----- Chapter 9: “Drugs that Affect the Skin and Mucous Membranes” p Chapter 10: “Drugs that Affect the Respiratory System” p )

Very complex structure (the body’s largest ORGAN) MANY CRITICAL FUNCTIONS including: *Regulating body-temperature *Electrolyte/water balance *Protection (our outer shield!) *Vitamin-D … ‘sunshine vitamin’

LOCAL effect – works on the skin itself SYSTEMIC effect – must be absorbed for example … emollients – soothe the skin, work locally (Vaseline, lanolin) Accutane (isotretinoin) capsules – swallowed and absorbed into the bloodstream … delivered to site-of-action (‘SYSTEMIC’)

SOOTHING agents abrasions, irritations – protects/reduces itching Emollients – fatty, oily substances (vaseline) -used as vehicles for fat-soluble drugs Demulcents – antidote for corrosive poisons

Astringents (tightens pores)

Keratolytics

Local Anesthetics numbing agents, causing loss of sensation sunburn - insect bites - hemorrhoids either applied or Injected locally *procaine *dibucaine *benzocaine

Topical ANTIFUNGALS

Anti-INFECTIVE agents Antibacterial and/or Germicidal To ‘disinfect’ skin, medical instruments Alcohol - ethyl & isopropyl(x2) Povidone-iodine (Betadine solution/scrub) Hydrogen peroxide – dead tissue, pus removal

WOUND CARE Bed sores - pressure ulcers – burns Goal of treatment is 3-fold: - Debridement (removal of dead tissue to control bacterial growth) –maintaining a moist wound environment –keeping intact skin dry

WOUND CARE continued Bactroban (mupirocin) – antibiotic oint and cream to TREAT (cure) infxn Silvadene cream – 2 nd /3 rd degree burns to PREVENT infection

ACNE defined INFLAMMATORY eruption of the skin (scarring) adolescents AND adults Aggravating factors: *oily cosmetics/styling gels (clog pores) … use hypoallergenic, water-based Dietary theories – suspected, NOT PROVEN

ACNE preparations CLEANSING agents – 2x/day mild soap (Dove/Neutrogena) and Astringents (drying agent … StriDex, Clearasil) Retin-A cream, Differin, Cleocin topically Accutane capsule orally --- WARNINGS !

CORTICOSTEROIDS (table 18-2) Use lowest possible potency Anti-inflammatory, antipruritic (anti-itch), and vasoconstrictive properties Possible adverse effects: *skin atrophy *depigmentation *adrenal suppression

Chap 10 RESPIRATORY system oxygen IN (supplies tissues) carbon-dioxide OUT (accumulation is toxic) BODY-TEMPERATURE regulation Lung Inflammation (wheezing, breathlessness) - due to injury or abnormal stimulation

Respiratory drugs acting in the BRAIN STIMULANTS (carbon dioxide, doxapram)..… stimulates breathing Respiratory DEPRESSANTS …undesirable side-effect! The opium group – morphine, codeine The barbiturate group – phenobarbital, secobarbital

Physical features of ASTHMA … AIRFLOW OBSTRUCTION EDEMA BRONCHOCONSTRICTION (narrowing of bronchioles) EXCESSIVE MUCUS PRODUCTION AIRWAY INFLAMMATION AIRWAY HYPERACTIVITY

In order to MINIMIZE asthma attacks …eliminate levels of SMOKE PET DANDER POLLEN and DUST

BRONCHODILATORS Usually by inhalation (aerosol, nebulizer) Dilates/widens the bronchioles (air sacs) in the lungs by relaxing smooth-muscle Oral-tablets – increased side-effects See pages

Inhaled Corticosteroids Reduced inflammation of the lungs’ lining (mucous membrane surface) Combined with Bronchodilators Thins, breaks up mucus/phlegm … allows it to be ‘coughed up’ Page 85

Other misc Respiratory agents Mucomyst (acetylcysteine) -- liquifies mucus, allowing it to drain Intal (cromolyn sodium) -- useful in prevention of asthma-attacks

So long!!!