cont.)
  • Antiseptics
  • Inhibits or slows the growth of microorganisms
  • Antibiotics
  • Kills or stops the growth of microorganisms
  • Anesthetics
  • Pain relief
  • Miticides
  • Kill parasites that infest the skin (like
    scabies, lice)

14
What to Focus on
  • In the following slides of this chapter, I want
    you to focus on the TYPE or CLASS of medicines
    used to treat the disorders.
  • EXAMPLES of specific drugs are only given as
    examplesdont worry about learning specific
    names of drugs.

15
Skin Disorder Contact Dermatitis
  • Inflammation from direct contact with a substance
    to which the skin is sensitive (e.g. poison oak,
    soaps, etc.)
  • Symptoms include red, hive-like papules, itching,
    pain, and oozing, scaly lesions.

16
Skin Disorder Contact Dermatitis
  • Treatment
  • Avoid causative agent
  • Use a protective/astringent/antihistamine lotion
  • Calamine and diphenhydramine (Caladryl) lotion
  • Topical steroids are the mainstay of treatment.
  • Triamcinolone acetate (Aristocort)
  • Hydrocortisone valerate 0.2 (LactiCare HC,
    DermaGel, Cortaid, Dermacort)
  • Oral corticosteroids may be used if reaction is
    severe or covers large area of body.

Note the steroid names in this slide end in
-sone and -lone
17
Skin Disorder Eczema (atopic dermatitis)
  • Inflammation with eruptions of pimple-like bumps,
    blisters, scales, or scabs. Symptoms include dry
    or weepy lesions, redness, swelling, itching,
    and a feeling of warmth to the touch
  • Cause is not clear, but it can be triggered
  • Treatment relieves symptoms
  • Corticosteroids (oral and topical)
  • oral antihistaminescetirizine (Zyrtec)
  • pimecrolimus cream 1 (Elidel) (suppresses immune
    response)

18
Skin Disorder Psoriasis
  • Chronic (long-term) dermatitis no cure
  • Identified by its red, raised lesions covered
    with dry, silvery scales
  • Treatment
  • topical corticosteroids
  • oral antihistamines
  • Biologicssubcutaneously self-injected drugs
    made from animal or human proteins that work with
    the immune system.
  • etanercept (Enbrel)

19
Skin Disorder Acne
  • Increased secretions of the oil (sebaceous)
    glands. The open pores of the skin become plugged
    with oil (sebum) and dead cells
  • Treatment
  • topical application of keratolytics like benzoyl
    peroxide, or tretinoin (Retin-A)
  • topical or systemic long-term
    antibiotic therapy (often
    tetracycline antibiotics)
  • isotretinoin (Accutane)
    given orally

20
Skin Disorders Seborrheic Dermatitis
  • Inflammatory skin disorder of unknown cause that
    begins on the scalp/at base of hair
  • Symptoms include yellow or brownish-grey greasy
    scales
  • Treatment
  • frequent shampooing
  • mild keratolytic agents
  • Anti-fungal shampoos

21
Skin Disorders Dandruff
  • Scaling of the scalp that produces dry, white
    flakes
  • Generally considered to be a much less severe
    form of seborrheic dermatitis.
  • Treatment
  • Very similar to seborrheic dermatitis, although
    not as concentrated medications
  • frequent shampooing
  • mild keratolytic agents
  • Anti-fungal shampoos

22
Skin Disorder Infections
  • Caused by microbes invading the skin tissues
  • Examples impetigo, boils
  • Signs of infection reddening, swelling, warmth
    to the touch, and pain. Bacterial skin infections
    usually exhibit pus, a thick, yellowish fluid
    made up of dead white blood cells and debris,
    and/or crusting.
  • Treatment
  • topical or oral antibiotics
  • Aseptic treatments

23
Skin Disorders Burns
  • Caused by fire, chemicals, smoke, electricity.
  • Can vary greatly in severity from blisters to
    complete tissue destruction.
  • Treatment
  • Anti-infectives (antibiotic, antifungal)
  • mafenide acetate (Sulfamylon)
  • Anesthetic for pain
  • benzocaine (Solarcaine)

24
Skin Disorders Pressure Ulcers
  • Pressure ulcers develop where a bony prominence
    is in contact with the bed or chair for long
    periods without moving. Skin is deprived of
    oxygen and nutrients for too long, the skin dies,
    and an ulcer develops.
  • Very difficult to healprevention is key.
  • Keep clean and dry

25
Skin Disorders Scabies
  • Scabies is a parasitic infection in the skin
    caused by mites. Very itchy, with blisters and
    insect burrows.
  • Treatment
  • topical insecticides called scabicides applied
    from the neck down (remember Elimite from our
    Brand Name Guesser on the first day?)
  • Oral scabicides are available, but greater risk
    of toxic side effects
  • Also antipruitics to relieve itching.

26
Skin Disorders Pediculosis
  • Pediculosis is lice. Not caused by poor hygiene,
    and very common in elementary schools.
  • Treatment
  • Manually removing nits and lice with special
    combs and fingernails
  • shampoos containing pediculicides

27
Transdermal Patches
  • Transdermal patches dont usually treat a skin
    condition.
  • Can treat hypertension, smoking cessation,
    hormone replacement, birth control, pain, etc.
  • The medicine is absorbed into the bloodstream
    through the skin very slowly over time.
  • Patches are often left in place for a day (e.g.
    nicotine patch) to a few weeks (e.g.
    contraception)

28
And finally
  • The following slide lists ways to INCREASE a
    topical drugs absorption into the body.
  • If you wanted to DECREASE it, generally you would
    do the opposite (think of opposite ideas as you
    look at the next slide).

29
Increasing Absorption of Drugs into Skin Layers
  • Apply wet dressings.
  • Use a fat or lipid-soluble drug.
  • Rub the preparation into the skin.
  • Keep medicine in contact with skin for an
    extended period of time.
  • Apply an occlusive dressing (does not allow air
    in) if ordered by the physician.
  • Use a stronger concentration of the drug.
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