Medication : ADMINISTRATION OF TOPICAL MEDICINE BY MRS. JAYA.R

1. R.Jaya Bsc nursing
Lecture
Ganga college of nursing
Topical Administration

2. Topical Administration
• Topical medications are applied
directly to the body surfaces, including
the skin and mucous membranes of the
eyes, ears, nose, vagina, and rectum.
• Topical medications differ from many
other type of drugs because
mishandling them can lead to certain
complications in a patient or
administrator of the drug.
• Many topical medications are
epicutaneous.meaning that they are
applied directly to the skin.

3. Purpose
• The purpose of using topical medicine
is to deliver medication directly onto
areas of the skin that are irritated,
inflamed, itching, or infected.
• Topical medicines are often applied
directly onto a rash or a irritated area
on the skin for rapid relief of
symptoms.

4. Topical Administration
• Topical medications may also be inhalational,such as asthma medication, or applied
to the surface of tissues othre than the skin, such as eye drops applied to conjunctiva,
or ear drops placed in the ear, or medication, topical medications applied to the
surace of a tooth.
• Cream Spong
• Gel Tape
• Foam. Vapor
• Transdermal patch Paste
• Powder Tincture
• Solid

5. Topical Administration
• There are many classes of topical medications, such as creams, ointments,
lotions, patches, and aerosol sprays.
• Medications that are applied to the skin to produce slow, controlled, systemic
effect are also referred to as transdermal.
• Medications that can be administered via a topical route include antibiotics,
narcotics, hormones, and even chemotherapeutics.
• This requires adherence to the ten "rights" of medication administration and
three checks during the administration process to ensure the safe
administration of these medications.
• Also, the administration of the topical medications requires wearing gloves to
protect the healthcare provider from accidental exposure and absorption of the
medication. ‐ Topical medications should never be applied with the bare
hands.

6. Cream
• A cream is an emulsion of oil and water in approximately equal proportions. It
penetrates the stratum corneum outer layer of skin wall. Cream is thicker than
lotion, and maintains its shape when removed from its container. It tends to be
moderate in moisturizing tendency.
• For topical steroid products, oil-in-water emulsions are common. Creams have a
significant risk of causing immunological sensitization due to preservatives and
have a high rate of acceptance by patients.
• There is a great variation in ingredients, composition, pH, and tolerance among
generic brands

7. Foam/Lotion
• Foam can be seen with topical steroid
marketed for the scalp.
 Lotions are similar to solution but are
thicker and tend to be more emollient in
nature than solution.
 They are usually oil mixed with water,
and more often than not have less
alcohol than solution. Lotions can be
drying if they contain a high amount of
alcohol.

8. Gel
• Gels are thicker than liquids. Gels are often a semisolid emulsion and sometimes use
alcohol as a solvent for the active ingredient; some gels liquefy at body temperature.
• Gel tends to be cellulose cut with alcohol or acetone.
• Gels tend to be self-drying, tend to have greatly variable ingredients between brands,
and carry a significant risk of inducing hypersensitivity due to fragrances and
preservatives.

9. • Gel is useful for hairy areas and body
folds.
• In applying gel one should avoid
fissures in the skin, due to the stinging
effect of the alcohol base.
• Gel enjoys a high rate of acceptance
due to its cosmetic elegance.

10. Ointment
• Metal case for Cruz Roja ointment from Mexico (beginning of the 20th century)
from the permanent collection of the Museo del Objeto del Objeto.
• An ointment is a homogeneous, viscous, semi-solid preparation, most commonly
a greasy, thick oil (oil 80% - water 20%) with a high viscosity, that is intended for
external application to the skin or mucous membranes.
• Ointments have a water number that defines the maximum amount of water that
they can contain.
• They are used as emollients or for the application of active ingredients to the
skin for protective, therapeutic, or prophylactic purposes and where a degree of
occlusion is desired.

11. • Ointments are used topically on a
variety of body surfaces.
• These include the skin and the mucous
membranes of the eye (an eye
ointment), chest, vulva, anus, and nose.
An ointment may or may not be
medicated
• Ointments are usually very
moisturizing, and good for dry skin.
They have a low risk of sensitization
due to having few ingredients beyond
the base oil or fat, and low irritation
risk.
• There is typically little variability
between brands of drugs. They are
often disliked by patients due to
greasiness

12. • The vehicle of an ointment is known as the ointment base. The choice of a base
depends upon the clinical indication for the ointment. The different types of
ointment bases are:
• Absorption bases, e.g., beeswax and wool fat
• Emulsifying bases, e.g., cetrimide and emulsifying wax
• Hydrocarbon bases, e.g., ceresine, microcrystalline wax, hard paraffin, and soft
paraffin
• Vegetable oil bases, e.g., almond oil, coconut oil, olive oil, peanut oil, and
sesame oil
• Water-soluble bases, e.g., macrogols 200, 300, 400

13. • The medicaments are dispersed in the
base and are divided after penetrating
the living cells of the skin.
• The water number of an ointment is
the maximum quantity of water that
100g of a base can contain at 20 °C.
• Ointments are formulated using
hydrophobic, hydrophilic, or water-
emulsifying bases to provide
preparations that are immiscible,
miscible, or emulsifiable with skin
secretions.
• They can also be derived from
hydrocarbon (fatty), absorption,
water-removable, or water-soluble
bases.
• Drug content
• Release of medicament from base
• Medicament penetration
• Consistency of the preparation
• Absorption of medicament into
blood stream
• Irritant effect
• Stability
• Penetrability
• Solvent property
• Irritant effects
• Ease of application and removal

14. Methods of preparation of ointments
• Fusion: In this method the ingredients are melted together in
descending order of their melting points and stirred to ensure
homogeneity.[citation needed]
• Trituration: In this finely subdivided insoluble medicaments are
evenly distributed by grinding with a small amount of the base
followed by dilution with gradually increasing amounts of the base.
• Paste
• Paste combines three agents - oil, water, and powder. It is an
ointment in which a powder is suspended.

15. Powder/Shake lotion
• Powder is either the pure drug by itself
(talcum powder), or is made of the drug
mixed in a carrier such as corn starch
or corn cob powder (Zeosorb AF -
miconazole powder). Can be used as an
inhaled topical (cocaine powder used in
nasal surgery).
• A shake lotion is a mixture that
separates into two or three parts over
time. Frequently, an oil mixed with a
water-based solution needs to be
shaken into suspension before use and
includes the instructions: "Shake well
before use"

16. Solid
• Medication may be placed in a solid form.
Examples are deodorant, antiperspirants,
astringents, and hemostatic agents. Some solids
melt when they reach body temperature (e.g.
rectal suppositories).

17. Sponge/Tape
• Certain contraceptive methods rely on
sponge as a carrier of a liquid
medicine. Lemon juice embedded in a
sponge has been used as a primitive
contraception in some cultures.
• Cordran tape is an example of a topical
steroid applied under occlusion by tape.
This greatly increases the potency and
absorption of the topical steroid and is
used to treat inflammatory skin
diseases.

18. Tincture
• A tincture is a skin preparation that has a high
percentage of alcohol.
• It would normally be used as a drug vehicle if
drying of the area is desired.
• If you are using the spray, shake the container
well before using.
• Do not use large amounts, use this product
more often, or use it for a longer time than
directed. Your condition will not clear faster,
but the chance for side effects may be
increased.
• Do not use this product in children younger
than 6 months without talking to the doctor
first.
• Do not drink or swallow this product. Avoid
contact in or around the eyes.

19. Topical solution
• Topical solutions can be marketed as
drops, rinses, or sprays, are generally
of low viscosity, and often use alcohol
or water in the base.These are usually a
powder dissolved in alcohol, water, and
sometimes oil; although a solution that
uses alcohol as a base ingredient, as in
topical steroids, can cause drying of the
skin. There is significant variability
among brands, and some solutions may
cause irritation, depending on the
preservative(s) and fragrances used in
the base.

20. Topical solution
• Aluminium acetate topical solution:
This is colorless, with a faint acetous
odour and sweetish taste.
• It is applied topically as an astringent
after dilution with 10-40 parts of water.
This is used in many types of
dermatologic creams, lotions, and
pastes.
• Commercial premeasured and packed
tablets and powders are available for
this preparation.
• Povidone iodine topical solution: This
is a chemical complex of iodine with
polyvinylpyrrolidone. The agent is a
polymer with an average molecular
weight of 40,000. The povidone iodine
contains 10% available iodine, slowly
released when applied to skin. This
preparation is employed topically as a
surgical scrub and non irritating
antiseptic solution; its effectiveness is
directly attributed to the presence and
release of iodine from the complex.
Commercial product: Betadine solution

21. Transdermal patch
• For short-term relief of acute pain after
surgery: Adults—Your doctor will
decide which dose of the patch you
need based on your present daily
narcotic dose.
• The patch is applied by your healthcare
provider to your upper outer arm or
chest.
• Nitroglycerin transdermal patches are
used to prevent episodes of angina
(chest pain) in people who have
coronary artery disease (narrowing of
the blood vessels that supply blood to
the heart)

22. Vapor
Some medications are applied as an
ointment or gel, and reach the mucous
membrane via vaporization.
Examples are nasal topical decongestants
and smelling salt.

23. Application to skin
• Definition:
• it is the application of medication
locally to the skin or mucus membranes
in the form of lotion ointments or
lininment.
• Purposes:
• to protect, soothen or soften surfce
area.
• to warm an afeectrd area and also for
mucles relaxation.
• to relieve itching.
• to check the growth of micro organisms
• Transdermal patches are applied
topically, and therefore are considered
under the umbrella of topical
medication. These patches adhere to
the skin with an adhesive base, and
they typically contain a time-release
mechanism, allowing the skin to absorb
a consistent, constant amount of
medication throughout the course of
hours or even days.
•

24. Application to skin
Procedure:
• Before application always wash and
dry your hands thoroughly.
• Topical should be applied directly to
the skin.
• Apply a thin layer of the cream,
spreading evenly over the affected area.
They should be spread gently on the
skin, not smoothed or rubbed.

25. Application to skin
• The finger-tip unit is the classical
measure of the quantity of a topical
medication and corresponds to the
amount pushed out of a tube onto the
region of the distal phalanx of the
index.
• This amount is sufficient for an area
corresponding to two palms, or both
elbow or knee folds.
• A medication with a gauze improves
the persistence of the topical on the
skin avoiding the dispersion on the
clothes.
• The application with cellophane
(occlusion) increases the penetration of
the drug in the skin.
• In the case of using moisturizers and
topical medications, first apply the
moisturizer and after a few minutes the
topical medication.

26. Side Effects
• Stinging, burning, and redness may
occur. If any of these effects persist or
worsen, notify your doctor or
pharmacist promptly.
• A very serious allergic reaction to this
drug is rare. However, seek immediate
medical attention if you notice any
symptoms of a serious allergic reaction
including: rash, itching/swelling
(especially of the face/tongue/throat),
severe dizziness, trouble breathing.

27. Inunction
• It is the act of rubbing an oily or
fatty preparation into the skin to
produce local effect such as
cleaning soothing disinfecting or
relieving a local inflammation.
• Lotion and ointment are used for
inunction .

28. General instruction
• The skin area should be thoroughly
cleaned before .
• Should follow sterile techniques.
• They should be rubbed in instead of
‘painted on’ to achieve the therapeutic
effect
• A lotion should be shaken well.
• The lotions tend to flake and fall off
.they have to be re applied if necessary.
• The skin should be observed
frequently.
• Take sufficient medication.
• When lotion and ointments are applied.
Avoid introducing them into the eyes,
mouth, nose, mouth.
• Look for the special instructions on the
label

29. Direct application of Liquid Medication
• Liquid medicines include liquids, solutions, syrups and mixtures and are
commonly used in patients that have difficulty swallowing medicines. They are
also commonly used in children and the elderly. The liquid medicine should be
made such that the dose needed will be a sensible volume such as 5mL (one
teaspoon).
• Name of the medicine
• Correct dosage (amount of medicine, often written as both the strength and
volume)
• Time(s) of day to give medicine ,Number of days to continue the medicine
• Special instructions (example: give with food, give on an empty stomach,
refrigerate)
• Side effects to watch for

30. Direct application of Liquid Medication
• When to call the doctor if you have
concerns
• Liquid medications should be measured
using either a syringe, medication cup or
special medication spoon. Occasionally a
medication will be packaged with a
graduated dropper for measuring doses.
• Teaspoons and tablespoons used at home
are not accurate and should not be used to
measure medication doses. Medication
cups are useful when giving medication to
older children.

31. Procedure
• Measuring Liquid Medication
• When measuring liquid medication, a
milliliter equals a cubic centimeter (ml
= cc).
• Other frequently used conversions:
• ½ teaspoon = 2.5 mL
• 1 teaspoon = 5 mL
• 1 tablespoon (or 3 teaspoons) = 15 mL

32. Gargle and swabbing the throat
• This medication relieves pain and inflammation
associated with a sore throat or mouth sores caused by
radiation therapy.
• HOW TO USE:
• This medication is a mouth rinse and/or gargle. It is not
to be swallowed.
• Betadine mint gargle contains povidone iodine which
kills a wide range of germs including bacteria, viruses,
fungi, spores and simple organisms.
• It is used for the treatment of acute infections of the lining
of the mouth and throat, for example, inflammation of the
gums (gingivitis) and mouth ulcers.

33. Gargle
• Pour gargle and mouthwash into the
cup and dilute it with an equal amount
of warm water if the taste is an issue.
Swish the solution for a short time in
the mouth and spit it out.
• Thirty-second gargle kills the germs in
the mouth or throat.
• Repeat this every two to four hours or
as directed by your dentist.

34. Side effects Contraindication
• Signs of an allergic reaction, like rash;
• hives; itching; red, swollen, blistered, or
peeling skin with or without fever;
wheezing; tightness in the chest or throat;
trouble breathing, swallowing, or talking;
unusual hoarseness; or swelling of the
mouth, face, lips, tongue, or throat. Redness.
• If you are allergic (hypersensitive) to
povidone iodine or any of the other
ingredients listed - if you currently have or
have ever had a thyroid problem, including
swelling (nodular colloid goiter, endemic
goiter or Hashimoto's thyroiditis),

35. Swabbing the throat

36. Swabbing
• Using nasal swabs instead of
nasopharyngeal swabs, samples from
gargled fluids and saliva, using glass-
walled kiosks, sampling from the side
using a mirror for guidance, self-
sampling by the patient and sampling
in the patient’s car through the side
window have been employed but
mitigate the technique having direct
impact on sample quality .
Through this study we wish to introduce
lignocaine as a possible measure that
improves patient comfort and hence,
reduces aerosol while sampling.