McKenna's Pharmacology for Nursing, 2e

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A P P E N D I X C  Topical agents

■■ TABLE C Topical agents (continued) Drug Brand name

Dosage

Usual indications/special considerations

Antifungals (continued)

miconazole

Daktarin, Eulactol, Resolve

Apply to area b.d. for 2 weeks after clinical signs disappear Apply to area b.d. until clinical signs are improved; 1–4 weeks Apply small amount b.d. for 2–3 weeks; 4–6 weeks may be needed if skin is very thick Thoroughly massage into skin over entire body, repeat in 24 hours; person should take a cleansing bath or shower 48 hours after last application Thoroughly massage into all skin areas; wash off after 8–14 hours; shampoo into freshly washed, rinsed and towel- dried hair, leave on for 10 minutes, rinse

Treatment of various fungal infections

terbinafine

Lamisil

Do not use occlusive dressings; report local irritation; discontinue if local irritation occurs Cleanse skin with soap and water before applying drug, dry thoroughly; wear loose, well-fitting shoes if feet affected; change socks at least q.i.d.

tolnaftate

Mycil, Tinaderm, Tineafax

Pediculocides/scabicides

crotamiton

Eurax

Change all bed linens and clothing the next day; contaminated clothing can be dry cleaned or washed in hot water; shake well before using

permethrin

Lyclear, Pyrifoam, Quellada

Single application is usually curative; notify healthcare provider if rash, itch becomes worse; approved for prophylactic use during head lice epidemics

Keratolytics

podophyllum resin

Posalfilin

Applied only by doctor

Do not use if wart is inflamed or irritated; very toxic; use minimum amount to avoid absorption Allow to dry before using area; dispose of used applicator; may cause burning and discomfort

podophyllotoxin

Condyline

Apply q 12 hours for three consecutive days

Pain relief

capsaicin

Zostrix

Do not apply more than three to four times per day

Provides temporary relief from the pain of osteoarthritis, rheumatoid arthritis, neuralgias; do not bandage tightly; stop use and seek medical help if condition worsens or persists after 14–28 days

Burn preparations

silver sulfadiazine

Flamazine, Silvazine

Apply daily to b.d. to a clean, debrided wound; use 3–5 mm thickness

Bathe person in a whirlpool to aid debridement; dressings are not necessary but may be used; reapply when necessary; monitor for fungal infections

Oestrogens

oestradiol

Sandrena

Applied once daily onto the skin of the trunk or thigh

Treatment of climacteric symptoms following menopause; attempt to taper every 3–6 months