Integumentary System Drugs for Skin Conditions REVIEW • What do you know about the integumentary system? • Identify and describe the structure and function of the layers of the skin. • Define the terms: – Pruritis – Inflammation – Erythema REVIEW • Describe the general categories of skin disorders. • What is a self-limiting skin infection? • Identify the two most common microorganisms causing bacterial skin infections. • Identify the most common fungal skin infection. • When is pharmacologic treatment necessary for a skin infection? Pharmacotherapy for Skin Infections • Describe two types (routes) of pharmacotherapy for skin infections. • Discuss indications for each type of pharmacotherapy. • Discuss the associated advantages of each type of pharmacotherapy. • Identify commonly used pharmacotherapeutic agents. Skin Infections Develop a plan of care for Skin Infections. Skin Infestations • Parasites – Mites – Lice • Compare and contrast mites and lice in regards to: – Physical characteristics – Location of infestation – Requirement for survival – Spread Pharmacotherapy for Skin Infestations • Compare and contrast scabicides and pediculocides. • What factors must be considered when choosing drug to use? • Identify the traditional drug of choice (prototype drug) for skin infestations. – Discuss why the traditional drug is not currently the drug of choice for treatment of skin infestations. – Discuss when treatment with the traditional drug of choice is indicated. Case Application Dawnelle is a 7-year-old who loves to play “beauty shop” with her friends. Her mother has noticed that she has been scratching the nape of her neck and behind her ears a lot lately. It is the night for Dawnelle to have her long hair washed and her mother asks her to sit while she combs out her hair in preparation for washing. As her mother separates her hair with the comb she sees a dark object about 1/8 inch long darting away from the comb. As she further lifts and separates the hair she finds many white bumps on the hair shaft. Case Application Dawnelle’s mother knows you are a nursing student and calls you in a panic. • What will you tell Dawnelle’s mother? • What treatment recommendations and instructions will you give her? Case Application You are a nursing assistant working in a long-term care facility. Over the course of a week many of the residents have developed a reddened, pimple-like rash. Today you noticed that you also have a rash and have intense itching between your fingers. You mention this to a co-worker during break and he states he also has the same symptoms. What do you think is wrong? What is the expected course of action? SUNBURN • What causes this condition? • What is the best strategy? • Describe local and systemic symptoms. • Describe pharmacologic and non-pharmacologic treatment. Acne Vulgaris & Rosacea • Compare and contrast acne vulgaris and rosacea: – Characteristic lesions – Age of onset – Exacerbating factors – Pharmacotherapy • OTC vs. prescription • Discuss important nursing considerations regarding the use of isotretinoin (Accutane) for the treatment of acne vulgaris. Dermatitis • What is dermatitis? • Identify characteristics of dermatitis. • Compare and contrast the four Types of dermatitis: – Atopic dermatitis – Contact dermatitis – Seborrheic dermatitis – Stasis dermatitis Dermatitis Pharmacotherapy • What type of medication preparations would you expect to use for dermatitis? • What classifications of drugs would you anticipate using for dermatitis? • Topical glucocorticoids are classified by potency. – Describe indications for: • High potency glucocorticoids • Medium potency glucocorticoids • Low potency glucocorticoids • What is the next course of action if atopic dermatitis does not respond to glucocorticoid therapy? Topical Glucocorticoids • Describe the characteristic skin changes associated with long-term glucocorticoid use. • What undesirable effects may occur with topical glucocorticoids, depending upon absorption? • What teaching would you provide to the patient needing topical glucocorticoid therapy to prevent serious side effects? Psoriasis • Describe the pathophysiology of psoriasis. • Discuss the etiology of psoriasis. • Identify the characteristic locations of psoriatic plaques. • Identify environmental triggers. • Identify drug triggers Psoriasis Therapy • What is the goal of therapy? • Discuss pharmacotherapeutic agents used to control psoriasis. • Discuss the benefits to combination therapy. • Discuss the role of biologic modifying drugs. • Identify other, non-pharmacologic therapies.