Dermatologic Drugs

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07, 2005, 2002 by Mosby, Inc., an
Types of Dermatologic Drugs

Antibacterial drugs
Antifungal drugs
Antiinflammatory drugs
Antineoplastic drugs
Antipruritic drugs (for itching)
Antiviral drugs
Drugs for treatment of burns

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Types of Dermatologic Drugs
(contd)

Emollients (soften skin)

Keratolytics
Local anesthetics
Topical vasodilators
Debriding drugs (promote wound healing)
Sunscreens

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Dermatologic Drugs:
Formulations

Aerosol foam/spray Cream

Bar (similar to soap) Gel/jelly
Lotion Oil
Ointment Paste
Powder Tape
Many others!

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Topical Antiinfectives

Antibacterial drugs
Anti-Acne Drugs
Antifungal drugs
Antiviral drugs

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Antibacterial Drugs

Used to treat:
Folliculitis Pustules
Impetigo Papules
Furuncles Vesicles
Carbuncles Cellulitis

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Antibacterial Drugs (contd)

Bacteria responsible for most common skin

disorders
Streptococcus pyogenes
Staphylococcus aureus

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Antibacterial Drugs (contd)

Most common drugs

bacitracin (Baciguent)
neomycin
polymyxin B

Neosporin: neomycin + polymyxin B

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Antibacterial Drugs (contd)

mupirocin
New, prescription only
Used topically for Staph and Strep impetigo
Intranasal form for MRSA

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Antibacterial Drugs (contd)

silver sulfadiazine (Silvadene)

Topical antiinfective
Used to prevent or treat infection at the site of
second- and third-degree burns
Cannot be used if allergic to sulfa drugs
1% topical cream
Apply to cleansed, debrided, burned areas
with sterile gloves

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Acne Drugs

Acne is caused by Propionibacterium acnes

Drugs used to treat acne:
benzoyl peroxide clindamycin
erythromycin meclocycline
tetracycline retinoic acid
isotretinoin (Accutane)

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Acne Drugs (contd)

benzoyl peroxide
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 improvements in 4 to 6 weeks

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Acne Drugs (contd)

benzoyl peroxide (cont'd)

May cause peeling skin, redness, or sensation of
warmth
Available in many formulations

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Acne Drugs (contd)

clindamycin
Antibiotic
Used topically to treat acne
May cause skin reactions

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Acne Drugs (contd)

isotretinoin (Accutane)
Oral and topical forms
Inhibits sebaceous gland activity
Pregnancy category X

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Acne Drugs (contd)

isotretinoin (Accutane)
STRINGENT guidelines for prescribing and use
Patient counseling regarding using two forms of
contraception and not becoming pregnant during
use is required
iPLEDGE
Strict guidelines are in place for monthly
pregnancy testing and prescription renewal
Monitor liver function before and during therapy

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Acne Drugs (contd)

tretinoin (retinoic acid, vitamin A acid)

Used to treat acne
Also used to reduce dermatologic changes
associated with sun damage
Stimulates the turnover of epithelial cells,
resulting in skin peeling
May result in severe irritation and skin peeling

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Topical Fungal Infections

Difficult
to eradicate
Therapy may be prolonged
Several weeks to 1 year
Topical fungal infections caused by:
Candida spp. (candidiasis)
Dermatophytes (tinea)

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Topical Antifungal Drugs

clotrimazole (Lotrimin)
Lozenge for oral candidiasis (thrush)
Vaginal form for yeast infections
Other forms used for other fungal infections
miconazole (Monistat)
Topical cream
Vaginal suppository or cream

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Topical Antiviral Drugs

acyclovir (Zovirax) and penciclovir (Denavir)

Both used to treat initial and recurrent herpes
simplex infections
Do not cure viral skin infections but may
reduce healing time and pain
Systemic drugs have been shown to be
better for controlling viral skin conditions

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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 (EMLA)
Ointments, creams, sprays, liquids, jellies

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Topical Antipruritic Drugs

Antihistamines
Corticosteroids
Antiinflammatory effects
Antipruritic effects
Vasoconstrictor actions

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Other Topical
Dermatologic Drugs

Antipsoriatic Drugs
tazarotene
tar-containing products
anthralin
calcipotriene

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Other Topical
Dermatologic Drugs (contd)

Topical ectoparasiticidal drugs

Pediculosis (three forms)
Scabies
lindane (Kwell, Scabene)
malathion (Ovide)
crotamiton (Eurax)

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Other Topical
Dermatologic Drugs (contd)

Topical hair growth drug

minoxidil (Rogaine)
Systemic hair growth drug
finasteride (Propecia)
Topical antineoplastic drug
fluorouracil (Efudex)

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Wound Care Drugs

Topicalwound care drugs

Used to prepare wound bed for healing
Remove nonviable tissue
Antibacterial

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Wound Care Drugs (contd)

sodium hypochlorite (Dakins solution)

cadexomer iodine (Iodosorb)
collagenase (Santyl)
papain-urea (Panafil)
papain-urea and chlorophyllin (Panafil)
topical emulsion (Biafine)

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Nursing Implications
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

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