TOPICAL MEDICATIONTOPICAL MEDICATION

SHARON HARVEYSHARON HARVEY

LEARNING OUTCOMESLEARNING OUTCOMESTHE STUDENT WILL BE ABLE TO:THE STUDENT WILL BE ABLE TO:

UNDERSTAND INDICATIONS, AND UNDERSTAND INDICATIONS, AND PREPARATIONS USED, FOR THE PREPARATIONS USED, FOR THE TOPICAL ROUTETOPICAL ROUTE

SHOW AN AWARENESS OF HOW SHOW AN AWARENESS OF HOW TOPICAL MEDICATION IS TOPICAL MEDICATION IS ADMINISTERED AND THE PARTICULAR ADMINISTERED AND THE PARTICULAR PRECAUTIONS THAT ARE NECESSARYPRECAUTIONS THAT ARE NECESSARY

WHAT IS THE TOPICAL ROUTE WHAT IS THE TOPICAL ROUTE OF ADMINISTRATIONOF ADMINISTRATION

IT IS THE ADMINISTRATION OF DRUGS IT IS THE ADMINISTRATION OF DRUGS VIA THE EPIDERMIS (OUTER LAYER VIA THE EPIDERMIS (OUTER LAYER OF THE SKIN) AND EXTERNAL OF THE SKIN) AND EXTERNAL MUCOUS MEMBRANES TO ACHIEVE MUCOUS MEMBRANES TO ACHIEVE LOCAL OR SYSTEMIC EFFECTS.LOCAL OR SYSTEMIC EFFECTS.

IN PAIRS DISCUSS WHY WE USE IN PAIRS DISCUSS WHY WE USE THE TOPICAL ROUTE FOR THE TOPICAL ROUTE FOR ADMINISTERING CERTAIN ADMINISTERING CERTAIN

DRUGS?DRUGS?

PERMITS LOCAL RATHER THAN SYSTEMIC PERMITS LOCAL RATHER THAN SYSTEMIC ABSORPTION OF THE DRUGABSORPTION OF THE DRUGREDUCES SIDE EFFECTSREDUCES SIDE EFFECTSSOME DRUGS ARE SLOW RELEASE OVER SOME DRUGS ARE SLOW RELEASE OVER 24 HOURS THEREFORE CONTINUOUS 24 HOURS THEREFORE CONTINUOUS ACTIONACTION

WHAT ROUTES CAN BE USED WHAT ROUTES CAN BE USED FOR ADMINISTERING TOPICAL FOR ADMINISTERING TOPICAL

MEDICATIONMEDICATIONEYEEYE

EAREAR

NOSENOSE

TRANSDERMALTRANSDERMAL

RECTALRECTAL

VAGINALVAGINAL

WHAT PREPARATIONS DO WHAT PREPARATIONS DO TOPICAL MEDICATION COME TOPICAL MEDICATION COME

IN?IN?PASTESPASTES

CREAMSCREAMS

OINTMENTSOINTMENTS

PATCHESPATCHES

DROPSDROPS

SPRAYSSPRAYS

GUIDELINES FOR THE TOPICAL GUIDELINES FOR THE TOPICAL ADMINISTRATION OF DRUGSADMINISTRATION OF DRUGS

WASH HANDSWASH HANDS

EXPLAIN THE PROCEDURE TO THE EXPLAIN THE PROCEDURE TO THE PATIENTPATIENT

PREPARE THE EQUIPMENTPREPARE THE EQUIPMENT

APPLY THE MEDICATION TO THE SITEAPPLY THE MEDICATION TO THE SITE

COMPLETE DOCUMENTATIONCOMPLETE DOCUMENTATION

EYE MEDICATIONEYE MEDICATION

Available in two forms: Available in two forms: ointments and dropsointments and drops

Important to treat Important to treat correct eyecorrect eye

If both eyes affected If both eyes affected treat least affected eye treat least affected eye firstfirst

Use aseptic techniqueUse aseptic technique

Should be done with Should be done with the patient lying flat the patient lying flat (not always possible)(not always possible)

EYE MEDICATION (CONTINUED)EYE MEDICATION (CONTINUED)

THE LOWER LID SHOULD BE PULL DOWN THE LOWER LID SHOULD BE PULL DOWN TO FORM A POUCH, THEN OINTMENT OR TO FORM A POUCH, THEN OINTMENT OR DROPS CAN BE ADMINISTEREDDROPS CAN BE ADMINISTEREDEYE MEDICATION IS USUALLY ABSORBED EYE MEDICATION IS USUALLY ABSORBED INTO THE CORNEA, HOWEVER IT IS INTO THE CORNEA, HOWEVER IT IS POSSIBLE FOR EYE DROPS TO BE POSSIBLE FOR EYE DROPS TO BE ABSORBED INTO THE CONJUNCTIVAL ABSORBED INTO THE CONJUNCTIVAL VESSELS AND INTO GENERAL VESSELS AND INTO GENERAL CIRCULATION. CIRCULATION. THE EXCESS CAN DRAIN THROUGH THE THE EXCESS CAN DRAIN THROUGH THE TEAR DUCTS INTO THE NASAL MUCOSATEAR DUCTS INTO THE NASAL MUCOSA

USING THE BNF FIND ONE USING THE BNF FIND ONE TOPICAL EYE PREPARATION TOPICAL EYE PREPARATION

WRITE THE DRUG NAME, WRITE THE DRUG NAME, TYPE OF PREPARATION E.G. TYPE OF PREPARATION E.G. OINTMENT, DROPS, ETC AND OINTMENT, DROPS, ETC AND

SIDE EFFECTS AND SIDE EFFECTS AND CONTRAINDICATIONSCONTRAINDICATIONS

EAR MEDICATIONEAR MEDICATION

EAR MEDICATION EAR MEDICATION SHOULD BE AT ROOM SHOULD BE AT ROOM TEMPERATURETEMPERATURETHE PATIENT SHOULD THE PATIENT SHOULD LIE ON THEIR SIDE IF LIE ON THEIR SIDE IF POSSIBLEPOSSIBLEIN ADULTS AND IN ADULTS AND CHILDREN OVER 3 CHILDREN OVER 3 YEARS GENTLY PULL YEARS GENTLY PULL THE PINNA UPWARDS THE PINNA UPWARDS AND BACKWARDS AND AND BACKWARDS AND INSTILL THE INSTILL THE MEDICATIONMEDICATION

EAR MEDICATIONS (CONT)EAR MEDICATIONS (CONT)

IN CHILDREN IN CHILDREN BELOW 3 THE PINNA BELOW 3 THE PINNA SHOULD BE PULLED SHOULD BE PULLED DOWNWARDS AND DOWNWARDS AND BACKWARDS TO BACKWARDS TO INSTILL MEDICATIONINSTILL MEDICATION

THE PATIENT THE PATIENT SHOULD STAY IN SHOULD STAY IN THAT POSITION FOR THAT POSITION FOR 5 MINUTES5 MINUTES

USING THE BNF FIND ONE USING THE BNF FIND ONE TOPICAL EAR MEDICATION TOPICAL EAR MEDICATION

WRITE THE NAME OF THE WRITE THE NAME OF THE DRUG, TYPE OF DRUG, TYPE OF PREPARATION, AND SIDE PREPARATION, AND SIDE EFFECTS OF THE DRUG EFFECTS OF THE DRUG AND ITS AND ITS CONTRAINDICATIONSCONTRAINDICATIONS

NASAL MEDICATIONNASAL MEDICATION

NASAL MEDICATIONS NASAL MEDICATIONS MAY FLOOD THE MAY FLOOD THE SINUSES AND DRIBBLE SINUSES AND DRIBBLE DOWN THE THROAT DOWN THE THROAT AND BE INGESTED AND BE INGESTED THEREFORE THE THEREFORE THE PATIENT SHOULD PATIENT SHOULD EXPECTORATE ANY EXPECTORATE ANY DRUG THAT THEY DRUG THAT THEY FEEL GOING DOWN FEEL GOING DOWN THEIR THROAT THEIR THROAT RATHER THAN RATHER THAN SWALLOWSWALLOW

NASAL MEDICATION (CONT)NASAL MEDICATION (CONT)

THE NASAL PASSAGES SHOULD BE THE NASAL PASSAGES SHOULD BE CLEARED PRIOR TO ADMINISTRATION CLEARED PRIOR TO ADMINISTRATION OF MEDICATIONOF MEDICATION

FOR NASAL SPRAY THE PATIENT FOR NASAL SPRAY THE PATIENT SHOULD BE SITTING UPRIGHTSHOULD BE SITTING UPRIGHT

FOR NASAL DROPS THE PATIENT FOR NASAL DROPS THE PATIENT SHOULD BE LYING DOWNSHOULD BE LYING DOWN

USING THE BNF FIND ONE TOPICAL USING THE BNF FIND ONE TOPICAL NASAL MEDICATION. WRITE THE NASAL MEDICATION. WRITE THE NAME OF THE DRUG, TYPE OF NAME OF THE DRUG, TYPE OF PREPARATION, CONTRAINDICATIONS PREPARATION, CONTRAINDICATIONS AND SIDE EFFECTS OF THE DRUG. AND SIDE EFFECTS OF THE DRUG.

TRANSDERMAL MEDICATIONSTRANSDERMAL MEDICATIONSFOLLOWING FOLLOWING APPLICATION OF THE APPLICATION OF THE DRUG, IT IS ABSORBED DRUG, IT IS ABSORBED THROUGH THE HAIR THROUGH THE HAIR FOLLICLES AND SWEAT FOLLICLES AND SWEAT GLANDS, ENTERING GLANDS, ENTERING THE BLOOD STREAMTHE BLOOD STREAMTHE PATCH SHOULD BE THE PATCH SHOULD BE APPLIED TO A NON APPLIED TO A NON HAIRY SKIN SURFACEHAIRY SKIN SURFACETHE SITES OF THE SITES OF ADMINISTRATION ADMINISTRATION SHOULD BE ROTATED SHOULD BE ROTATED TO PREVENT TO PREVENT IRRITATIONIRRITATION

RECTAL MEDICATIONRECTAL MEDICATIONTHE ACTION OF THE DRUG THE ACTION OF THE DRUG MAY BE LOCAL OR SYSTEMICMAY BE LOCAL OR SYSTEMICTHE PATIENT SHOULD LIE ON THE PATIENT SHOULD LIE ON THEIR LEFT SIDETHEIR LEFT SIDEFOR SYSTEMIC ACTION FOR SYSTEMIC ACTION RECTAL DRUGS THE RECTAL DRUGS THE SUPPOSITORY SHOULD BE SUPPOSITORY SHOULD BE INSERTED BLUNT END FIRSTINSERTED BLUNT END FIRSTFOR LOCAL ACTION RECTAL FOR LOCAL ACTION RECTAL DRUGS THE SUPPOSITORY DRUGS THE SUPPOSITORY SHOULD BE INSERTED SHOULD BE INSERTED POINTED END FIRSTPOINTED END FIRSTTHE SUPPOSITORY SHOULD THE SUPPOSITORY SHOULD ALWAYS BE LUBRICATED ALWAYS BE LUBRICATED WITH A WATER SOLUBLE WITH A WATER SOLUBLE LUBRICANTLUBRICANT

VAGINAL MEDICATIONVAGINAL MEDICATION

THE PATIENT SHOULD THE PATIENT SHOULD BE ENCOURAGED TO BE ENCOURAGED TO EMPTY HER BLADDER EMPTY HER BLADDER AS SHE HAS TO LIE AS SHE HAS TO LIE DOWN FOR 20 MINUTESDOWN FOR 20 MINUTESTHE PATIENT CAN THE PATIENT CAN EITHER LIE SUPINE EITHER LIE SUPINE WITH KNEES UP OR WITH KNEES UP OR LATERAL WITH KNEES LATERAL WITH KNEES UPUPALWAYS LUBRICATE ALWAYS LUBRICATE THE PESSARY OR THE PESSARY OR APPLICATOR BEFORE APPLICATOR BEFORE INSERTINGINSERTING

DISCUSSDISCUSS

WHAT ARE THE BENEFITS OF WHAT ARE THE BENEFITS OF ADMINISTERING DRUGS RECTALLY?ADMINISTERING DRUGS RECTALLY?

WHAT WOULD YOU DO IF YOU WHAT WOULD YOU DO IF YOU SUSPECTED THAT A PATIENT WAS SUSPECTED THAT A PATIENT WAS SUFFERING FROM A SIDE EFFECT OF SUFFERING FROM A SIDE EFFECT OF A DRUG THAT YOU HAVE GIVEN A DRUG THAT YOU HAVE GIVEN TOPICALLY?TOPICALLY?

HOW DO YOU MINIMISE THE RISK TO HOW DO YOU MINIMISE THE RISK TO YOURSELF WHEN ADMINISTERING YOURSELF WHEN ADMINISTERING TOPICAL MEDICATION?TOPICAL MEDICATION?

SUMMARYSUMMARY

TOPICAL DRUGS ARE PREPARED IN MANY TOPICAL DRUGS ARE PREPARED IN MANY DIFFERENT FORMATS, AND HAVE A DIFFERENT FORMATS, AND HAVE A NUMBER OF ADVANTAGES, SUCH AS NUMBER OF ADVANTAGES, SUCH AS DIRECT ACTION ON THE AFFECTED AREA DIRECT ACTION ON THE AFFECTED AREA AND SLOW ABSORPTION THROUGH THE AND SLOW ABSORPTION THROUGH THE SKINSKINSPECIFIC INSTRUCTIONS SHOULD BE SPECIFIC INSTRUCTIONS SHOULD BE FOLLOWED CAREFULLYFOLLOWED CAREFULLYMEASURES TO PREVENT CROSS MEASURES TO PREVENT CROSS INFECTION WHEN ADMINISTERING TOPICAL INFECTION WHEN ADMINISTERING TOPICAL MEDICATION ARE PARTICULARLY MEDICATION ARE PARTICULARLY IMPORTANTIMPORTANT