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. 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