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Chapter 33
Topical and Inhalant
Medications
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
1
Topical Route
 Topical Route
 Administered of medication to skin or mucous membranes
externally or internally; local or systemic effect
 Cutaneous Applications
 rubbed into or placed in contact with the skin, scalp, or
mucous membrane
1. Inunction Application
 Medication incorporated into an agent (ointment, oil, cream)
and rubbed into skin
2. Transdermal Applications
 applied to skin via patch/paste and allowed to absorbed
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
2
Pathway for Absorption From a Transdermal
Skin Patch
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
3
Topical Route (cont’d)
 Ophthalmic Applications
 Appling drugs onto mucous membrane
of one or both eyes (conjunctiva) as
drops or ointment ,blink it but don't rub
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
4
Topical Route (cont’d)
 Otic applications
 Drug is instilled into outer ear, used to moisten
impacted cerumen or treat infections.
 Technique for straightening canal
1.
2.

In an adult ( pull the ear up and back)
In young child ( pull the ear down and back)
Technique for irrigation of the external auditory canal or instillation of ear drops. Note the
difference in direction of pull on the pinna between (A) the adult (up and back) and (B) the
child (down and back).
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
5
Topical Route (cont’d)
 Nasal applications
 dropped or sprayed in nose; watch for rebound
inflammation
 Sublingual and buccal applications
 under tongue or between cheek and gum
 Instruct the client not to chew or swallow the
medication
 Vaginal applications
 Used most often to treat local infection
as yeast
 Rectal applications
 to or within rectum; suppositories, ointments
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
6
 Inhalant Route
 Administers drugs to lower airways
 This method is effective because the lungs
provide extensive area from which the circulatory
system can quickly absorb the drug
 Educate patients to clean devices appropriately
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
7
Inhalant Route (cont’d)
 Inhaler
 is handheld device for delivering
medications into respiratory passages.
 Types
1. Dry Powder Inhaler
 holds reservoir of drug and a carrier
substance; dependent on inhalation effort
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
8
• Inhalant Route (cont’d)
2. Metered-Dose Inhaler
• delivers aerosolized medication
forced through a narrow channel
via a chemical propellant
Nebulizer
•
breathing machine; converts
liquid to mist; used with those
who have difficulty
coordindinating inspiration with
the inhaler
Spacer
•
chamber; provides an aerosol
reservoir
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
9
Spacer and Inhaler
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
10
 Sample Documentation
Time and date ( 11/21/2015 5:42:58 PM)
Prescribed eye medication instilled
into left eye before cataract surgery . Conjunctiva
appears pink and intact . Lens is opaque . Eyelashes
have been clipped ( cut )
Signature/ Title
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
11
Nursing Implications
• Nursing diagnoses
– Deficient knowledge
– Ineffective therapeutic regimen
management
– Impaired gas exchange
– Impaired skin integrity
– Impaired tissue integrity
Second semester 15 - 16
Bader A. EL Safadi
BSN , MSc
Fundamental of Nursing – B
Topical and Inhalant
12