1. ----- Chapter 9: “Drugs that Affect the Skin and Mucous Membranes” p 71-80 Chapter 10: “Drugs that Affect the Respiratory System” p 81-87 )

2. 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’

3. 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’)

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

5. Astringents (tightens pores)

7. Keratolytics

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

9. Topical ANTIFUNGALS

10. 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

11. 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

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

13. 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

14. 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 !

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

16. 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

17. 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

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

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

22. 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 83 - 85

23. 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

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

25. So long!!!