chapter 9 over-the-counter medications and skin care products copyright © 2004 by elsevier inc. all...

Chapter 9Chapter 9

Over-the-Counter Medications Over-the-Counter Medications and Skin Care Productsand Skin Care Products

Copyright © 2004 by Elsevier Inc. All rights reserved.


IntroductionIntroduction

• OTC medications–no prescriptions OTC medications–no prescriptions necessarynecessary

• Drugs–common staples in home Drugs–common staples in home medicine cabinetmedicine cabinet

• Acetaminophen (Tylenol), cough syrup, Acetaminophen (Tylenol), cough syrup, Ibuprofen (Motrin)Ibuprofen (Motrin)

• OTC drugs–50% medication purchasedOTC drugs–50% medication purchased



• It is important that consumers learn It is important that consumers learn about appropriate dosages and proper about appropriate dosages and proper use of these medicationsuse of these medications

• Pharmacists need to know what OTC Pharmacists need to know what OTC medications are being taken medications are being taken

• Patients need to know what to avoidPatients need to know what to avoid

• Buying drugs OTC–substantial savingsBuying drugs OTC–substantial savings



• Consumers use OTC products:Consumers use OTC products:

– To save moneyTo save money

– To be involved in their To be involved in their own treatmentown treatment

– Because they are more Because they are more readily availablereadily available


Over-the-Counter Drug Over-the-Counter Drug ConsiderationsConsiderations• Wide variety of drugsWide variety of drugs

• Identify the cause of the problemIdentify the cause of the problem

• Misuse of drugs–contribute to Misuse of drugs–contribute to hospital stayshospital stays

• Expiration dates need to be checkedExpiration dates need to be checked

• Tamper-proof packaging needs to Tamper-proof packaging needs to be checkedbe checked


Over-the-Counter Drug Over-the-Counter Drug ConsiderationsConsiderations• Dosages for children under 2 years Dosages for children under 2 years

not recommendednot recommended

• Many OTC medications have identical Many OTC medications have identical ingredientsingredients

• Manufacturers swap “like ingredients” Manufacturers swap “like ingredients” without notifying the customer. without notifying the customer. The label will show the changeThe label will show the change


Over-the-Counter Drug Over-the-Counter Drug ConsiderationsConsiderations• No adverse reaction reports requiredNo adverse reaction reports required

• Patients with special diets, allergies, Patients with special diets, allergies, diabetes, and other medications need diabetes, and other medications need to exercise cautionto exercise caution

• Extra care for babies and young Extra care for babies and young children when purchasingchildren when purchasing


Three Categories of OTC DrugsThree Categories of OTC Drugs

• FDA classification:FDA classification:

– Safe and effective for claimed Safe and effective for claimed therapeutic indicationtherapeutic indication

– Not recognized as safe and effectiveNot recognized as safe and effective

– Additional data must determine Additional data must determine whether safe and effectivewhether safe and effective


FDA RegulationsFDA Regulations

• Five major safety areas:Five major safety areas:

– PurityPurity

– PotencyPotency

– BioavailabilityBioavailability

– EfficacyEfficacy

– Safety and toxicitySafety and toxicity


PurityPurity

• Purity of a product represents the lack Purity of a product represents the lack of contamination from environmental of contamination from environmental factors of the chemical (drug) factors of the chemical (drug) contained in the productcontained in the product

• Additives include fillers, dyes, Additives include fillers, dyes, solvents, buffers, and waxessolvents, buffers, and waxes

• Various ingredients increase the Various ingredients increase the size of the medication, decrease size of the medication, decrease absorption, improve taste absorption, improve taste


PotencyPotency

• Refers to the strength of the drugRefers to the strength of the drug

• Measurement done in grams, Measurement done in grams, milligrams, or microgramsmilligrams, or micrograms

• Drug tested on research animalsDrug tested on research animals

• Strength measured in unitsStrength measured in units


BioavailabilityBioavailability

• Level at which a drug is both absorbed Level at which a drug is both absorbed and transported to the site of actionand transported to the site of action

• Measured by the concentration of the Measured by the concentration of the drug in the blood or tissue at the peak drug in the blood or tissue at the peak time of administrationtime of administration


EfficacyEfficacy

• The ability of the drug to produce the The ability of the drug to produce the desired chemical change in the bodydesired chemical change in the body

• Clinical trials judge effectivenessClinical trials judge effectiveness

• Variances affect end resultsVariances affect end results

• Variance–unknown health conditions, Variance–unknown health conditions, age, weight, lifestyle, gender, and age, weight, lifestyle, gender, and genetic influencesgenetic influences


Safety and ToxicitySafety and Toxicity

• Represent opposite effects of a drug Represent opposite effects of a drug being studiedbeing studied

• Lab animals used as test subjects in Lab animals used as test subjects in beginning stages of trialsbeginning stages of trials

• Later years, published results include Later years, published results include effects of drugs on pregnancyeffects of drugs on pregnancy


Safety and ToxicitySafety and Toxicity

• Any drug can be toxic if not taken Any drug can be toxic if not taken correctlycorrectly

• Difference between toxic and desirable Difference between toxic and desirable effects documentedeffects documented

• Difference “margin of safety”Difference “margin of safety”

• Drug falls into “margin of safety” is Drug falls into “margin of safety” is “therapeutic dose”“therapeutic dose”


How a Prescription Becomes How a Prescription Becomes an OTC Drugan OTC Drug• Amount of research extensiveAmount of research extensive

• FDA approves all new drugs entering FDA approves all new drugs entering the marketplacethe marketplace

• FDA uses three phases of testing FDA uses three phases of testing

• Monograph gives information about Monograph gives information about a druga drug


3 FDA Phases3 FDA PhasesOTC Drug ApprovalOTC Drug Approval• Phase 1: Phase 1: Advisers evaluate agent for Advisers evaluate agent for

safety and efficacysafety and efficacy

• Phase 2: Phase 2: Final review done on Final review done on ingredientsingredients

• Phase 3: Phase 3: After evidence presented After evidence presented and all aspects of the agent and all aspects of the agent are are exhausted, the final exhausted, the final monograph is monograph is publishedpublished


How a Prescription How a Prescription Becomes an OTC DrugBecomes an OTC Drug• Agent meets criteria–approved as Agent meets criteria–approved as

an OTC drugan OTC drug

• Some legend drugs become Some legend drugs become OTC– strength is loweredOTC– strength is lowered

• Legend Ibuprofen Legend Ibuprofen (400 mg, 600 mg, 800 mg)(400 mg, 600 mg, 800 mg)

• OTC Ibuprofen (200 mg)OTC Ibuprofen (200 mg)


How a PrescriptionHow a PrescriptionBecomes an OTC DrugBecomes an OTC Drug• FDA in charge of recallsFDA in charge of recalls

• Manufacturers must show consistency Manufacturers must show consistency between batches of drugs on a between batches of drugs on a day-to-day basisday-to-day basis

• OTC drugs can be taken off the OTC drugs can be taken off the market if not consistentmarket if not consistent


Conditions Treated withConditions Treated withOTC DrugsOTC Drugs• Table 9.2 in the textbook lists the Table 9.2 in the textbook lists the

most common OTC medications most common OTC medications with symptoms treated and route with symptoms treated and route of administrationof administration


OTC Agents–Patient InformationOTC Agents–Patient Information

• Analgesics and Antipyretics–help Analgesics and Antipyretics–help reduce or relieve pain and feverreduce or relieve pain and fever

• Aspirin–antiinflammatory agent; Aspirin–antiinflammatory agent; decreases platelets; prophylaxis to decreases platelets; prophylaxis to decrease risk of blood clotting in decrease risk of blood clotting in heart disease and strokeheart disease and stroke

• Associated with Reye’s syndromeAssociated with Reye’s syndrome


AntiinflammatoriesAntiinflammatories

• Nonsteroidal antiinflammatory drugs Nonsteroidal antiinflammatory drugs (NSAIDs)–treat inflammation(NSAIDs)–treat inflammation

• Reduce painReduce pain

• Used as antipyretic and analgesicUsed as antipyretic and analgesic

• May cause drowsiness, upset stomach; May cause drowsiness, upset stomach; take with food or milktake with food or milk


Analgesics Analgesics and Antipyretic Productsand Antipyretic ProductsConditionCondition ProductProduct Dosage FormsDosage Forms

Fever/painFever/pain AcetaminophenAcetaminophen Tab, cap, Tab, cap, (Tylenol)(Tylenol) liq supp liq supp

Fever/painFever/pain Aspirin (Bayer, Aspirin (Bayer, Tab, cap, Tab, cap, Alka-Seltzer)Alka-Seltzer) powder powder

Fever/painFever/pain Ibuprofen (Motrin)Ibuprofen (Motrin) Tab, cap, liqTab, cap, liq

Pain/arthritisPain/arthritis Capsaicin (Zostrix)Capsaicin (Zostrix) TopTop

TabTab, Tablet; , Tablet; capcap, capsule; , capsule; liqliq, liquid; , liquid; toptop, topical; , topical; suppsupp, suppository., suppository.


Allergy and Cold AgentsAllergy and Cold Agents

• Relief of common cold–decongestants Relief of common cold–decongestants and antihistamines and antihistamines

• Decongestants dry out membranes, Decongestants dry out membranes, open airways, cause vasoconstriction, open airways, cause vasoconstriction, reduce congestionreduce congestion

• Antihistamines–used with allergic Antihistamines–used with allergic symptoms; action blocks histamine symptoms; action blocks histamine (H-1) that causes allergic reaction(H-1) that causes allergic reaction


Decongestant ProductsDecongestant ProductsConditionCondition ProductProduct Dosage FormsDosage Forms

CommonCommon OxymetazolineOxymetazoline SpraySpraycold/allergiescold/allergies (Afrin)(Afrin)

PhenylephrinePhenylephrine SpraySpray(Neo-Synephrine)(Neo-Synephrine)

Normal salineNormal saline SpraySpray(Ocean)(Ocean)

Common coldCommon cold Pseudoephedrine*Pseudoephedrine* Tab, cap, liqTab, cap, liq(Sudafed)(Sudafed)

Clemastine (Tavist)Clemastine (Tavist) Tab, liqTab, liq

TabTab, Tablet; , Tablet; capcap, capsule; , capsule; liqliq, liquid., liquid.*Pseudoephedrine (Sudafed) is a decongestant and is less likely to cause *Pseudoephedrine (Sudafed) is a decongestant and is less likely to cause drowsiness. It is used exclusively as a decongestant, not for allergies.drowsiness. It is used exclusively as a decongestant, not for allergies.


Antihistamine ProductsAntihistamine ProductsConditionCondition ProductProduct Dosage FormsDosage Forms

CongestedCongested ChlorpheniramineChlorpheniramine Tab, cap Tab, cap nose, sinusnose, sinus (Chlor-Trimeton)(Chlor-Trimeton)

DiphenhydramineDiphenhydramine Tab, cap, liqTab, cap, liq(Benadryl)(Benadryl)

LoratadineLoratadine Tab, capTab, cap (Claritin) (Claritin)

TabTab, Tablet; , Tablet; capcap, capsule; , capsule; liqliq, liquid., liquid.*These agents also come in many combinations with agents that treat cough, *These agents also come in many combinations with agents that treat cough, fever, and pain.fever, and pain.


AntihistaminesAntihistamines

• First-generation–common side effect First-generation–common side effect is sleepinessis sleepiness

• Second-generation–require a Second-generation–require a prescriptionprescription

• May cause drowsinessMay cause drowsiness


DecongestantsDecongestants

• Indicated for stuffiness and congestion Indicated for stuffiness and congestion of nasal passages and sinusesof nasal passages and sinuses

• Acts to open passages and allow release Acts to open passages and allow release of mucusof mucus

• Used for chest congestion–permits Used for chest congestion–permits coughing up of phlegmcoughing up of phlegm

• Available in both OTC and prescription Available in both OTC and prescription preparationspreparations


Headache ProductsHeadache Products

• AnalgesicsAnalgesics

• Some contain additives–caffeineSome contain additives–caffeine

• Migraines–prescription drug requiredMigraines–prescription drug required


Headache ProductsHeadache ProductsConditionCondition ProductProduct Dosage FormsDosage Forms

SevereSevere ASA/caffeine/ASA/caffeine/headache/migraineheadache/migraine acetaminophenacetaminophen

combination (Excedrin)combination (Excedrin) TabTabCapletCaplet

ASA/calciumASA/calcium carbonate combinationcarbonate combination

(Bayer Women's Aspirin (Bayer Women's Aspirin Plus Calcium) Plus Calcium) CapletCaplet

Acetaminophen/Acetaminophen/caffeine combinationcaffeine combination

(Excedrin Tension (Excedrin Tension Headache [aspirin free])Headache [aspirin free])

ASAASA, Acetylsalicylic acid (aspirin); , Acetylsalicylic acid (aspirin); tabtab, tablet., tablet.


Interactions Between Interactions Between Aspirin and Other AgentsAspirin and Other Agents• Table 9.8 in the textbook lists Table 9.8 in the textbook lists

common interactionscommon interactions

• Pharmacist alerted by technicians Pharmacist alerted by technicians about interactionsabout interactions


Sleep AidSleep Aid

• Diphenhydramine or magnesium Diphenhydramine or magnesium salicylate used to treat insomniasalicylate used to treat insomnia

• Anti-Insomnia products are listed in Anti-Insomnia products are listed in Table 9.9 in the textbookTable 9.9 in the textbook

• Diphenhydramine–most commonly Diphenhydramine–most commonly prescribed agent ordered in hospitals prescribed agent ordered in hospitals for sleepfor sleep


Sleep AidSleep Aid

• May cause drowsinessMay cause drowsiness

• Avoid alcoholic beveragesAvoid alcoholic beverages

• Do not use if suffering with asthma, Do not use if suffering with asthma, glaucoma, emphysema, or an enlarged glaucoma, emphysema, or an enlarged prostateprostate


CoughCough

• Largest OTC section–cold and fluLargest OTC section–cold and flu

• Congested coughs–expectorantsCongested coughs–expectorants

• Dry nonphlegm-producing coughs–Dry nonphlegm-producing coughs–suppressantsuppressant

• Do not use if suffering with asthma, Do not use if suffering with asthma, glaucoma, emphysema, heart glaucoma, emphysema, heart problems, or an enlarged prostateproblems, or an enlarged prostate


Cold and Cough ProductsCold and Cough Products

ConditionCondition ProductProduct Dosage FormsDosage Forms

Congested coughCongested cough Guaifenesin/Guaifenesin/pseudoephedrinepseudoephedrine(Robitussin PE)(Robitussin PE) Tab, liq, syrTab, liq, syr

GuaifenesinGuaifenesin(Robitussin)(Robitussin) Tab, cap, syrTab, cap, syr

Dry coughDry cough Guaifenesin/Guaifenesin/dextromethorphandextromethorphan (Robitussin (Robitussin DM)DM) Liq, syrLiq, syr

TabTab, Tablet; , Tablet; liqliq, liquid; , liquid; syrsyr, syrup; , syrup; capcap, capsule., capsule.


Sore Throat ProductsSore Throat Products

• Cold or flu–causes of sore, scratchy, Cold or flu–causes of sore, scratchy, and dry throatsand dry throats

• Sore throat–can be symptom of Strep Sore throat–can be symptom of Strep throat (treat with antibiotics)throat (treat with antibiotics)

• Syrups and sprays–relieve throat painSyrups and sprays–relieve throat pain

• Phenol, Menthol, alcohol, and Phenol, Menthol, alcohol, and benzocainebenzocaine


Sore Throat ProductsSore Throat Products

ConditionCondition ProductProduct Dosage FormsDosage Forms

Sore throatSore throat BenzocaineBenzocaine(Chloraseptic)(Chloraseptic) LozengesLozenges

Dyclonine HClDyclonine HCl(Cepacol)(Cepacol) LozengesLozenges

Dyclonine/alcoholDyclonine/alcohol(Sucrets)(Sucrets) LozengesLozenges


Stomach RemediesStomach Remedies

• Common upset stomach remedies Common upset stomach remedies

• Histamine-2 (HHistamine-2 (H22) antagonists–decrease ) antagonists–decrease acid secretions (heartburn)acid secretions (heartburn)

• Proton pump inhibitors–relieve acid Proton pump inhibitors–relieve acid secretionssecretions


Stomach Products/AntacidsStomach Products/AntacidsConditionCondition ProductProduct Dosage FormsDosage Forms

HeartburnHeartburn CimetidineCimetidine(Tagamet-HB)(Tagamet-HB) Tab, liqTab, liq

RanitidineRanitidine(Zantac-75)(Zantac-75) TabTab

FamotidineFamotidine(Pepcid-AC)(Pepcid-AC) TabTab

NizatidineNizatidine(Axid-AR)(Axid-AR) TabTab

AntacidsAntacids Calcium hydroxateCalcium hydroxate(Tums)(Tums) Chewable tabChewable tab

Aluminum Aluminum hydroxide/magnesiumhydroxide/magnesium Tab, liq, gelcapTab, liq, gelcaphydroxide/simethiconehydroxide/simethicone(Mylanta)(Mylanta)

TabTab, Tablet; , Tablet; liqliq, liquid., liquid.


Stomach RemediesStomach Remedies

• Antacid agents–used to balance Antacid agents–used to balance pH level of the stomach pH level of the stomach (decrease heartburn)(decrease heartburn)

• Taken for short-term relief Taken for short-term relief of heartburnof heartburn


Intestinal RemediesIntestinal Remedies

• Intestinal discomfort–constipation, Intestinal discomfort–constipation, diarrhea, gas (flatulence)diarrhea, gas (flatulence)

• Intestinal products contain oil or Intestinal products contain oil or saline solutionsaline solution

• Diarrhea–anticholinergic agent, fiberDiarrhea–anticholinergic agent, fiber


Intestinal ProductsIntestinal ProductsConditionCondition ProductProduct Dosage FormsDosage Forms

ConstipationConstipation CombinationCombinationstimulant (Ex-Lax)stimulant (Ex-Lax) Tab, chew tabTab, chew tab

Stool softenersStool softeners Docsuate sodiumDocsuate sodium(Colace)(Colace) gelcapgelcap

DiarrheaDiarrhea LoperamideLoperamide(Imodium A-D)(Imodium A-D) Tab, cap, liqTab, cap, liq

FlatulenceFlatulence SimethiconeSimethicone(Mylicon)(Mylicon) Tab, chew tab, Tab, chew tab,

liqliq

Irregular bowelsIrregular bowels PsylliumPsyllium(Metamucil)(Metamucil) PowderPowder

TabTab, Tablet; , Tablet; capcap, caplet; , caplet; liqliq, liquid., liquid.


Intestinal RemediesIntestinal Remedies

• Loperamide, MetamucilLoperamide, Metamucil

• Most commonly used gas treatment–Most commonly used gas treatment–simethacone (Gas-X)simethacone (Gas-X)

• Laxatives–do not use if abdominal Laxatives–do not use if abdominal pain, nausea, and vomiting are presentpain, nausea, and vomiting are present

• Loperaminde–may cause drowsiness Loperaminde–may cause drowsiness or dizzinessor dizziness


Skin AnatomySkin Anatomy

• Skin–integumentary system, largest Skin–integumentary system, largest organ in the bodyorgan in the body

• Includes–skin, hair, subcutaneous Includes–skin, hair, subcutaneous tissuestissues

• One of the most abused organs One of the most abused organs in the bodyin the body

• Protects the body, regulates Protects the body, regulates temperature, is a sensor or stimulitemperature, is a sensor or stimuli



• Keratin–top layer of skin; for protectionKeratin–top layer of skin; for protection

• Epidermis and dermis–layers beneath Epidermis and dermis–layers beneath keratinkeratin

• Below dermis–subcutaneous layer Below dermis–subcutaneous layer of fatof fat

• Epidermis–no blood flow of its ownEpidermis–no blood flow of its own



• Dermis–much thicker; holds nerves, Dermis–much thicker; holds nerves, blood vessels, and other connective blood vessels, and other connective tissuetissue

• Skin–can absorb moisture and Skin–can absorb moisture and medicationsmedications

• Diabetics–inject insulin subcutaneouslyDiabetics–inject insulin subcutaneously

• Intradermal route–between the Intradermal route–between the dermis layerdermis layer

• Intramuscular–into the muscle layerIntramuscular–into the muscle layer


Anatomy of the SkinAnatomy of the Skin

EpidermisEpidermis

DermisDermis

HypodermisHypodermis

AdiposeAdiposeTissueTissue


Conditions Affecting the SkinConditions Affecting the Skin

• Common dosage forms and types Common dosage forms and types of conditions they treat are listed of conditions they treat are listed in Table 9.14 in the textbookin Table 9.14 in the textbook


Skin Disorders and MedicationsSkin Disorders and Medications

• Proper diagnosis–physical Proper diagnosis–physical assessment, family history, drug assessment, family history, drug history, lab tests, possible biopsyhistory, lab tests, possible biopsy

• Two very common skin conditions–Two very common skin conditions–sunburn and acnesunburn and acne


Sunscreen Skin Sunscreen Skin Protectant FactorProtectant Factor

• SPF agents–topical form; prevent SPF agents–topical form; prevent sunburnsunburn

• UVA rays and UVB rays–two main UVA rays and UVB rays–two main wavelengths of rays that cause wavelengths of rays that cause concernconcern

• UV rays–cause premature aging, UV rays–cause premature aging, changes in the DNA, erythema, changes in the DNA, erythema, and blistering and blistering


Sunscreen Skin Sunscreen Skin Protectant FactorProtectant Factor• Overexposure to the sun can cause Overexposure to the sun can cause

mutations in DNAmutations in DNA

• Cancer can occur and discoloration Cancer can occur and discoloration of prematurely aged skinof prematurely aged skin

• Melanin–chemical for skin colorMelanin–chemical for skin color


Sunscreen Skin Sunscreen Skin Protectant FactorProtectant Factor• Two types of protectants:Two types of protectants:

– Sunscreens–protect from UVA Sunscreens–protect from UVA and UVB raysand UVB rays

– Sun blocks–reflect UV raysSun blocks–reflect UV rays

• SPF factor importantSPF factor important

• Choose coverage based on skin typesChoose coverage based on skin types


Skin Protectant Factor Guide Skin Protectant Factor Guide for Application of Sunscreenfor Application of Sunscreen

Skin CharacteristicsSkin Characteristics SuggestedSuggestedSkin TypeSkin Type After 10 Min Sun Exposure After 10 Min Sun Exposure Minimum CoverageMinimum CoverageII Burns easily/rarely tansBurns easily/rarely tans 20 to 30 SPF20 to 30 SPF

IIII Burns easily/tans minimallyBurns easily/tans minimally 12 to 20 SPF12 to 20 SPF

IIIIII Burns moderately/tans graduallyBurns moderately/tans gradually 8 to 12 SPF8 to 12 SPF

IVIV Burns minimally/tans wellBurns minimally/tans well 4 to 8 SPF4 to 8 SPF

VV Rarely burns/always tansRarely burns/always tans 2 to 4 SPF2 to 4 SPF

VIVI Never burns/deeply pigmentedNever burns/deeply pigmented NoneNone

SPFSPF, Skin protectant factor., Skin protectant factor.


Acne Development Acne Development and Treatmentand Treatment• Acne affects teenagers and adultsAcne affects teenagers and adults

• Caused by hormonal changes and Caused by hormonal changes and geneticsgenetics

• Hormones enlarge the glands of Hormones enlarge the glands of the skinthe skin


Acne Development Acne Development and Treatmentand Treatment• Two productive glands:Two productive glands:

– Sweat: regulate temperatureSweat: regulate temperature

– Sebaceous: produce skin oil Sebaceous: produce skin oil or sebumor sebum

• Increased sebum traps bacteriaIncreased sebum traps bacteria

• Keep skin clean and free from bacteriaKeep skin clean and free from bacteria


Acne Development Acne Development and Treatmentand Treatment• Acne classified into two groups:Acne classified into two groups:

– Noninflammatory–treatment is Noninflammatory–treatment is mild medication (keratolytics)mild medication (keratolytics)

– Inflammatory–Benzoyl peroxide Inflammatory–Benzoyl peroxide most common OTC product most common OTC product recommendedrecommended


Acne Development Acne Development and Treatmentand Treatment• Antibiotics used–tetracycline, Antibiotics used–tetracycline,

erythromycin, clindamycinerythromycin, clindamycin

• Topical Agents–retinoic acid, Topical Agents–retinoic acid, isotretinoin (Accutane), and tretinoin isotretinoin (Accutane), and tretinoin (Retin A)(Retin A)


Miscellaneous Skin ConditionsMiscellaneous Skin Conditions

• Two categories:Two categories:

– Noninfectious inflammatory Noninfectious inflammatory conditionsconditions

– Infectious inflammatory conditionsInfectious inflammatory conditions

• See physician for persistent symptoms See physician for persistent symptoms


Hives/InflammationHives/Inflammation

• Common noninfectious conditions Common noninfectious conditions include: urticaria (hives), eczema include: urticaria (hives), eczema (red skin rash), psoriasis (plaques, (red skin rash), psoriasis (plaques, scaly skin), seborrheic dermatitis scaly skin), seborrheic dermatitis (rash), and atopic dermatitis (rash)(rash), and atopic dermatitis (rash)

• Topical agents: used for hives and Topical agents: used for hives and skin rashes causing inflammation skin rashes causing inflammation from severe itchingfrom severe itching

• Psoriasis: consult a doctorPsoriasis: consult a doctor


Infectious Inflammatory Infectious Inflammatory Skin ConditionsSkin Conditions• Warts–viral, contagious Warts–viral, contagious

(See Table 9.18 in the textbook)(See Table 9.18 in the textbook)

• Genital warts–see doctorGenital warts–see doctor

• Athlete’s foot–caused by fungus; treat Athlete’s foot–caused by fungus; treat with powdered antibiotics with powdered antibiotics (See Table 9.19)(See Table 9.19)

• Canker sores–inside cheek of mouth; Canker sores–inside cheek of mouth; small topical ulcers (See Table 9.20)small topical ulcers (See Table 9.20)


Topical AntibioticsTopical Antibiotics

• Used to treat abrasions, small cuts, Used to treat abrasions, small cuts, and scrapesand scrapes

• Clean wound properlyClean wound properly

• See the list of agents for treating See the list of agents for treating such wounds on the next slidesuch wounds on the next slide


Antibiotic ProductsAntibiotic Products

ProductProduct Trade NamesTrade Names Dosage FormsDosage Forms

BacitracinBacitracin BacitracinBacitracin OintOint

NeomycinNeomycin NeomycinNeomycin OintOint

MyciguentMyciguent CreamCream

Polymyxin B,Polymyxin B,neomycin,neomycin,bacitracinbacitracin NeosporinNeosporin Oint, creamOint, cream

OintOint, Ointment., Ointment.


PsoriasisPsoriasis

• Genetic skin condition; cannot be Genetic skin condition; cannot be cured; lasts a lifetimecured; lasts a lifetime

• Not contagious but looks bad Not contagious but looks bad when inflamedwhen inflamed

• Most affected areas: joints, limbs, Most affected areas: joints, limbs, neck, scalpneck, scalp

• Potent drugs used: corticosteroids Potent drugs used: corticosteroids (require physician’s prescription) (require physician’s prescription)

• Sunlight treatments Sunlight treatments

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