TOPICAL MEDICATION SHARON HARVEY

LEARNING OUTCOMES THE STUDENT WILL BE ABLE TO: UNDERSTAND INDICATIONS, AND PREPARATIONS USED, FOR THE TOPICAL ROUTE SHOW AN AWARENESS OF HOW TOPICAL MEDICATION IS ADMINISTERED AND THE PARTICULAR PRECAUTIONS THAT ARE NECESSARY

WHAT IS THE TOPICAL ROUTE OF ADMINISTRATION IT IS THE ADMINISTRATION OF DRUGS VIA THE EPIDERMIS (OUTER LAYER OF THE SKIN) AND EXTERNAL MUCOUS MEMBRANES TO ACHIEVE LOCAL OR SYSTEMIC EFFECTS.

IN PAIRS DISCUSS WHY WE USE THE TOPICAL ROUTE FOR ADMINISTERING CERTAIN DRUGS? PERMITS LOCAL RATHER THAN SYSTEMIC ABSORPTION OF THE DRUG REDUCES SIDE EFFECTS SOME DRUGS ARE SLOW RELEASE OVER 24 HOURS THEREFORE CONTINUOUS ACTION

WHAT ROUTES CAN BE USED FOR ADMINISTERING TOPICAL MEDICATION EYE EAR NOSE TRANSDERMAL RECTAL VAGINAL

WHAT PREPARATIONS DO TOPICAL MEDICATION COME IN? PASTES CREAMS OINTMENTS PATCHES DROPS SPRAYS

GUIDELINES FOR THE TOPICAL ADMINISTRATION OF DRUGS WASH HANDS EXPLAIN THE PROCEDURE TO THE PATIENT PREPARE THE EQUIPMENT APPLY THE MEDICATION TO THE SITE COMPLETE DOCUMENTATION

EYE MEDICATION Available in two forms: ointments and drops Important to treat correct eye If both eyes affected treat least affected eye first Use aseptic technique Should be done with the patient lying flat (not always possible)

EYE MEDICATION (CONTINUED) THE LOWER LID SHOULD BE PULL DOWN TO FORM A POUCH, THEN OINTMENT OR DROPS CAN BE ADMINISTERED EYE MEDICATION IS USUALLY ABSORBED INTO THE CORNEA, HOWEVER IT IS POSSIBLE FOR EYE DROPS TO BE ABSORBED INTO THE CONJUNCTIVAL VESSELS AND INTO GENERAL CIRCULATION. THE EXCESS CAN DRAIN THROUGH THE TEAR DUCTS INTO THE NASAL MUCOSA

USING THE BNF FIND ONE TOPICAL EYE PREPARATION WRITE THE DRUG NAME, TYPE OF PREPARATION E.G. OINTMENT, DROPS, ETC AND SIDE EFFECTS AND CONTRAINDICATIONS

EAR MEDICATION EAR MEDICATION SHOULD BE AT ROOM TEMPERATURE THE PATIENT SHOULD LIE ON THEIR SIDE IF POSSIBLE IN ADULTS AND CHILDREN OVER 3 YEARS GENTLY PULL THE PINNA UPWARDS AND BACKWARDS AND INSTILL THE MEDICATION

EAR MEDICATIONS (CONT) IN CHILDREN BELOW 3 THE PINNA SHOULD BE PULLED DOWNWARDS AND BACKWARDS TO INSTILL MEDICATION THE PATIENT SHOULD STAY IN THAT POSITION FOR 5 MINUTES

USING THE BNF FIND ONE TOPICAL EAR MEDICATION WRITE THE NAME OF THE DRUG, TYPE OF PREPARATION, AND SIDE EFFECTS OF THE DRUG AND ITS CONTRAINDICATIONS

NASAL MEDICATION NASAL MEDICATIONS MAY FLOOD THE SINUSES AND DRIBBLE DOWN THE THROAT AND BE INGESTED THEREFORE THE PATIENT SHOULD EXPECTORATE ANY DRUG THAT THEY FEEL GOING DOWN THEIR THROAT RATHER THAN SWALLOW

NASAL MEDICATION (CONT) THE NASAL PASSAGES SHOULD BE CLEARED PRIOR TO ADMINISTRATION OF MEDICATION FOR NASAL SPRAY THE PATIENT SHOULD BE SITTING UPRIGHT FOR NASAL DROPS THE PATIENT SHOULD BE LYING DOWN

USING THE BNF FIND ONE TOPICAL NASAL MEDICATION USING THE BNF FIND ONE TOPICAL NASAL MEDICATION. WRITE THE NAME OF THE DRUG, TYPE OF PREPARATION, CONTRAINDICATIONS AND SIDE EFFECTS OF THE DRUG.

TRANSDERMAL MEDICATIONS FOLLOWING APPLICATION OF THE DRUG, IT IS ABSORBED THROUGH THE HAIR FOLLICLES AND SWEAT GLANDS, ENTERING THE BLOOD STREAM THE PATCH SHOULD BE APPLIED TO A NON HAIRY SKIN SURFACE THE SITES OF ADMINISTRATION SHOULD BE ROTATED TO PREVENT IRRITATION

RECTAL MEDICATION THE ACTION OF THE DRUG MAY BE LOCAL OR SYSTEMIC THE PATIENT SHOULD LIE ON THEIR LEFT SIDE FOR SYSTEMIC ACTION RECTAL DRUGS THE SUPPOSITORY SHOULD BE INSERTED BLUNT END FIRST FOR LOCAL ACTION RECTAL DRUGS THE SUPPOSITORY SHOULD BE INSERTED POINTED END FIRST THE SUPPOSITORY SHOULD ALWAYS BE LUBRICATED WITH A WATER SOLUBLE LUBRICANT

VAGINAL MEDICATION THE PATIENT SHOULD BE ENCOURAGED TO EMPTY HER BLADDER AS SHE HAS TO LIE DOWN FOR 20 MINUTES THE PATIENT CAN EITHER LIE SUPINE WITH KNEES UP OR LATERAL WITH KNEES UP ALWAYS LUBRICATE THE PESSARY OR APPLICATOR BEFORE INSERTING

DISCUSS WHAT ARE THE BENEFITS OF ADMINISTERING DRUGS RECTALLY? WHAT WOULD YOU DO IF YOU SUSPECTED THAT A PATIENT WAS SUFFERING FROM A SIDE EFFECT OF A DRUG THAT YOU HAVE GIVEN TOPICALLY? HOW DO YOU MINIMISE THE RISK TO YOURSELF WHEN ADMINISTERING TOPICAL MEDICATION?

SUMMARY TOPICAL DRUGS ARE PREPARED IN MANY DIFFERENT FORMATS, AND HAVE A NUMBER OF ADVANTAGES, SUCH AS DIRECT ACTION ON THE AFFECTED AREA AND SLOW ABSORPTION THROUGH THE SKIN SPECIFIC INSTRUCTIONS SHOULD BE FOLLOWED CAREFULLY MEASURES TO PREVENT CROSS INFECTION WHEN ADMINISTERING TOPICAL MEDICATION ARE PARTICULARLY IMPORTANT