1. TOPICAL MEDICATION
SHARON HARVEY

2. 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

3. 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.

4. 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

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

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

7. 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

8. 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)

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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.

17. 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

18. 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

19. 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

20. 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?

21. 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