MEDICATIONS FOR INTEGUMENTARY SYSTEM

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ACTION: ANTIVIRAL SIDE EFFECTS:TOPICAL: ,BURNNG RASH,PRURITUS,STINGING SYSTEMIC: HEADACHE SEIZURES RENAL TOXICITY PHLEBITIS AT IV SITE NURSING IMPLICATIONS: USE GLOVE T APPLY; COVER LESION COMPLETELY SYSTEMIC: ENSURE ADEQUATE HYDRATION TO PREVENT CRYSTALIZATION IN KIDNEYS; ADMINISTER IV FOR AT LEAST 1 HR

acyclovir (zovirax)

an oral antiviral drug (trade name Zovirax) used to treat genital herpes available as a topical : Burning, rash ,pruritus,stinging. Systemic: Headache ,seizures renal toxicity, phlebitis at iv site. Nursing Implications; Topical use: use glove to apply: cover lesion completely. Systemic; ensure adequate hydration to prevent crystallization in kidneys; administer IV dose for at least 1 hr.

alpha keri

Emollient;local irritations allergix reactions;external use only;can slip in bathtub
SIDE EFFECTS; local irritation,allergic reactions
NURSING IMPLICATIONS; For external use only ;exercise caution when using in the tube to avoid slipping.

Aluminum acetate solution (Burows solutions)

astringent; local irritations; do not use with occlusive dressing

Antihistamines (benadryl)

Antihistamines block the effects of histamine at the H1 receptor. They do not block histamine release, antibody production, or antigen-antibody reactions. Can cause sedations

ACTION: Blocks histamine @ H1 receptor site, inhibiting many allergic reactions.
SIDE EFFECTS: Drowsiness,dizziness,confusion, dry mouth urinary retention
NURSING IMPLICATIONS: If drowsiness occurs avoid activities that require concentration; avoid using with alcohol or other CNS deppresents.

Benzoyl Peroxide

ACTION: antiacne agent
SIDE EFFECTS: EXCESSIVE DRYING OF THE SKIN ALLERGIC REACTIONS

NURSING IMPLICATIONS: Discontinue use if excessive drying or peeling occurs avoid contact w/ hair or fabric.

Chlorhexidine gluconate (Hibiciens)

ACTION:Antimicrobal skin cleanser
SIDE EFFECTS: Irritation, dermatitis, allergic reactions NURSING IMPLICATIONS:external use onlydo not use on broken skin unless directed by a Physician.

Calamine lotion

ACTION:calamine astringent
SIDE EFFECTS: Local irritation
NURSING IMPLICATIONS: For external use only

Coal Tar ( Estar gel, psorigel, other)

ACTION:Coal tar is used to treat psoriasis and other chronic disorders of the skin.

SIDE EFFECTS: PHOTOSENSITIVITY ,dermatitis, allergic reactions.

NURSING IMPLICATIONS: Avoid exposure to sunlight at least 72 hrs after use ; may stain clothes and bathtub; for external use only

Corticosteroids (topical) including:
Fluocinonide (lidex)
Triamcinolome (kenalog)
Betamethasone ( valisone)

ACTION: antiinflammatory agent
SIDE EFFECTS: Local irritation ,maceration,superinfection, atrophy, itching, and drying of the skin( more severe local reactions and systemic effects possible w/higher3 doses and potency or when used with occlusive dressings)\

NURSING IMPLICATIONS: do not use occlusive dressings unless directed by a physician; washing or soaking area before application increases drug penetration.

crotamiton ( eurax)

ACTION: Scabicidal and antipruritic
SIDE EFFECTS: Local irritation, allergic reactions
NURSING IMPLICATIONS; For external use only ; do not apply yo severly irritated skin.

Curel, EUCERIN, Lubriderm

ACTION: EMOLLIENT
SIDE EFECTS: Local irritation, allergic reactions
NURSING IMPLICATIONS: For external use only

Fluconazole (Diflucan)

ACTION: ANTIFUNGAL
SIDE EFFECTS: headache, nausea, vomiting, diarrhea
NURSING IMPLICATIONS: May elevate liver function test; monitor BUN ,creatine

Griseofulvin (fulvicin,grisactin, grifulvin,others)

ACTION: ANTIFUNGAL AGENT
SIDE EFFECTS: HYPERSENSITIVITY reactions, photosensitivity, nausea, fatigue, mental confusion

NURSING IMPLICATIONS: avoid exposure to sunlight; drug absorption when given w/meals; clinical responce may appear only after full course of theraphy.

Isotretinoin ( Accutane)

ACTION; antiacne agent
SIDE EFFECTS: SEVERE DRYNESS OF SKIN ,mouth, eyes,mucous membranes, nose and nails, skin fragility, epistaxis, joint and muscle pain ,nausea,abdominal pain
NURSING IMPLICATIONS: Absolutely contraindicated in pregnant women or women contemplating pregnancy; women of childbering age must practice contraception during theraphy and 1 month before and after theraphy give drug w/meals do not give vitamins supplements containing vitamin A avoid exposure to sunlight.

itraconazole (sporanox)

ACTION: antifungal agent
SIDE EFFECTS: HYPERTENSION, HEADACHE , NAUSEA, ANOREXIA

NURSING IMPLICATIONS: give w/food check hepatic function can increase PT level.

Lindane (kwell)

ACTION: Scabicide ,ovicide
SIDE EFFECTS: Local irritation,dizziness, seizures (rare)
NURSING IMPLICATIONS: for external use only avoid applying to open skin lesions.

Lubriderm

ACTION: EMOLLIENT
SIDE EFFECTS: Local irritation, allergic reactions
NURSING IMPLICATIONS: For external use only exercise caution when using in tub to avoid slipping.

Methoxsalen (oxsoralen, oxsoralen-ultra 8-MOP)

ACTION: Skin pigmentation agent
SIDE EFFECTS; SEVERE PHOTOSENSITIVITY , NAUSEA, NERVOUSNESS, INSOMNIA, HEADACHE, HYPOPIGMENTATION.

NURSING IMPLICATIONS:

povidone -iodine (betadine)

ACTION: TOPICAL ANTIMICROBIAL AGENT
SIDE EFFECTS: LOCAL IRRITATION
NURSING IMPLICATIONS: FOR EXTERNAL USE ONLY MAY STAIN SKIN AND CLOTHING.

PYRENTHRIN ( RID OTHERS)

ACTION: Pediculicide
SIDE EFFECTS: LOCAL IRRITATION
NURSING IMPLICATIONS: For external use only do not use for infestations, eyebrows or eyelashes.

SALICYLIC ACID

ACTION; Keratolytic agent
SIDE EFFECTS; Local irritation , erythema, scaling
NURSING IMPLICATIONS: For external use only may damage clothing, plastic, wood, and other materials on contact

TERBINAFINE ( LAMISIL)

ACTION: antifungal
SIDE EFFECTS: Pruritus, local burning, erythema
NURSING IMPLICATIONS: For external use only do not use occlusive dressings unless directed by physician.

TETRACYCLINE

ACTION: antibacterial agent
SIDE EFFECTS: TOPICAL: Stinging , burning, slight yelllowish of skinmay occur
SYSTEMIC: nausea, diarrhea,photosensitivity
NURSING IMPLICATIONS: TOPICAL: AVOID CONTACT W/ SUNLIGHT
SYSTEMIC: GIVE ON EMPTY STOMACH AVOID CONCOMITANT ADMINISTRATION OF DAIRY PRODUCTS LAXATIVES,ANTAIDS, AND PRODUCTS CONTANING IRON, MAY CAUSE PERMANENT TOOTH DISCOLORATION WHEN USED IN CHILDREN.

TOLNAFTATE (TINACTIN, AFTATE OTHERS)

ACTION: ANTIFUNGAL AGENT
SIDE EFFECTS: Local irritation
NURSING IMPLICATIONS: For external use only.

MAFENIDE ( SULFAMYLON)

ADVANTAGES: Bacteriostatic against gram- negative and gram -positive organism penetrates thick eschar

DISADVANTAGES: Metabolic acidosis pain on application allergic rash.

SILVER SULFADIAZINE ( SILVADENE)

ADVANTAGES: Broad antimicrobial acttivity against gram- negative , gram positive and candida organisms. no electrolytr imbalances painless and somewhat soothing not nephrotoxic.

DISADVANTAGES: With repeated application skin may develop slimy, greyish , appearance simulating an infection despite negative cultures. prolonged use may cause skin rash and depress granulocyte formation.

SILVER NITRATE

ADVANTAGES: bacteriostatic effect lessens pain and eliminates odor reduces evaporative water loss from burns.

DISADVANTAGES: Electrolyte imbalances stains everything it comes incontact with does not penetrate eschar pain on application.

NITROFURAZONE ( FURACIN)

ADVANTAGES: Inhibits enzymes necessary for bacterial metabolism broad spectrum of activity effective against staphylococcus aureus, not absorbed systemically loe incidence of sensitivity.

DISADVANTAGES: CONTACT dermatitis in unaffected skin urine turns a reddish color.

GENTAMICIN SULFATE 9GARAMYCIN)

ADVANTAGES: BROAD antimicrobial activity painless.

DISADVANTAGES; OTOTOXICITY, NEPHROTOCITY,DEVELOPMENT OF RESISTANT BACTERIAL STRAINS.

NEOMYCIN

ADVANTAGES: broad antimicrobial activity causes miscoding in the messenger RNA of bacterial cells.

DISADVANTAGES: Serious toxic effects, ototoxicity, nephrotoxicity.

SCARLET RED

ADVANTAGES: Non antiseptic ,drying agent, applied to donor site , promotes epithelialization.

DISADVANTAGES: NO antimicrobial effects stains and irritates skin infection may develop beneath scarlet red gause which may have systemic effects

XEROFORM

ADVANTAGES: NON ANTISEPTIC DEBRIDES AND PROTECTS DONOR SITE PROTECTS GRAFT.

DISADVANTAGES: Removal may be painful, because it sometimes adheres to wound neither antiseptic nor antimicrobial.

SODIUM HYPOCHLORITE ( DAKINS SOLUTION)

ADVANTAGES: chloride base solution that is bactericidal aids in debriding wounds aids cleaning of copious drainage.

DISADVANTAGES: Dissolves blood clots may inhibit clotting may irritate the skin

SUTILAINS OINTMENT (TRAVASE)

advantages: TOPICAL ENZYMATIC AGENT DISSOLVES NECROTIC tissue by proteolytic action facilitates removal of eschar and purulent drainage.

DISADVANTAGES: Mild, transient pain on application paresthesia, bleeding, dermatitis dressing must be kept moist at all times.

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