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Topic Therapy 外用药物治疗

Topic Therapy 外用药物治疗. 昆明医学院第二临床学院 皮肤性病学教研室 邓丹琪 教授. How to use them. ?. Before. After. Contents. Characteristic of topic agents( 外用药的性能 ) Vehicles for topical agents( 外用药的剂型 ) Therapeutic principle of topic agents ( 治疗原则 ) Caution( 注意事项 ). Characteristic of topic agents.

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Topic Therapy 外用药物治疗

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  1. Topic Therapy外用药物治疗 昆明医学院第二临床学院 皮肤性病学教研室 邓丹琪 教授

  2. How to use them ?

  3. Before After

  4. Contents • Characteristic of topic agents(外用药的性能) • Vehicles for topical agents(外用药的剂型) • Therapeutic principle of topic agents (治疗原则) • Caution(注意事项)

  5. Characteristic of topic agents • 清洁剂 (clearing agents): • Function：Use to clear effusion(渗出物), scale(鳞), crust and residue. Examples ：3％硼酸 Boric Acid Solution Sodium Chloride生理盐水 Liquid Paraffin液体石蜡

  6. Characteristic of topic agents • 保护剂 (protective agents) Fouction： Protect skin, reduce friction(摩擦), prevent effect of external irritant Examples： Talc Powder (滑石粉) Zinc Oxide Powder(氧化锌粉 ) Amylum(淀粉)

  7. Characteristic of topic agents • 止痒剂 (antipruritic agents) Function： Reducing the itching Examples：5% 苯唑卡因 Benzocaine 0.5-2% 薄荷 Menthol 2% 樟脑 Camphor glucocorticoid

  8. Characteristic of topic agents • 角质促成剂（keratoplastics） Function ：Promote corneum epidermidis to become nomal. Anastole vascellum(收缩血管), relieve effusion and infiltrating.(减轻炎性渗出和浸润)（ Examples：焦油 empyreumatic oil 3%水杨酸 Salicylic Acid 3%一5%硫磺 Sulfur

  9. Characteristic of topic agents • 角质剥脱剂（keratolytics） Function：Make hyperkeratosis（过度角化）cell amotic(脱落). Examples：10％ 硫磺 Sulfur 5％～10％ 水杨酸 Salicylic Acid 0.01％～0.1％维A酸 Tretinoin

  10. Characteristic of topic agents • 收敛剂（astringents） Function：Inhibit externalization of sweat gland and coil gland.凝固蛋白质、减少渗出 抑制分泌、促进炎症消退 Examples：5％甲醛 Formaldehyde 0.2％～0.5％硝酸银 Silver Nitrate

  11. Characteristic of topic agents • 腐蚀剂（caustics） Function：Destroy and removal hyperplastic(增生）granulation tissue and ecphyma(赘生物). Examples：苯酚 Phenol 硝酸银 Silver Nitrate 5-20%乳酸 Lactic Acid

  12. Characteristic of topic agents • 抗菌剂（antiseptics） Function：Have disinfection or bacteriostasis.(杀灭或抑制细 Exzamples：3％硼酸 Boric Acid Solution 1％红霉素Erythromycin Ointment 2%莫匹罗星 Mupirocin Ointment

  13. Characteristic of topic agents • 抗真菌剂（antifungal agents） Function：Have kill or fungistasis(抑制真菌) Examples：2％～3％克霉唑 Clotrimazole 1%益康唑 Econazole 1%～2.5%硫化硒 Selenium Sulfide Benzoic Acid, (笨甲酸） Glacial acetic acid,（冰醋酸） Allylamine（丙烯胺）

  14. Characteristic of topic agents • 抗病毒剂（antiviral agents） Function： antiviral Examples：2%～3%阿昔洛韦 Aciclovir 0.5%～1%疱疹净 Indo-Deoxyuridine

  15. Characteristic of topic agents • 杀虫剂（insecticides） Function:Kill parasite such as vermiform acari(蠕形 螨),pediculus(虱). Examples：5％～10％硫磺 Sulphur 2％甲硝唑 Metronidazole

  16. Characteristic of topic agents • 遮光剂 (sunscreen agents) Function：Absorb and prevent ultraviolet. Examples：5%二氧化钛 Titanium Dioxide 10%氧化锌 Zinc Oxide

  17. Characteristic of topic agents • 脱色剂 (Depigment agents) Function：Relieve hyperpigmentation,(色素沉着). Examples： 3%氢醌 Hydroquinone 20%壬二酸 Azelaic Acid

  18. Characteristic of topic agents • 维A酸类 (retinoids) Function：调节表皮角化 抑制表皮增生 调节黑素代谢 Examples：0.025%～0.05％维A酸霜 Tretinoin

  19. Characteristic of topic agents • 外用糖皮质激素 (glucocorticoid) • Function:Have anti-inflammatory, anaphylaxis, relieving itching.作用： 有明显的抗炎症作用 低效 氢化可的松、地塞米松 中效 去炎松、 氟轻松 强效 氯氟舒松 、氯倍他索 、 倍氯米松

  20. Vehicles for topical agents 1 溶液(solution) 组成：药物的水溶液 Solution of medicine. Function：dephlogisticate(消炎), loss of heat 散热, reduce effusion(收敛) Examples：硼酸 Boric Acid cold wet compresses

  21. Vehicles for topical agents 2 酊剂和醑剂 (tincture and spiritus) 酊剂：非挥发性药物的酒精溶液 Fixed medicine dissolved in alcohol 醑剂：挥发性药物的酒精溶液 Volatility medicine dissolved in alcohol Function ：dephlogisticate, sterilize(杀菌） and reliev itching. Examples：斑秃酊 Alopecia Areata、 樟脑醑 Camphor

  22. Vehicles for topical agents 3 粉剂 (powder) ：Medical powder Function：They also cool the skin, reduce friction, and smooth the skin surface. Examples：氧化锌粉 Zinc Oxide They are effective in preventing miliaria ( 痱子）and intertrigo（擦烂）.

  23. Vehicles for topical agents 4 洗剂（lotion） Insoluble medicine powder mixed with water Function:anti-itching ,bring cooling, astringent and protective effects. Examples:Lotion Sulphur硫磺洗剂

  24. Vehicles for topical agents 5 油剂 (oi1) Insoluble medicine powder mixed with vegetable oil Function：clearing, softening crust, protecting and moist skin lesion. Examples: seed fat, mineral oil, animal oil. 25％～40％Zinc oxide oil

  25. Vehicles for topical agents 6 乳剂 (emulsion)： Emulsifyingmixture of oil and water. Two types of emulsion: one type are water-in-oil emulsive vehicles(脂）, they are mostly applied on dry lesions. The other are creams(霜）, called oil-in-water emulsive vehicles.

  26. Function： protecting and moist skin lesion. Examples：糖皮质激素Glucocorticoids

  27. Vehicles for topical agents 7 软膏 (ointment)：Medicine mixed with lipidic groundsubstance, such as vaseline、simple ointment (vegetable oil add Beeswax )or animal fat. Function:softening crust, protecting and moist skin lesion. Examples：红霉素软膏 Erythromycin Ointment

  28. Vehicles for topical agents 8 糊剂（paste): Ointment with 25%-50%powder. Function： astringent Examples： 氧化锌糊 Paste Zinc Oxide

  29. Vehicles for topical agents 9 硬膏 (plaster) Medicine dissolved or mixed , attached to groundsubstance，such as cloth, paper or pellicle with hole. Function：protecting and moist skin lesion. Examples： 肤疾宁硬膏

  30. Vehicles for topical agents 10 涂膜剂（film） Film-former of high molecular compound dissolving organism menstruum(溶剂)or water add medicine. Function： protecting and moist skin lesion.

  31. Vehicles for topical agents 11 凝胶（gel） Mixed with high molecular compound and organism solvent. Examples：Gel adapalane阿达帕林凝胶 过氧苯甲酰凝胶

  32. Vehicles for topical agents 12 气雾剂（aerosol) Medicine mixed with aerosol ,film-former of high molecular Compound. Examples：牛纤维细胞生长因子气雾剂

  33. Vehicles for topical agents 13 Others 如二甲基亚砜（DMSO）可溶解多种水溶性和脂溶性药物，是皮肤渗透促进剂。

  34. 皮炎的分期

  35. Therapeutic principle of topic agents Characteristic of topic gents Etiology and pathogenesis: Bacteria- antiseptics Allergic disease- glucocorticoid、antihistamine Symptom： antipruritic agents Pathology: hyperkeratosis-- keratolytics parakeratosis--keratoplastics

  36. Therapeutic principle of topic agents

  37. Therapeutic principle of topic agents Acute dermatitis： without exudation: powder or lotion more exudation: solution less exudation : oils or paste Subacute dermatitis： without exudation: emulsion orpaste Less exudation: oils or paste Chronic dermatitis: ointment, plaster, emulsion, film Itaching： film, mulsion

  38. Therapeutic principle of topic agents

  39. Caution • Suitable consistency • Considering sex, age and lesion location • Method • Observation the efficacy and side-effect

  40. Summary

  41. Discussion 1 1、Dermatitis stage ? 2、What vehicles should be used for this dermatitis ？

  42. Discussion 2 1、 Dermatitis stage? 2、What vehicles can be elected？

  43. 1、Dermatitis stage ? 2、What vehicles can be elected ？

  44. Discussion 3 1、Dermatitis stage ? 2、What vehicles can be elected ？

  45. Question 1.What is the Therapeutic principle of topic agents?How to choice vehicles for chronic dermatitise? 2. Could we use ointment for acute dermatitise ?Why?

  46. Thank You !

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