1 Second semester Chapter 33 Topical and Inhalant Medications Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant

2 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Topical Route Administered of medication to skin or mucous membranes externally or internally; local or systemic effect Cutaneous Applications rubbed into or placed in contact with the skin, scalp, or mucous membrane 1. Inunction Application Medication incorporated into an agent (ointment, oil, cream) and rubbed into skin 2. Transdermal Applications applied to skin via patch/paste and allowed to absorbed Topical Route

3 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Pathway for Absorption From a Transdermal Skin Patch

4 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Topical Route (cont’d) Ophthalmic Applications Appling drugs onto mucous membrane of one or both eyes (conjunctiva) as drops or ointment,blink it but don't rub

5 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Topical Route (cont’d) Otic applications Drug is instilled into outer ear, used to moisten impacted cerumen or treat infections. Technique for straightening canal 1. In an adult ( pull the ear up and back) 2. In young child ( pull the ear down and back) Technique for irrigation of the external auditory canal or instillation of ear drops. Note the difference in direction of pull on the pinna between (A) the adult (up and back) and (B) the child (down and back).

6 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Topical Route (cont’d) Nasal applications dropped or sprayed in nose; watch for rebound inflammation Sublingual and buccal applications under tongue or between cheek and gum Instruct the client not to chew or swallow the medication Vaginal applications Used most often to treat local infection as yeast Rectal applications to or within rectum; suppositories, ointments

7 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Inhalant Route Administers drugs to lower airways This method is effective because the lungs provide extensive area from which the circulatory system can quickly absorb the drug Educate patients to clean devices appropriately

8 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Inhalant Route (cont’d) Inhaler is handheld device for delivering medications into respiratory passages. Types 1. Dry Powder Inhaler holds reservoir of drug and a carrier substance; dependent on inhalation effort

9 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Inhalant Route (cont’d) 2. Metered-Dose Inhaler delivers aerosolized medication forced through a narrow channel via a chemical propellant Nebulizer breathing machine; converts liquid to mist; used with those who have difficulty coordindinating inspiration with the inhaler Spacer chamber; provides an aerosol reservoir

10 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Spacer and Inhaler

11 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Sample Documentation Time and date ( 11/21/2015 5:42:58 PM) Prescribed eye medication instilled into left eye before cataract surgery. Conjunctiva appears pink and intact. Lens is opaque. Eyelashes have been clipped ( cut ) Signature/ Title

12 Second semester Bader A. EL Safadi BSN, MSc Fundamental of Nursing – B Topical and Inhalant Nursing Implications Nursing diagnoses –Deficient knowledge –Ineffective therapeutic regimen management –Impaired gas exchange –Impaired skin integrity –Impaired tissue integrity