**Self Care McFalls (Dermatologic disorders 1 (general, ACD, fungal))

role of skin in drug absorption= __ body from harmful external agents

protect

3 regions of skin?

epidermis, dermis, hypodermis

Epidermis is outermost layer of skin and contains the __ __ at the surface

stratum corneum

Epidermis regulates the __ content of the skin

water

Epidermis controls drug ___ into lower layers of skin and into systemic circulation

transport

Dermis is thicker than the epidermis and contains __ endings, vasculature, and hair follicles

nerve

Hypodermis provides ___ and cushioning for upper 2 layers

nourishment

drug that is applied topically must be __ from its vehicle at the desired site of activity to exert an effect

released

1) creams are __-in-___ emulsions

oil-in-water

creams are __ absorbed into skin

quickly

creams allow some ___ to pass through, and therefore can be used on broken skin and open weeping lesions

fluid

2) gels are __ to apply and rapidly absorbed

easy

gels have a ___ effect and a ___ effect (from the alcohol)

cooling, drying

gels may contain ___ and therefore may cause irritation/burning when applied to open lesions

alcohol

3) lotions are __-in-___ emulsions

oil-in-water

lotions are good for application to ___ areas and can be applied over ___ areas

hairy, large

4) ointments are __-in-__ emulsions

water-in-oil

ointments contain ___

petralatum

ointments have a greasy texture and a high ___ content

lipid

ointments provide a protective film to impede ___ of water from wound area

evaporation

ointments are __ appropriate for open lesions, puncture wounds, infected areas, or lacerations (exception=neosporin)

not

ointments not appropriate for open lesions, puncture wounds, infected areas, or lacerations because they have an occlusive effect that promotes __ growth

bacterial

5) sprays are convenient and good for when patient does not want to __ the affected area

touch

sprays may contain ___ that can cause inflammation

propellants

sprays may contain ____, which can cause drying and irritation

alcohol

to apply spray, hold container ___ inches from skin

6

to apply spray, spray the affected area for __-__ seconds

1-3

topical pharm therapy for pain from minor wounds/burns/itching includes ____

anesthetics

what are the 3 anesthetics to know?

benzocaine, lidocaine, pramoxine

anesthetic MOA

-interrupt the transmission of ___ impulses along nerves

-inactivate ___ channels in sensory neurons

electrical, sodium

anesthetics uses

-temporary pain relief from minor wounds, burns, sunburns

-___ relief

itching

what is primary ingredient in Dermoplast First Aid Spray?

benzocaine

what is primary ingredient in Alocane Severe Sunburn Gel?

lidocaine

what are primary ingredients in Neosporin+ Pain relief dual action cream?

neomycin sulfate, polymyxin B sulfatem pramoxine HCL

topical pharm therapy for decreasing weeping, oozing, or discharge includes ____

astringents

what is the astringent to know?

aluminum acetate 5%

what is the brand name for aluminum acetate 5%?

burow's solution

astringent MOA:

-cool and dry skin through ____

-___ blood flow in inflamed tissue

evaporation, reduces

astringent MOA:

-induce vaso____

constriction

if you are going to soak in an astringent, dosing is __-__ min __-__x daily

15-30, 3-4

if you are going to use wet dressing/compress astringent, dosing is __-__ min __-__x daily

20-30, 4-6

can you use astringents in pediatrics, geriatrics, pregnant, lactating patients?

yes

what are the primary ingredients in Domeboro Astringent Solution Powder Packets?

aluminum sulfate, calcium acetate

topical pharm therapy for preventing infection includes __ __ __

first aid antibiotics

can you use first aid antibiotics to treat infection?

no

3 first aid antibiotics to know?

bacitracin, neomycin, polymyxin B

bactritracin MOA

-inhibits cell wall synthesis for gram __ bacteria

positive

neomycin MOA

-Aminoglycoside antibiotic

-Inhibits protein synthesis for gram ___ bacteria

negative

polymyxin B MOA

-Causes leakage of intracellular constituents for gram ___ bacteria)

negative

dosing for first aid antibiotics is application __-__ times a day

1-3

first clean wound

then apply first aid antibiotic

then ___ wound with sterile dressing

cover

first aid antibiotics are what type of vehicle?

ointment

there are ___ instances of allergic contact dermatitis with neosporin as opposed to polysporin

higher

primary ingredients in neosporin?

bacitracin, neomycin, polymyxin B sulfate

primary ingredients in polysporin?

bacitracin, polymixin B sulfate

topical pharm therapy for preventing infections and promoting healing includes __ __ __

first aid antiseptics

3 first aid antiseptics to know?

chlorhexidine, hydrogen peroxide, povidone-iodine solution

first aid antiseptic MOA

Destroy or inhibit the growth of ___ in tissue

microorganisms

what is the primary ingredient in Hibiclens Skin Cleanser?

chlorhexidine

what is the primary ingredient in Betadine Antiseptic Solution?

povidone-iodine

topical pharm therapy for minor skin irritations, itching, rashes includes ___

hydrocortisone

hydrocortisone comes in strengths ___% and ___%(more common)

0.5, 1

hydrocortisone MOA

-vaso____

-____ inflammation and pruritis (itching)

constriction, reduces

hydrocortisone warnings

-do not apply to __ and __

eyes, eyelids

hydrocortisone warnings

-do not use with dressings or ___

bandages

how old do you have to be to use hydrocortisone?

2

can you use hydrocortisone in pediatrics over 2, geriatrics, pregnant, and lactating patients?

yes

what is the common brand name for hydrocortisone cream?

cortaid

topical pharm therapy for injury protection, skin drying prevention, and pain reduction at injured area includes skin ___

protectants

Skin protectants to know?

petrolatum, white petrolatum, dimethicone, zinc oxide, glycerin, lanolin, cocoa butter, colloidal oatmeal

skin protectant uses:

-protect injured area from ___ caused by friction and rubbing

-prevent ___ of stratum corneum

-make injured area less painful

irritation, drying

what is the primary ingredient in Aquaphor Healing Ointment?

petrolatum

what is the primary ingredient in Desitin Multi-Purpose Healing Ointment?

white petrolatum

what is the primary ingredient in Neutrogena Norwegian Formula Hand Cream?

glycerin

what is the primary ingredient in Palmer’s Cocoa Butter Formula?

cocoa butter

allergic contact dermatitis (ACD) phase 1 is the __ phase

induction

during induction phase (first contact with allergen):

-sensitizes the immune system

-___ rash

no

during second contact with allergen:

-cell-mediated, type ___ hypersensitivity reaction

4

during second contact with allergen:

-sensitized __ cells are activated

T

during second contact with allergen:

the sensitized T cells __ to the site of contact

migrate

during second contact with allergen:

the sensitized T cells migrate to site of contact and release __ __ (like prostaglandin)

inflammatory mediators

during second contact with allergen:

rash and other symptoms appear within __-__ hours after exposure

24-48

80% of population has allergic sensitivity to ___ (a toxicondendron plant)

urushiol

"Leaves of __, let it be!"

3

urushiol is carried within the resin ___ of the plant and only released if the plant is ___

canals, damaged

on exposure, urushiol will enter skin within __ __

10 minutes

Clinical presentation of urushiol exposure

symptoms occur only where ___ was made with urushiol

contact

Clinical presentation of urushiol exposure

symptoms of urushiol exposure begin ___-__ hours after contact

24-48

Clinical presentation of urushiol exposure

involves intense ___ of exposed skin surfaces

itching

Clinical presentation of urushiol exposure

___ (redness)

erythema

Clinical presentation of urushiol exposure

vesicles or bullae form which may break open and release __ content

fluid

when vesicles/bullae form and break open to release fluid content, this fluid does __ contain any antigenic material

not

Clinical presentation of urushiol exposure

oozing and weeping of vesicular fluid occurs for several __

days

Clinical presentation of urushiol exposure

affected areas __ and begin to dry in the last stage, which is 10-21 days after exposure

crust

Exclusions to allergic contact dermatitis self treatment

less than __ years of age

2

Exclusions to allergic contact dermatitis self treatment

dermatitis present for more than __ __

1 week

Exclusions to allergic contact dermatitis self treatment

dermatitis that involves more than ___% body surface area

20

Exclusions to allergic contact dermatitis self treatment

presence of numerous __

bullae

Exclusions to allergic contact dermatitis self treatment

____ itching, irritation, or severe vesicle formation

extreme

Exclusions to allergic contact dermatitis self treatment

swelling of body, extremities, or eyelids/areas surrounding __

eyes