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When to Refer at patient to MD |
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Definition
multiple or extensive burns
human or animal bites
multiple or extensive cuts, bruises, or abrasions
rash that is extensive, weeping, or infected
tumors or growths
yellow skin
deep infection (cellulitis)
large blisters of unknown origin |
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Vehicles for derm products |
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ointment
cream
lotion
gel
solution/spray |
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semi-solid preparations intended for external application to skin and mucous membranes |
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1. hydrocarbon 2. absorption 3. water-removable 4. water-soluble |
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ointment bases of the water-removable class
consisting of oil-in-water emulsions or aqueous microcrystalline dispersions of long fatty acids or alcohols
water washable and more cosmetically and aesthetically acceptable than ointments
lotions are basically watered down creams |
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semi-solid systems consisting either of suspensions made up of small inorganic particles or large organic molecules interpenetrated by a liquid |
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Emollients - softens the skin, soothes irritation in skin or mucous membranes
Protective - protects injured or exposed skin surfaces from harmful or annoying stimuli
Occlusive - promotes retention of water in the skin, forms a hydrophobic barrier that prevents moisture in the skin from evaporating
Humectant - causes water to be retained because of its hygroscopic properies |
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protect skin or mucous membrane
permit rejuvenation of tissue
provide hydration of the skin
provide a vehicle for applying a medication |
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Examples of drugs delivered via ointments |
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can be a local or systemic effect
antibiotic
anti-fungal
corticosteroids
retinoids
nitroglycerin
analgesics |
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Consider: -condition of the skin -desired effect from the base -area of application -nature of the incorporated medicine (bioavailability, stability, compatibility) |
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Ointments (advantages/disadvantages/preferred area of use) |
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Definition
Advantages: -hydrates -removes scales -greatest bioavailability of the active ingredient
Disadvantages: -greasy
Preferred area of use: -smooth skin with short/sparse hair |
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Creams (advantages/disadvantages/preferred area of use) |
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Definition
Advantages: -good cosmetic appearance -high patient acceptance
Disadvantages: -not as hydrating as ointments
Preferred area of use: -smooth or hair-bearing skin -intertriginous areas |
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Gel (advantages/disadvantages/preferred area of use) |
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Advantages: -non-greasy -easy to apply to hairy areas -high patient acceptance
Disadvantages: -drying
Preferred area of use: -hairy areas |
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Lotions, Solutions, Sprays (advantages/disadvantages/preferred area of use) |
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Definition
Advantages: -easy to apply to hairy areas (scalp) -high patient acceptance
Disadvantages: -drying -lower bioavailability
Preferred area of use: -intertiginous and hair-bearing skin, face |
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white petrolatum
Vaseline
Plastibase
Absorbs no water Not water washable - soap required |
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Aquaphor
Aquabase
Polysorb
Can absorb several times its weight in water not water washable - soap required |
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Water-in-oil emulsion bases |
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Nivea
Eucerin
Hydrocerin
absorbs less water than absorption bases not water washable - soap required |
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Oil-in-water emulsion bases |
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Hydrophilic ointment
Dermabase
Hydrocerin
Unibase
Cetaphil lotion
Vanicream
Water washable Add water = lotion |
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Polyethylene Glycol (PEG) |
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water washable base
minimal therapeutic effect
primarily used for drug delivery |
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Methylcelluose gel liqua-gel carbomer gel poloxamer gel water washable accepts water |
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