Dermatologicals

1. Dermatologicals EO 003.01 Part 20

2. Overview of Lesson(Insert Dari) Antifungals for dermatologic use Emollients and protectives Antipuretics Antipsoriatics Antibiotics and chemotherapeutics for dermatological use Corticosteroids Anti-acne preparations Other Insert Dari

3. What I need to know as a pharmacy technician(Insert Dari) Insert Dari • In this lecture we will cover the drugs listed in the ANA Formulary which are classified according to the ATC system under • (D) Dermatologicals • For each of these medications/classes students must obtain an understanding of: • (1) Mechanism of Action • (2) Indications (Uses) • (3) Efficacy • (4) Side Effects

6. Antifungals for dermatologic use(Insert Dari) Athletes foot (tinea pedis) (Insert Dari)

8. Clotrimazole (topical) (Insert Dari) Insert Dari • Mechanism of Action • Interferes with the formation of the cell membrane. • Indications (Use) • Athletes foot (tinea pedis) • Vaginal yeast infections • Side Effects • May causes a slight irritation at the site of application.

9. Clotrimazole (topical) (Insert Dari) Insert Dari • Important Points • This drug is for external use only and is to be applied directly to the skin. • If this medication is being used to treat a vaginal yeast infection it is best applied before bedtime. • Patients should wash their hands before and after use. • Generally needs to be used for a week to 7 days to fully clear up the infection. • However, should start to see improvement within a few days.

10. Emollients and Protectives(Insert Dari)

12. Zinc Oxide(Insert Dari) Insert Dari • Mechanism of Action • Hydrates the skin. • Indications (Use) • Dry skin • Irritated skin • commonly used to treat ‘diaper rash’ – which is irritation of a baby’s skin due to wearing a diaper. • Side Effects • May cause skin irritation at the site of application.

13. Antipuretics(Insert Dari) Pruritis = itchiness Insert Dari Reddened skin from patient scratching due to puritis (Insert Dari)

15. Calamine Lotion(Insert Dari) • Insert Dari • Mechanism of Action • Works as an anti-itching agent. • Indications (Use) • To soothe minor skin irritations and contact with irritants (i.e. poison ivy in North America). • Side Effects • Can cause skin irritation. • Important Points • For external use only • Should provide some relief within a few hours. • Generally used for about 7 days.

16. Antipsoriatics(Insert Dari) Psoriatic plaques on the elbows (Insert Dari)

17. What is Psoriasis? (Insert Dari) Insert Dari • Psoriasis is a skin condition that makes your skin thick and red and also causes silver or white scales to form on the skin. • Doctors do not know what causes psoriasis. The symptoms can include: • Areas of skin that are dry or red, and that are usually covered with silvery or white scales. • Rashes on the scalp, genitals, or in skin folds (like the folds you have at the elbow) • Itching • Nail changes that make the fingernails or toenails look pitted, crumbly, or different in color

19. Methoxsalen and Aminobenzoic acid (topical) (Insert Dari) Insert Dari • Mechanism of Action • Prevents cell division which causes formation of the plaques. • Indications (Use) • Psoriasis • Side Effects • Sunburn. • Skin irritation. • Itching. • Can cause damage to unborn babies, should not be used if pregnant.

20. Methoxsalen and Aminobenzoic acid (topical) (Insert Dari) Insert Dari • Important Points • For external use only. • The use of this medication will make the condition worse at first (cause redness and irritation) but it will start to get better over the following week. • Should be applied using a glove.

21. Antibiotics and Chemotherapeutics for Dermatological Use(Insert Dari)

23. Silver Sulfadiazine (topical) (Insert Dari) Insert Dari • Mechanism of Action • Prevents bacterial growth. • Indications • Used to prevent infections (i.e. open wounds). • Side Effects • Can cause skin irritation. • Important Points • For external use only.

24. Acyclovir (topical)(Insert Dari) Insert Dari • Mechanism of Action • Prevents replication of the Herpes Simplex Virus by disrupting the replication of genetic material. • Indications (Uses) • Used to treat Herpes Simplex infections • shingles • cold sores • genital herpes • Side Effects • Can cause skin irritation • Important Points • For external use only • Should use a glove to apply (to avoid spreading infection to other areas of the body).

25. Corticosteroids for Dermatological Use(Insert Dari)

27. Hydrocortisone (topical) (Insert Dari) Insert Dari • Mechanism of Action • Decreases inflammation (swelling) and skin irritation by suppressing the body’s normal immune response. • Indication • To treat skin irritation and minor inflammation. • Side Effects • Can cause minor skin irritation • Can cause thinning of the skin if used long term. • Important Points • For external use only. • Apply in a nice thin layer to the affected area.

28. Corticosteroid Combinations (topical) (Insert Dari) Topical corticosteroids can be combined with anti-infective agents in order to reduce inflammation and irritation. Betamethasone and Clotrimazole – to treat fungal skin infections. Triamcinalone/Neomycin/Nystatin – to treat infections that could be fungal or bacterial. Important Points • For external use only. • Patient should use for the length of time specified in order for the infection to fully clear. • Topical corticosteroids can be combined with anti-infective agents in order to reduce inflammation and irritation. • Betamethasone and Clotrimazole – to treat fungal skin infections. • Triamcinalone/Neomycin/Nystatin – to treat infections that could be fungal or bacterial. • Important Points • For external use only. • Patient should use for the length of time specified in order for the infection to fully clear.

29. Anti-acne Preparations(Insert Dari)

30. Acne(Insert Dari) Acne develops as a result of blockages in the hair follicles. Often, the blockages can cause an infection to occur in the follicle = severe acne and inflammation. (Insert Dari)

32. Erythromycin (topical) (Insert Dari) Insert Dari • Mechanism of Action • Erythromycin is an antibiotic that prevents protein synthesis = cell death. • Indications (Use) • Used to treat acne. • Side Effects • Skin irritation • Important Points • For external use only.

33. Other Dermatological Preparations(Insert Dari)

35. Minoxidil (topical) (Insert Dari) Insert Dari • Mechanism of Action • Causes vasodilatation which stimulates hair growth (increased nutrients received by the hair follicle. • Indications (Use) • Used to treat hair loss. • Side effects • Can cause skin irritation • Important Points • For external use only. • Wash your hands before and after use. • Put a thin layer on the affected skin and rub in gently.

36. Lindane(Insert Dari) Insert Dari • Mechanism of Action • Kills lice • Indications • Used to treat lice and scabies infections. • Side effects • May cause skin irritation • Important Points • Shake well before use. • Put a thin layer on the skin from the neck to the toes. Put in the skin folds, creases, and spaces between the fingers and toes. Be sure to cover the scalp. • Leave on for the amount of time specified. • Rinse off afterwards.

37. Lice (Insert Dari) Insert Dari • Lice are tiny insects that can live on people’s skin and in their hair, and cause itching. • Three types of lice can live on or close to people’s bodies: • Head lice can live on your scalp and in the hair on your head • Body lice can live in the clothes you wear, and feed on your body (these are uncommon) • Pubic lice, also called can live in your pubic hair, eyebrows, eyelashes, armpits, beard or mustache, or other areas

38. Scabies(Insert Dari) Insert Dari • Scabies is a condition that makes your skin very itchy. It happens when tiny insects called mites burrow under your skin to lay their eggs. • The condition spreads easily between people who are in close contact. It is also possible to catch scabies from the clothes of someone with the condition.

39. Selenium Sulfide(Insert Dari) Insert Dari • Mechanism of Action • Decreases skin cell growth. • Indications (Use) • Dandruff (flaking of the skin on the scalp) and seborrhea (flaking of the skin in oily regions). • Side Effects • Minor skin irritation • Important Information • - For external use only. • - Put on affected part, lather, and rub in gently. • - Leave on for 10 minutes. • - Rinse fully.

40. Questions?(Insert Dari)

41. In-class Assignment(Insert Dari) This assignment will consist of 3 questions which are to be completed individually. Once complete the instructor will review the answers with the class. Insert Dari

42. 1. Match the following drugs with their topical use(Insert Dari) • Clotrimazole • Hydrocortisone • Erythromycin • Lindane • Athlete’s foot (tinea pedis) • Acne • Scabies/lice • To decrease skin irritation • Insert Dari

43. 1. Match the following drugs with their topical use(Insert Dari) • Clotrimazole (1) athlete’s foot • Hydrocortisone (4) to decrease skin irritation • Erythromycin (2) acne • Lindane (3) scabies/lice • Insert Dari

44. 2. True or False: When a patient is using a topical preparation it is very important to explain to them that it only for external use(Insert Dari)

45. 2. True or False: When a patient is using a topical preparation it is very important to explain to them that it only for external use(Insert Dari)Answer: True(Insert Dari)

46. 3. What is silver sulfadiazine used for?(Insert Dari) • To treat dandruff • To prevent infection • To treat psoriasis • To treat acne • Insert Dari

47. 3. What is silver sulfadiazine used for?(Insert Dari) • To treat dandruff • To prevent infection • To treat psoriasis • To treat acne • Insert Dari