----- Chapter 9: “Drugs that Affect the Skin and Mucous Membranes” p 71-80 Chapter 10: “Drugs that Affect the Respiratory System” p 81-87

)

Very complex structure (the body’s largest ORGAN)

MANY CRITICAL FUNCTIONS including:

*Regulating body-temperature

*Electrolyte/water balance

*Protection (our outer shield!)

*Vitamin-D … ‘sunshine vitamin’

LOCAL effect – works on the skin itself

SYSTEMIC effect – must be absorbed

for example …

emollients – soothe the skin, work locally (Vaseline, lanolin)

Accutane (isotretinoin) capsules – swallowed and absorbed into the bloodstream … delivered to site-of-action (‘SYSTEMIC’)

SOOTHING agentsabrasions, irritations – protects/reduces

itching

Emollients – fatty, oily substances (vaseline)

-used as vehicles for fat-soluble drugs

Demulcents – antidote for corrosive poisons

Astringents (tightens pores)

Keratolytics

Local Anestheticsnumbing agents, causing loss of sensation

sunburn - insect bites - hemorrhoids

either applied or Injected locally

*procaine *dibucaine *benzocaine

Topical ANTIFUNGALS

Anti-INFECTIVE agentsAntibacterial and/or GermicidalTo ‘disinfect’ skin, medical instrumentsAlcohol - ethyl & isopropyl(x2)Povidone-iodine (Betadine solution/scrub)Hydrogen peroxide – dead tissue, pus removal

WOUND CARE Bed sores - pressure ulcers – burnsGoal of treatment is 3-fold: -

Debridement (removal of dead tissue to control bacterial growth) –maintaining a moist wound environment –keeping intact skin dry

WOUND CARE continuedBactroban (mupirocin) – antibiotic oint

and cream to TREAT (cure) infxnSilvadene cream – 2nd/3rd degree burns to

PREVENT infection

ACNE definedINFLAMMATORY eruption of the skin (scarring)

adolescents AND adults

Aggravating factors: *oily cosmetics/styling gels (clog pores) … use hypoallergenic, water-based

Dietary theories – suspected, NOT PROVEN

ACNE preparationsCLEANSING agents – 2x/day mild soap

(Dove/Neutrogena) and Astringents (drying agent … StriDex, Clearasil)

Retin-A cream, Differin, Cleocin topicallyAccutane capsule orally --- WARNINGS !

CORTICOSTEROIDS (table 18-2)Use lowest possible potency

Anti-inflammatory, antipruritic (anti-itch), and vasoconstrictive properties

Possible adverse effects: *skin atrophy *depigmentation *adrenal suppression

Chap 10 RESPIRATORY systemoxygen IN (supplies tissues)

carbon-dioxide OUT (accumulation is toxic)

BODY-TEMPERATURE regulation

Lung Inflammation (wheezing, breathlessness) - due to injury or abnormal stimulation

Respiratory drugs acting in the BRAINSTIMULANTS (carbon dioxide, doxapram) ..…

stimulates breathing

Respiratory DEPRESSANTS …undesirable side-effect!

The opium group – morphine, codeine

The barbiturate group – phenobarbital, secobarbital

Physical features of ASTHMA … AIRFLOW OBSTRUCTION

EDEMA

BRONCHOCONSTRICTION (narrowing of bronchioles) EXCESSIVE MUCUS PRODUCTION

AIRWAY INFLAMMATION

AIRWAY HYPERACTIVITY

In order to MINIMIZE asthma attacks

…eliminate levels of

---------------------- SMOKE

---------------------------- PET DANDER

------------------------------------ POLLEN and DUST

BRONCHODILATORSUsually by inhalation (aerosol, nebulizer)Dilates/widens the bronchioles (air sacs)

in the lungs by relaxing smooth-muscleOral-tablets – increased side-effects See pages 83 - 85

Inhaled CorticosteroidsReduced inflammation of the lungs’ lining

(mucous membrane surface)Combined with BronchodilatorsThins, breaks up mucus/phlegm … allows it to

be ‘coughed up’Page 85

Other misc Respiratory agentsMucomyst (acetylcysteine)

-- liquifies mucus, allowing it to drain

Intal (cromolyn sodium)

-- useful in prevention of asthma-attacks

So long!!!