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Topical Drugs Chapter 11 Topical Medications • Topical Medications: – Drugs applied to the skin • Absorption is affected by: – – – – – – Strength of drug How long drug is in contact to the skin Size of the area of application Skin thickness Hydration Amount of skin breakdown or irritation Topical Medications (continued) • Drugs are applied topically to: – Clean and debride a wound – Hydrate the skin – Reduce inflammation – Relieve itching or rash – Provide a protective barrier – Reduce thickening of the skin Dose Forms • Cream: – Semi-solid emulsion containing a drug • Non greasy & easily removed with water • Lotion: – Watery preparation containing suspended particles • Shake prior to application • Pat lotion onto skin….do not rub – Used to soothe & protect skin, relieve itching and cleanse the skin • Ointment: – Semi-solid preparation containing a drug in an oily base • Not easily removed with water • Powder: – Finely ground drug in talc base – Used to absorb moisture, cool and protest the skin Applying Topical Medications • • • • • • • • Hand hygiene Follow standard precautions Wear gloves Provide privacy Position to expose application site Clean & dry skin Observe skin Apply dose form to clean dry skin – Use a sterile tongue blade or cotton-tipped applicator to remove dose from container • Cover site with gauze or other covering AS DIRECTED Observations to Report • • • • • • • • • Color of skin Location & description of rashes Dry skin Bruises or open skin areas Pale or reddened areas, particularly over boney parts Blisters Drainage or bleeding from wounds or body openings Skin temperature Complaints of pain or discomfort Applying Nitroglycerin • Used to prevent angina (chest pain) • Relaxes the heart blood vessels and increase the blood & oxygen supply to the heart • DOSAGE MUST BE ACCURATE Applying Nitroglycerin • Apply to clean dry skin that has little hair – Do not shave an area – Do not apply to irritated, scarred, open, broken, or calloused skin areas • Wear gloves • Check for old applications – Check MAR – Ask patient • • • • Remove old application Rotate application site Do not rub or massage the ointment into the skin Document date, time, location and sign your name/title to the tape securing the new application Sites for Applying Nitroglycerin Transdermal Drug Delivery • Transdermal Patches: – Provides continuous, gradual absorption of a drug through the skin and into the blood stream – Provides controlled release of a drug over several hours or days • Insert Photo Application of a Transdermal Patch • Follow rules learned for “Applying Nitroglycerin Ointment” – Do not cover the patch with a dressing unless directed • Insert photo