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This administration route is chosen when rapid drug action is desired; when the patient is uncooperative prostate cancer fighting foods buy rogaine 2 with mastercard, unconscious prostate on ultrasound purchase rogaine 2 60 ml with amex, or unable to accept medication by the oral route; or when a drug is ineffective by other routes. Drugs may be injected into the joints, spinal column, arteries, veins, and muscles. Drugs administered parenterally may be mixed in either a solution or a suspension; those mixed in a solution typically act more rapidly than those mixed in a suspension. Drugs may be administered as a single, small-volume injection or as a slow, large-volume infusion. Subcutaneous the subcutaneous route may be used to inject small volumes of medication, usually 1 ml or less. Subcutaneous injections typically are given below the skin in the abdominal area, lateral area of the anterior thigh, posterior surface of the upper arm, or lateral lumbar area. Injection sites should be rotated to minimize tissue irritation if the patient receives frequent subcutaneous injections-as, for example, in a patient who takes insulin. This route includes sublingual, inhalation, ophthalmic, otic, nasal, topical, and vaginal administration. Sublingual In sublingual administration, tablets are placed under the tongue and allowed to dissolve. Nitroglycerin is commonly administered by this route, which allows rapid drug absorption and action. These drugs, which include anesthetics, antibiotics, and anti-inflammatory drugs, usually require occlusion of the ear canal with cotton after instillation. Nasal Some drugs may be inhaled orally or nasally to produce a local effect on the respiratory tract or a systemic effect. Although drugs given by inhalation avoid first-pass hepatic metabolism, the lungs can also serve as an area of first-pass metabolism by providing respiratory conversion to more water-soluble compounds. Ophthalmic Nasal solutions and suspensions are applied directly to the nasal mucosa for enhanced local penetration and decreased systemic absorption. These drugs are usually used to reduce the inflammation typically associated with seasonal or perennial rhinitis. Topical Ophthalmic solutions and ointments are applied directly to the cornea or conjunctiva for enhanced local penetration and decreased systemic absorption. Ophthalmic solutions pose a greater risk of drug loss through the nasolacrimal duct into the nasopharynx than ophthalmic ointments do. Otic Topical drugs-including creams, ointments, lotions, and pastes-are applied directly to the skin. Transdermal delivery systems, usually in the form of an adhesive patch or a disk, are among the latest developments in topical drug administration. Because they provide slow drug release, these systems are typically used to avoid first-pass metabolism and ensure prolonged duration of action. Vaginal Otic solutions are instilled directly into the external auditory canal for local Vaginal troches, suppositories, and creams are inserted into the vagina for slow, localized absorption. Body pH that differs from blood pH causes drug trapping or reabsorption, which delays drug excretion through the renal tubules. The nursing process consists of five steps, including assessment, nursing diagnosis, planning, implementation, and evaluation. Ask about his previous use of over-the-counter and prescription drugs, as well as herbal remedies. For each drug, determine: · the reason the patient took it · the prescribed dosage · the administration route · the frequency of administration · the duration of the drug therapy · any adverse reactions the patient may have experienced and how he handled them. As you did in the drug history, find out the specific details for each drug (dosage, route, frequency, and reason for taking). Also ask the patient if he thinks the drug has been effective and when he took the last dose. If the patient uses herbal remedies, similarly explore the use of these products because herbs may interact with certain drugs. If the patient acknowledges use of these drugs, be alert for possible drug interactions. Try to find out if the patient has any other problems that might affect his compliance with the drug treatment plan, and intervene appropriately. For instance, a patient who is unemployed and has no health insurance may fail to fill a needed prescription. In such a case, contact an appropriate individual in your facility who may be able to help the patient obtain financial assistance. Be sure to ask the patient if his drug treatment plan requires special monitoring or follow-up laboratory tests. For example, patients who take antihypertensives need to have their blood pressure checked routinely, and those who take warfarin must have their prothrombin time tested regularly. Other patients must undergo periodic blood tests to assess their hepatic and renal function. Determine whether the patient has complied with this part of his treatment plan, and ask him if he knows the results of the latest monitoring or laboratory tests. If he has an allergy, explore it further by determining the type of drug or food that triggers a reaction, the first time he experienced a reaction, the characteristics of the reaction, and other related information. Keep in mind that some patients consider annoying symptoms, such as indigestion, an allergic reaction. Also, document allergies to foods because they may lead to drug interactions or adverse drug reactions.

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Baclofen may work in the spinal cord at the afferent spinal end of upper motor neurons man health issues generic 60 ml rogaine 2, where it hyperpolarizes nerve fibers and inhibits impulse transmission prostate cancer psa cheap rogaine 2 60 ml with visa. Before implantable pump insertion, also expect prescriber to make sure patient is free of infection to reduce risk of complications and interference with determining most appropriate dose. Be aware that abrupt withdrawal of intrathecal infusion may produce symptoms similar to autonomic dysreflexia, high fever, lifethreatening complications such as multiple organ-system failure, and death. Be aware that inadvertent injection into subcutaneous tissue can occur if the reservoir refill septum is not properly accessed, resulting in symptoms of a systemic overdose or early depletion of the reservoir. Also take precautions for patients who use spasticity to maintain locomotion or upright posture and balance. Emphasize the importance of keeping follow-up appointments for intrathecal infusion. Prostaglandin mediates inflammatory activity and produces signs and symptoms of inflammation. By inhibiting prostaglandin synthesis, balsalazide may reduce signs and symptoms of inflammation in inflammatory bowel disease. Balsalazide also interferes with leukotrine synthesis and inhibits the enzyme lipoxygenase. Peak Duration Nursing Considerations warning Monitor Unknown Unknown 22­50 days patient teaching patients who are sensitive to sulfasalazine or olsalazine for possible cross-sensitivity to balsalazide. Mechanism of Action Initiates immunosuppression by blocking interleukin-2 receptors located on the surface of activated T cells. Normally, interleukin-2 is released by stimulated T lymphocytes, causing activation and differentiation of other T lymphocytes responsible for cell-mediated immunity. Further dilute with normal saline solution or D5W for infusion to a volume of 50 ml. Be aware that bolus dose may cause nausea, vomiting, and a localized injection-site reaction, including pain. For patients with severe asthma, 6 to 8 inhalations (504 to 672 mcg) daily with dosage reduced based on patient response. For patients with severe asthma, 12 to 16 inhalations (504 to 672 mcg) daily with dosage reduced based on patient response. Initial: 1 or 2 inhalations (42 mcg or 84 mcg) three times daily or four times daily or 4 inhalations (168 mcg) twice daily with dosage reduced based on patient response. Initial for patients previously taking bronchodilators alone: 1 to 2 inhalations (40 to 80 mcg) twice daily, 132 beclomethasone dipropionate relief of acute bronchospasm or of asthma controlled by bronchodilators or other nonsteroidal drugs, treatment of nonasthmatic bronchitis depending on strength used. Initial for patients previously taking inhaled corticosteroids: 1 to 4 inhalations (160 mcg) twice daily, depending on strength used. To relieve symptoms of seasonal or Adverse Reactions nasal inhalation aerosol perennial allergic and nonallergic (vasomotor) rhinitis and prevent nasal polyps from recurring after surgical removal Adults and children age 12 and over. Initial: 1 inhalation (42 mcg) in each nostril twice daily to four times daily for total dose of 168 to 336 mcg daily. Maintenance: 1 inhalation (42 mcg) in each nostril three times daily for total dose of 252 mcg daily. Nursing Considerations Mechanism of Action May decrease number and activity of cells involved in the inflammatory response of asthma, allergies, and rhinitis, such as mast cells, eosinophils, basophils, lymphocytes, macrophages, and neutrophils. Also may inhibit production or secretion of chemical mediators, such as histamine, eicosanoids, leukotrienes, and cytokines. May produce direct smooth-muscle cell relaxation and decrease airway hyperresponsiveness. If present, notify prescriber and expect to reduce dose or frequency or to stop beclomethasone. Urge her to notify prescriber if she develops signs of adrenal insufficiency, such as nausea, fatigue, anorexia, dyspnea, hypotension, fever, malaise, dizziness, and fainting. If patient has trouble using device and coordinating inhalation with it, suggest using a spacer device. B bedaquiline Sirturo Class and Category Chemical class: Diarylquinoline Therapeutic class: Antimyobacterial antibiotic, antitubercular Pregnancy category: B As adjunct to combination therapy to tablets Indications and Dosages treat pulmonary multidrug-resistant tuberculosis Adults. Mechanism of Action Interferes with the function of an enzyme required by the tuberculosis bacterium to produce energy and to replicate. Know that an increase in serum aminotransferases to greater than 3 times the upper level normal should be followed by repeat testing within 48 hours. Also expect the patient to be tested for viral hepatitis and any hepatotoxic drugs patient is taking to be discontinued. Also expect bedaquiline to be discontinued if the patient exhibits aminotransferase elevations. In addition, expect drug to be discontinued if total bilirubin elevations greater than 2 times upper level normal, aminotransferase elevations greater than 8 times upper level normal, or aminotransferase elevations persist beyond 2 weeks. Report significant elevations of aminotransferases and/or bilirubin and/ or symptoms such as fatigue, anorexia, nausea, jaundice, dark urine, liver tenderness, or hepatomegaly. Incompatibilities B Do not infuse belatacept concomitantly in the same intravenous line with other agents, as drug incompatibilities are unknown. Initial: 10 mg/kg day of transplant but prior to transplant and repeated on day 5 (about 96 hours after day 1 dose) after transplant, followed by 10 mg/kg at the end of wk 2, 4, 8, and 12. Maintenance: 5 mg/kg at end of wk 16 after transplant and every 4 wks (plus or minus 3 days) thereafter. For example, to calculate a dose for a patient who weighs 64 kg who is ordered a dose of 10 mg/kg results in a dose of 640 mg.

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Due to this significant role of the nucleus accumbens in the neural mechanism of reward mens health journal order rogaine 2 master card, drugs that augment the dopamine release and transmission in this nucleus may serve as a basis for self-inflicted drug abuse prostate cancer 2 stages discount 60 ml rogaine 2 mastercard. There are several drugs and chemical substances that influence the neuronal activity of the accumbens septi. They include cocaine that blocks the reuptake of dopamine, amphetamine that promotes dopamine release, and heroin that interacts with receptors in the nucleus accumbens and mesencephalic dopaminergic neurons in the ventral tegmental area. Thus, when cocaine is self-administered intravenously in conjunction with a dopamine receptor antagonist, the effect of cocaine is reduced. Increase in the rate of administration of the dopamine receptor antagonist requires a proportional increase in the rate of intravenous administration of the drug up to a point that blockade of the receptors is complete and the addictive effect of the drug is eliminated. Heroin primarily increases dopamine release in the nucleus accumbens, but this is also coupled with some increase in the neuronal activity of the mesencephalic dopaminergic neurons through their interaction with the -opiate receptors in the ventral tegmental area. Again, the reinforcing effect of heroin remains primarily dependent on the dopaminergic neuronal activity of the nucleus accumbens. This is evident in the fact that dose-dependent self-administration of heroin increases proportionally with the administration of methyl naloxinium into the nucleus accumbens. However, systemic infusion of the dopamine antagonists remains ineffective in countering the self-administered heroin, which is attributed to duality of opiate receptor-dependent mechanism that activates the mesolimbic system in the nucleus accumbens independent from its stimulation of the mesencephalic ventral tegmentum. Experimental data indicate that the dopaminergic function of the ventral striatum modulates the effects of conditioned as well as nonconditioned aspects of rewards. In order for the ventral striatum to exert its influence on behavior controlled by reward-related stimuli or conditioned reinforces through dopamine release, the basolateral amygdala projects heavily to the ventral striatum, completing the "limbic-ventral striatal loop. It appears that Limbic System 399 this loop is a significant circuit in the regulation of the emotional control on behavior, which includes the control of the neuroadaptive processes that mediate the ability of drug-paired stimuli to acquire re-enforcing feature and control of the drug-seeking behavior (craving). It has been argued that D1 receptor­dependent neural mechanisms within the medial prefrontal cortex and basolateral amygdala form substrates for the compelling effects of drug-related stimuli. In view of the above, simultaneous effect of environmental triggers on relapse must be considered in the development of therapeutic approaches. In addition to its involvement in addiction, the nucleus accumbens plays a role in rewards such as sex and food. It is stimulated during emotional scenes induced by music, pictures, or mental imagery of pleasant and serene situation. Attempts have been made to induce deep brain stimulation of the nucleus accumbens through surgical placement of electrodes as a treatment for severe depression. Attempts have also been made to treat alcoholism through the ablation of the nucleus accumbens. Research findings indicate that during placebo administration, expectation of benefit from the placebo induces changes in the neural circuitry and neurotransmitter systems that correlate with the observed physiologic changes. The amygdala is adjacent to the pyriform lobe, which consists of the prepyriform (cortical area near the lateral olfactory stria) and periamygdaloid cortex. Caudally, the amygdala continues with the hippocampal formation, forming the amygdalohippocampal area. The fasciolar (splenial) gyrus, which is continuous with the dentate gyrus, represents the caudal connections of the induseum griseum. The induseum griseum contains the medial and lateral longitudinal striae of Lancisi. Some fibers of the longitudinal stria intersect the corpus callosum, contributing to the dorsal fornix, while other fibers continue rostrally with the paraterminal gyrus and caudally with the fasciolar gyrus. It continues with the dorsally located claustrum, the external capsule, and the magnocellular FiGure 17. The amygdala encompasses a corticomedial subdivision, which continues with the anterior perforated substance, and a basolateral subdivision that merges with the claustrum and parahippocampal gyrus. The basolateral complex is considered a cortical structure that maintains connections with the temporal lobe and other neocortical areas such as the precentral and postcentral gyri but lacks the laminar organization. It consists of the lateral, basal, and accessory basal nuclei, whereas the corticomedial subdivision is regarded to have central, medial, and cortical nuclei. The lateral nucleus is the largest component that lies ventrolateral to the basal nucleus. The basal nucleus is composed of the dorsal magnocellular, intermediate parvicellular, and paralaminar nuclei. The accessory basal nucleus lies medial to the basal nucleus and is divided into ventral, parvicellular, and dorsal magnocellular parts. The basolateral nuclear complex is a polymodal cortical structure that maintains direct and often reciprocal connections with areas of the cerebral cortex and thalamus, as well as unidirectional projections to the motor and premotor cortices. Excitatory amino acid neurotransmitters such as aspartate and glutamate are also used by this nuclear subdivision. The lateral nucleus, the largest subdivision, lies ventrolateral to the basal nucleus. The basal nucleus consists of dorsal magnocellular, intermediate parvicellular, and paralaminar subnuclei. The accessory basal nucleus located medial to the basal nucleus consists of similar subdivisions to that of the basal nucleus. Dopaminergic projections from the midbrain ventral tegmental area (A10) are mainly received by the lateral and central nuclei and the parvicellular part of the basal nucleus. Dense cholinergic projections from the magnocellular division of nucleus basalis of Mynert reach the basal and parvicellular accessory basal nuclei.

Syndromes

  • Nutritional deficiencies, especially niacin, thiamine, vitamin C, or vitamin B12
  • Enzyme exam of blood or body tissue for hexosaminidase levels
  • Head appears large in relation to the trunk
  • Bluish-colored lips and fingers
  • Abnormal blood vessels in the brain (arteriovenous malformations; AVM)
  • Wheezing
  • Screening for alcohol and tobacco use
  • Acute respiratory failure
  • Blood smear
  • Depression

The medial segment prostate examination order rogaine 2 in india, in particular mens health yahoo answers 60 ml rogaine 2 order with visa, exhibits similar cytological, morphological, and functional characteristics to that of the pars reticulata of the substantia nigra, containing substance P. It is a derivative of the diencephalon and forms the efferent (output) portion of the basal nuclei. Neurons of the lateral segment are charged spontaneously and continuously without long intervals of inactivity (fast-spiking pacemaker). This segment receives robust input from the striatum as well as dopaminergic afferent fibers from the substantia nigra pars compacta. The paraolfactory cortex, septal nuclei, and the diagonal band of Broca merge with the nucleus accumbens. Inferior and posterior to the ventral striatum and separated by the anterior commissure is the ventral pallidum. The latter is located superior and lateral to the nucleus basalis of Meynert and caudal to the anterior perforated substance. The distribution of the neuroactive chemicals in the striatum shows variation in concentrations in different parts of the striatum irrespective of their origin. Rostral striatum 466 Neuroanatomical Basis of Clinical Neurology by its neurons compared to a lesser degree of utilization of acetylcholine. Substance P is concentrated in the internal segment and enkephalin in the external segment. It receives retinotopically organized visual fibers from both eyes, as well as sensory fibers from the postcentral gyrus. The claustrum, superior colliculus, and pulvinar may mediate activities associated with visual attention. Ventral PalliDum the ventral pallidum represents the area superolateral to the nucleus basalis of Meynert and caudal to the anterior perforated substance (substantia innominata), separated from the dorsal pallidum by the anterior commissure. In addition, the ventral striatum projects to the ventral pallidum using substance P and enkephalin as neurotransmitters. It is a bilaterally represented pigmented nucleus that extends through the entire length of the mesencephalon from the pons to the subthalamic nucleus. It is crossed by the medial fibers of the oculomotor nerve that exit through the interpeduncular fossa. It maintains reciprocal connection with the basal nuclei and receives corticonigral fibers from the precentral and postcentral gyri, which partly terminate in the pars reticularis while others continue into the red nucleus and the reticular formation. It consists of two adjoining but contrasting components with cell-rich pars compacta that exhibits larger and thicker dendritic arborizations and sparsely cell-populated pars claustrum the claustrum, a gray matter mass that resembles the thalamus, is located between the external and extreme capsules. It continues with the amygdala, the prepiriform cortex, and the anterior perforated substance. Observe the subthalamic nucleus, lenticular and thalamic fasciculi, caudate nucleus, putamen, and substantia nigra. The pigment granules reside mainly in the pars compacta and increase with age through the deposition of melanin. In contrast to the pars reticulata, dopaminergic neurons of the pars compact are "slow-spiking pacemakers," and their activity is believed to be linked to reward and prediction of reward. It has been reported that dopamine release is associated with phasic responses of these neurons to rewardrelated activity, particularly reward-prediction behavioral inaccuracies. The pars compacta on both sides interconnects in the midline through the paranigral nucleus, which is also known as the ventral tegmental dopaminergic A10 cell group of Tsai. The latter forms the mesolimbic dopamine system, which provides dopaminergic projections to the prefrontal and anterior cingulate cortices as well as the dorsal striatum. Clinical depression in parkinsonian patients is accompanied by marked dysfunction and reduced neuronal activity of the prefrontal cortex and the striatal neurons as well as the dopaminergic, noradrenergic, and serotonergic neurons within the brainstem. Parkinsonian depression is thought to be an expression of the disruption of the direct connections of the basal nuclei to the frontal and limbic cortices as well as a reflection of the disruption of the indirect ascending connection to the prefrontal cortex via the substantia nigra pars reticulata, dorsomedial and ventromedial thalamic nuclei. It has been proposed that patients with compulsiveobsessive disorders and hyperactive child syndrome manifest depression as a result of this disruption. The pedunculopontine tegmental nucleus (cholinergic cell group 5) and the lateral dorsal tegmental nucleus (cholinergic cell group 6) lie in close proximity to group cell A10. The A8 (retrorubral nucleus or nucleus parabrachialis pigmentosus) and dopaminergic A9 cell groups of Dählstrom and Fuxe together constitute the mesostriatal dopamine system. Cell groups A10 and A8 that spread inside the crus cerebri do not receive striatal afferents. In addition to the above, the cells in the lateral parts of A9 and A10 cell groups also contain somatostatin, while the medial parts of these cell groups contain cholecystokinin. The thin neuronal axons of the pars compacta that carry dopamine travel dorsally, encircle the medial border of the subthalamic nucleus to enter the H2 field, and then cross the internal capsule to project to the upper part of the medial pallidum and then the striatum. Their fibers end in a nonhomogeneous manner in the striatum, but not in the matrix or in the striosomes. But it also harbors dopaminergic dendrites of the pars compacta with small interneurons. Ventrally, it continues with the subthalamic region, intermingles with the crus cerebri, and extends with the globus pallidus, containing unusual concentration of iron. The dendrites of the multipolar neurons receive the striatonigral comb fiber system and are oriented at a right angle to enable maximal exposure to these afferents. The pars reticulata is considered a fast-spiking pacemaker, and its stimulation may not elicit motor activity as a few neurons are capable of responding to any form of movements but are responsive to signals that relate to memory, attention, or the mechanism that prepares for movements. Despite the high concentration of dopamine in these neurons, cholinergic neurons represent one-fourth of neuronal population in the pars compacta of the substantia nigra. These neurons also send projections to the superior colliculus of the ipsilateral side via the nigrotectal fibers to mediate saccadic eye movements (fast-spiking pacemaker).

Usage: p.r.n.

Inject Lantus once daily at any time mens health zero excuses workout 60 ml rogaine 2 buy, keeping the daily injection time consistent androgen hormone x organic cheap rogaine 2 60 ml on line. Inject Levemir prescribed once daily with the evening meal or at bedtime; inject Levemir prescribed twice daily with the morning meal and with the evening meal, at bedtime, or 12 hours after the morning dose. Also gently turn the prefilled syringe up and down several times before using to achieve a uniform mixture. For example, the Canadian Humulin 30/70 and the American Humulin 70/30 both contain 30 units of a short-acting insulin and 70 units of an intermediate-acting insulin. Canadian products list the short-acting insulin first; American products list it second. If heart failure develops, provide supportive care, as ordered, and expect the thiazolidinedione to be discontinued or dosage reduced. In most cases, the patient or a family member has administered these preparations at home. Your patient teaching should include a review of proper administration and storage of these drugs. Have the patient or a family member demonstrate proper use of the drug to make sure it will be administered correctly at home. Also, instruct him to report any changes in the condition being treated, either negative or positive. A properly educated patient not only ensures safe drug administration, but also is more likely to detect adverse reactions that require a dosage reduction or drug discontinuation, thus preventing the development of more serious health problems. Apply small amount of ointment to lower conjunctival sac every 3 to 6 hr and as needed for at least 48 hr after eye resumes normal appearance 2 gtt in affected eye every 15 min for first 6 hr, then 2 gtt every 30 min for rest of first day; on day 2, 2 gtt in affected eye every hr; on days 3 to 14, 2 gtt in affected eye every 4 hr 1 or 2 gtt in conjunctival sac of affected eye every 2 hr while awake for first 2 days and then 1 or 2 gtt every 4 hr while awake for next 5 days; or 1/2-inch strip of ointment in affected eye three times a day for 2 days, then twice daily for next 5 days 1 cm (0. Then 1 gtt four times a day, starting 4 to 6 hr after surgery for up to 3 days, as needed. Ophthalmic cycloplegic mydriatics (continued) To dilate pupils for cycloplegic refraction To treat uveitis To dilate pupils for cycloplegic refraction To treat iritis or uveitis To dilate pupils for cycloplegic refraction 1 or 2 gtt in each eye, repeated in 5 to 10 min for 2 or 3 doses, as needed1 or 2 gtt in each eye every 3 to 4 hr 1 or 2 gtt of 0. The table below includes trade names; usual dosages; and onset, peak, and duration for antihistamines your patient is most likely to use daily or intermittently to control symptoms of allergic rhinitis. When caring for a patient who takes an antihistamine, individualize your plan of care but be sure to include these general interventions: · Use antihistamines cautiously in patients with a history of glaucoma, peptic ulcer, or urine · retention because anticholinergic effects may worsen these conditions. Before antihistamine therapy, assess the patient for hypokalemia and correct the imbalance, as prescribed, to reduce the risk of arrhythmias. Before antihistamine therapy, obtain a detailed medication history to help prevent drug interactions. Be aware that short- and long-acting antihistamines may be combined and H2 blockers added to increase antihistamine effects. Be aware that products containing pseudoephedrine should be used for less than 7 days. Media commonly are chosen based on drug solubility; rate of drug release; ability to hydrate the outer skin layer; ability to enhance penetration; drug stability; and interactions between the chosen medium, skin, and active ingredient. Topical media include aerosols, creams, gels, lotions, ointments, powders, tinctures, and wet dressings. Aerosols, gels, lotions, and tinctures are convenient for application to the scalp and other hairy areas. Acutely inflamed areas are best treated with drying preparations, such as lotions, tinctures, and wet dressings. Chronic inflammation does well with applications of lubricating preparations, including creams and ointments. Because of its physical properties, the skin can act as a holding area for many drugs, allowing slow penetration and prolonged duration of action. For example, the scrotum, face, axillae, and scalp are more permeable than the limbs, and ventral surfaces typically are more permeable than dorsal surfaces. Topical antivirals such as penciclovir can shorten the duration of herpetic lesions, lessen lesion pain, and minimize viral shedding. Topical corticosteroids cause vasoconstriction, probably by suppressing cell degranulation. They also cause decreased cell permeability by reducing histamine release from basal and mast cells. When applied to the skin, retinoids remain primarily in the dermis; less than 10% of the drug is absorbed into the circulation. Prolonged use of retinoids promotes new dermal growth, new blood vessel formation, and thickening of the epidermis. Topical Drug Types Topical drugs are classified as antibacterials, antifungals (the largest group), antivirals, corticosteroids, retinoids, and other miscellaneous preparations. Minor skin infections may respond well to topical drugs applied at the infection site. Minor wounds should be treated at the site and in the immediately surrounding area to prevent other pathogens from colonizing the area. Systemic use of antifungals is limited by their potentially toxic adverse effects, most commonly renal or hepatic damage. They work by targeting any one of the steps involved in viral replication: penetration into Administration Tips Before you apply a topical drug, clean the site and let it dry. Use gloves or a finger cot during application to prevent the drug from being absorbed through your own skin. Inform your patient of any expected discomfort, such as temporary stinging or burning. Be sure to teach the patient and a family member correct administration technique. Also, review possible adverse reactions, highlighting those that should be reported to the prescriber.

References

  • Christner P, Fein AM, Goldberg S, et al. Collagenase in the lower respiratory tract of patients with adult respiratory distress syndrome. Am Rev Resp Dis 1985;131:690-5.
  • Singh SK, Clarke ID, Terasaki M et al. Identification of a cancer stem cell in human brain tumors. Canc Res. 2003;63:5821-5828.
  • Redfors B, Bragadottir G, Sellgren J, et al. Effects of norepinephrine on renal perfusion, filtration and oxygenation in vasodilatory shock and acute kidney injury. Intensive Care Med. 2011;37:60-67.
  • O'Connor ES, Greenblatt DY, LoConte NK, et al. Adjuvant chemotherapy for stage II colon cancer with poor prognostic features. J Clin Oncol 2011;29(25):3381-3388.
  • Tran PH, Tran TT, Park JB, Lee BJ. Controlled release systems containing solid dispersions: strategies and mechanisms. Pharm Res. 2011;28:2353-2378.
  • Dahl LB, Dahl IM, Engstrom- Laurent A, Granath K. Concentration and molecular weight of sodium hyaluronate in synovial fluid from patients with rheumatoid arthritis and other arthropathies. Ann Rheum Dis 1985; 44:817-822.