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Pharmacology
1. Topical
2. Intralesional
3. Systemic
Oral
Parenteral
1. Topical
Transdermal patch
Semisolid Preparation:
Ointment, cream
Gel, etc
local application for
localized effects
local application for
systemic absorption
and consequent
systemic effects
direct contact with
underlying pathologic
process
no first pass metabolism
form a drug depot that
slowly release the active
ingredient of the drug
Oral
capsules, tablets
syrup, oral suspension
Parenteral
IV, IM, SC
Three Routes of Drug Penetration Through the Skin:
1. Alcoholic gels
hand sanitizers
best suited for acute
exudative, pruritic
eruptions
6. Gels
Two Kinds of Gels:
2. Non-alcoholic gels
hair gels, sunscreens
more lubricating best suited for dry
scaly lesions in the scalp
7. Liniment
viscous liquids containing
substances possessing analgesic,
soothing or stimulating properties
should be rubbed when applied to
the skin to release active drug
should not be applied to broken skin
7. Liniment
similar viscosity as lotion
8. Astringent
forms a protein precipitate which
serve as a protective coat allowing
new tissues to generate underneath
check oozing discharge or bleeding
in skin and mucous membrane by
coagulating protein
8. Astringent
commonly used to reduce extent of
weeping dermatitis
e.g.
Zinc oxide
Burrows solution
8. Astringent
9. Humectants
substances that diffuse into the
stratum corneum and attract water
substances that promote water
retention due to their hygroscopicity
e.g. glycerine, urea, pyrrolidone
carboxylic acid (PCA), sorbitol
10. Collodion
liquid preparations consisting of a
solution of proxylin in a mixture of
ether and alcohol
painted on the skin and allowed to
dry to leave a flexible film over the
site of application
10. Collodion
used to seal minor cuts and
wounds or as a means to hold a
dissolved drug in contact with the
skin for prolonged periods
10. Collodion
11. Paste
stiff preparations containing a high
proportion of finely powdered solids
such as Zinc oxide, calcium
carbonate or starch
forms an unbroken, relatively water
impermeable film on the skin surface
less occlusive and messy than
ointments
11. Paste
suitable for subacute or chronic
dermatoses
useful for local application of
irritating drugs
Mode of administration:
1. Local
Topical
Intralesional
2. Systemic
Oral
Intramuscular
Intravenous
Corticosteroid
Mechanism of action:
Anti-inflammatory
inhibition of Phospholipase A2
Immunosuppression
classification of Topical Corticosteroids in
order of decreasing potency
more potent steroid is used initially
followed by a less potent agent
twice daily application is sufficient
more frequent application does not improve
response
Class 1 - Highest Potency
Clobetasol propionate 0.05%
Betamethasone dipropionate in
optimized vehicle 0.05%
Class 2 - High Potency
Fluocinonide 0.05%
Betamethasone dipropionate 0.05%
Class 1
Betamethasone dipropionate cream,
ointment 0.05% (in optimized vehicle)*
Clobetasol propionate cream, ointment
Diflorasone diacetate ointment 0.05%
Halobetasol propionate ointment 0.05%
Class 2
Amcinonide ointment 0.1%
Betamethasone dipropionate ointment 0.05%*
Desoximetasone cream, ointment 0.25%, gel
0.05%
Diflorasone diacetate ointment 0.05%
Fluocinonide cream, ointment, gel 0.05%
Halcinonide cream, ointment 0.1%
Class 3
Betamethasone dipropionate cream 0.05%*
Betamethasone valerate ointment 0.1% \
Diflorasone diacetate cream 0.05%
Fluticasone proprionate 0.005%
Mometasone furoate 0.1%
Triamcinolone acetonide ointment 0.1%,
cream 0.5%
Class 4
Amcinonide cream 0.1%
Desoximetasone cream 0.05%
Fluocinolone acetonide cream 0.2%*
Fluocinolone acetonide ointment 0.025%*
Flurandrenolide ointment 0.05%, tape 4 mg/cm2
Hydrocortisone valerate ointment 0.2%
Triamcinolone acetonide ointment 0.1%
Mometasone furoate cream, ointment 0.1%
Class 5
Betamethasone dipropionate lotion 0.05%*
Betamethasone valerate cream, lotion 0.1%
Fluocinolone acetonide cream 0.025%
Flurandrenolide cream 0.05%
Hydrocortisone butyrate cream 0.1%
Hydrocortisone valerate cream 0.2%
Triamcinolone acetonide cream, lotion 0.1%*
Triamcinolone acetonide cream 0.025%
Class 6
Aclometasone dipropionate cream, ointment
0.05%
Desonide cream 0.05%
Fluocinolone acetonide cream, solution
0.01%*
Class 7
Dexamethasone sodium phosphate cream
0.1%
Hydrocortisone cream, ointment, lotion
0.5%, 1.0%, 2.5%*
Methylprednisolone aceponate cream,
ointment 1 mg/g
Prednisolone cream 5 mg/g
1. Type of skin lesions
2. Location of the skin lesions
3. Severity of skin lesions
4. Age of the patient
5. Duration of treatment
If its dry, wet it.