Mosby's 2014 Nursing Drug Reference (441 page)

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

TOPICAL
GLUCOCORTICOIDS

betamethasone (augmented) (Rx)

(bay-ta-meth′a-sone)

Diprolene

desonide (Rx)

(dess′oh-nide)

LoKara, Verdeso Foam

fluocinolone (Rx)

(floo-oh-sin′oh-lone)

Derma-Smoothe/F, Synalar

flurandrenolide (Rx)

(flure-an-dren′oh-lide)

Cordran, Cordran SP, Drenison 1/4
, Drenison Tape

halcinonide (Rx)

(hal-sin′oh-nide)

Halog

ACTION:

Antipruritic, antiinflammatory

USES:

Psoriasis, eczema, contact dermatitis, pruritus; usually reserved for severe dermatoses that have not responded to less potent formulation

CONTRAINDICATIONS:

Hypersensitivity, viral infections, fungal infections

Precautions:
Pregnancy (C)

DOSAGE AND ROUTES
Calculator

• Adult and child:
Apply to affected area

Administer:

• 
Only to affected areas; do not get in eyes

• 
Leaving site uncovered or lightly covered; occlusive dressing is not recommended—systemic absorption may occur

• 
Use only on dermatoses; do not use on weeping, denuded, or infected area

• 
Cleansing before application of product

• 
Continuing treatment for a few days after area has cleared

• 
Store at room temperature

SIDE EFFECTS

INTEG:
Acne, atrophy, epidermal thinning, purpura, striae

NURSING CONSIDERATIONS
Assess:

• 
Temp; if fever develops, product should be discontinued

• 
For systemic absorption, increased temp, inflammation, irritation

Evaluate:

• 
Therapeutic response: absence of severe itching, patches on skin, flaking

Teach patient/family:

• 
To avoid sunlight on affected area, burns may occur

• 
To limit treatment to 14 days

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

TOPICAL
ANTIFUNGALS

nystatin (
OTC
)

(nye-stat′in)

Nyamyc, Nystop, Pediaderm, Pedia-dri

selenium (
OTC
)

(see-leen′ee-um)

Dandrex, Selsun, Selsun Blue

terbinafine (
OTC
)

(ter-bin′a-feen)

Lamisil

tolnaftate (
OTC
)

(tole-naf′tate)

Absorbine Athlete’s Foot Cream, Fungi-Guard, Tinactin

undecylenic acid (
OTC
)

(un-deh-sih-len′ik)

ACTION:

Interferes with fungal cell membrane permeability

USES:

Tinea cruris, tinea pedis, diaper rash, minor skin irritations; amphotericin B is used for candida infections

CONTRAINDICATIONS:

Hypersensitivity

Precautions:
Pregnancy (B), breastfeeding, children

DOSAGE AND ROUTES
Calculator

• 
Massage into affected area, surrounding area daily or bid, continue for 7-14 days, not to exceed 4 wk

Administer:

Topical route

• 
To affected area, surrounding area; do not cover with occlusive dressings

• 
Store below 86° F (30° C)

SIDE EFFECTS

INTEG:
Burning, stinging, dryness, itching, local irritation

NURSING CONSIDERATIONS
Assess:

• 
Skin for fungal infections; peeling, dryness, itching before and throughout treatment

• 
For continuing infection; increased size, number of lesions

Evaluate:

• 
Therapeutic response: decrease in size, number of lesions

Teach patient/family:

• 
To apply with glove to prevent further infection; not to cover with occlusive dressings

• 
That long-term therapy may be needed to clear infection (2 wk-6 mo depending on organism); compliance is needed even after feeling better

• 
Proper hygiene; hand-washing technique, nail care, use of concomitant top agents if prescribed

• 
To avoid use of OTC creams, ointments, lotions unless directed by prescriber

• 
To use medical asepsis (hand washing) before, after each application; to change socks and shoes once a day during treatment of tinea pedis

• 
To report to health care prescriber if infection persists or recurs; if blisters, burning, oozing, swelling occur

• 
To avoid alcohol because nausea, vomiting, hypertension may occur

• 
To use sunscreen or avoid direct sunlight to prevent photosensitivity

• 
To notify health care provider of sore throat, fever, skin rash, which may indicate overgrowth of organisms

Canada only   Side effects:
italics
= common;
bold
= life-threatening   
Nurse Alert

TOPICAL
ANTIINFECTIVES

bacitracin (
OTC
)

(bass-i-tray′sin)

mafenide (Rx)

(ma′fe-nide)

Sulfamylon

salicylic acid (Rx)

(sal′i-sil′ik)

silver sulfADIAZINE (Rx)

(sul-fa-dye′a-zeen)

Flamazine
, Silvadene, SSD, SSD AF, Thermazene

tretinoin (Rx)

(treh′tih-noyn)

Atralin, Avita, Retin-A, Renova

ACTION:

Interferes with bacterial protein synthesis

USES:

Skin infections, minor burns, wounds, skin grafts, primary pyodermas, otitis externa

CONTRAINDICATIONS:

Hypersensitivity, large areas, burns, ulcerations

Precautions:
Pregnancy (C), breastfeeding, impaired renal function, external ear or perforated eardrum

Administer:

• 
Enough medication to cover lesions completely

• 
After cleansing with soap, water before each application; dry well

• 
To less than 20% of body surface area when patient has impaired renal function

SIDE EFFECTS

INTEG:
Rash, urticaria, scaling, redness

NURSING CONSIDERATIONS
Assess:

• 
Allergic reaction: burning, stinging, swelling, redness

• 
For signs of nephrotoxicity or ototoxicity

Perform/provide:

• 
Storage at room temperature in dry place

Evaluate:

• 
Therapeutic response: decrease in size, number of lesions

Other books

The Most Mauve There Is by Nancy Springer
Right Place Right Time by Prince, Joseph
Long Day's Journey into Night (Yale Nota Bene) by O'Neill, Eugene, Bloom, Harold
Miss Marcie's Mischief by Lindsay Randall
The Housemistress by Keira Michelle Telford
ODDILY by Pohring, Linda