Skin and mucous membrane drugs
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Cutaneous Membrane = Skin
Figure 6.2
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Demulcents
Are inert substances which sooth inflamed/denuded mucosa or skin by preventing contact with air/ irritants in the surroundings.
Liquorice Methylcellulose Propylene glycol Glycerine
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Emollients
Indication: To soften and soothe rough, dry skin and increase absorbability of topical medications
Directions: Apply as necessary or as prescribed; generally after showering/bathing and pat drying; apply liberally to affected areas
Olive oil, sesame oil, cocoa butter, liquid paraffin
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Adsorbants and protectives They are finely powdered, inert and
insoluble solids capable of binding to their surface
Magnesiu/zinc stearate Talc-hydrous megnesium silicate Calamine Starch Boric acid Aloe vera gel Polyvinyl polymer
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Astringents
Astringents reduce secretions (by causing contraction of tissues) and are antibacterial
Best used in eczema where vesicular or draining lesions are present
Acetic Acid 5% (white vinegar) – especially useful in Pseudomonas infections
Burow’s Solution (Domeboro and others) Potassium Permanganate Tannic acid Zinc
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Topical Vehicles
Creams: Less greasy and most acceptable to patient Applies more easily Penetrates skin well Works well in intertriginous and hairy areas Can be drying Have a cooling effect Easy to wash off
Lotions: more water content and less viscous than creams
Ointments: Petrolatum based Alleviates dryness by prevention of evaporation Removes scales Enables medication to penetrates skin well Water repellant Remains on the skin Occlusive and protective Soothing and lubricating
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Irritants and counter irritants
They stimulate the sensory nerve endings and induce inflammation at the dite of application
Rubificiants –irritation+hyperemia+sensory stimulation
Vesicants –strong irritation+hyperemia
+sensory stimulation+ capillary
permeability
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Irritants and counter irritants
Volatile oils- turpentine oil, Clove oil, eucalyptus oil, camphor,
menthol Mustard seeds, capsicum, canthridin Methyl salicylate alcolhol
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Caustics and escharotics
Corrosive Podophyllium resin Silver nitrate Phenol Trichloro acetic acid
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Keratolytics
Salicylic acid Resorcinol –antiseptic, antifungal,
local irritant Urea –hygroscopic, with steroid
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Anti -seborrheics
Selenium sulfide Zinc pyrithione Corticosteroids Immidazole antifungals Sulfur, coaltar
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Melanizing agents
Increase sensitivity to solar radiation Psoralen Methoxsalen Trioxsalen
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Psoriasis
Calcipotriol- supresses epidermal proliferation
Tazarotene –synthetic retinoid Coaltar –exerts phototoxic action Photochemotherapy-PUVA Acitretin-synthetic retinoid Etanercept Methotrexate
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Coal Tar Preparations
Tegrin cream and lotion Medotar ointment PsoriGel gel Polytar and Tegrin soaps Tegrin, T/Gel, and other shampoosIndication: to relieve and control itching,
and flaking skin associated with psoriasis and seborrhea as well as eczema
Directions: Depending on product 1-4 times daily
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Demelanising agents
Hydroquinone Monobenzene Azelaic acid
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Sun screens
Chemical –PABA, benzophenones Cinnamates Physical – petroleum jelly, zinc oxide,
calamine
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Drugs for acne vulgaris
Topical therapy-benzoyl peroxide Retinoic acid Adapalene – synthetic tretinoin Tazarotene Topical antibiotics Azelaic acid
Systemic therapy Antibiotics , Isotretinoin
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Steroid Classifications
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Other Medicines
Antiinflammatory topicals Hydrocortisone creams, 0.5% to 1%
Antipruritics and others1. Benadryl (diphenhydramine 25-50mg q6h
prn)2. Calamine Lotion (zinc oxide and ferric oxide
used as a mild astringent)3. Caladryl Lotion (both of above)4. Burow/s solution
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Coal Tar Preparations(cont’d)
Contraindications: HypersensitivityPrecautions: Do not use on broken skin, genital or
rectal area except on the advise of your health care provider.
Photosensitivity x 24hr after application May stain light colored hairWarning: High concentrations of some chemicals in
coal tar may cause cancer. Concentrations of 0.5% to 5% appear to be safe.