Topicals, Opthalmics and Topicals, Opthalmics and OticsOtics

Structure of the SkinStructure of the Skin

Disease ConditionsDisease Conditions

Therapeutic AgentsTherapeutic Agents

Ultraviolet RadiationUltraviolet Radiation Skin cancerSkin cancer WrinklesWrinkles

PhototoxicityPhototoxicity Excessive responseExcessive responsein the presence of ain the presence of asensitizing agentsensitizing agent

SunblocksSunblocks SunscreensSunscreens

PhotosensitivityPhotosensitivity Abnormal responseAbnormal response

Common Disease of the SkinCommon Disease of the Skin

Contact Dermatitis by Poison IvyContact Dermatitis by Poison Ivy

Classic Poison Ivy Poison Ivy EyeClassic Poison Ivy Poison Ivy Eye Rash developed puss edemaRash developed puss edema

Antiseptics and DisinfectantsAntiseptics and Disinfectants

A substance that inhibits A substance that inhibits the growth & developmt the growth & developmt of moos, but does not of moos, but does not necessarily kill themnecessarily kill them

Hibiclens Hibiclens (chlorhexidine)(chlorhexidine)

Phisohex Phisohex (hexachlorophene)(hexachlorophene)

Betadine (povidine- Betadine (povidine- iodine)iodine)

A chemical applied to A chemical applied to objects to free them objects to free them from pathogenic from pathogenic organismsorganisms

AlcoholAlcohol ChloroxChlorox Hydrogen peroxideHydrogen peroxide

Topical AntibioticsTopical Antibiotics

Silvadene, SSD cream (silver sulfadiazine)Silvadene, SSD cream (silver sulfadiazine) Triple antibiotics (bacitracin-neomycin-Triple antibiotics (bacitracin-neomycin-

polymixin B)polymixin B) Cleocin T (clindamycin)Cleocin T (clindamycin) Bactroban (mupirocin)Bactroban (mupirocin)

Topical CorticosteroidsTopical Corticosteroids

OTC versus RXOTC versus RX Creams, ointments, gels, lotionsCreams, ointments, gels, lotions AgentsAgents

Betamethasone (Diprolene, Diprosone)Betamethasone (Diprolene, Diprosone) Clobetasol (Temovate)Clobetasol (Temovate) Fluocinonide (Lidex)Fluocinonide (Lidex)

PsoriasisPsoriasis

PsoriasisPsoriasis

Immune mediated skin disease which causes Immune mediated skin disease which causes rapid growth of skin cells. rapid growth of skin cells.

TreatmentsTreatments Corticosteroids Corticosteroids (Reduce inflammation & slow skin cell turnover(Reduce inflammation & slow skin cell turnover

Salicylic acid -PeelerSalicylic acid -Peeler Ultraviolet PhototherapyUltraviolet Phototherapy

Reduce skin cell turnoverReduce skin cell turnover Systemic Immune System Therapy- MTXSystemic Immune System Therapy- MTX

Fungal InfectionsFungal Infections

DANDRUFFDANDRUFF Shedding of scales from Shedding of scales from

the scalpthe scalp Selsun BlueSelsun Blue

Selenium sulfideSelenium sulfide Head & ShouldersHead & Shoulders

Pyrithione zincPyrithione zinc NizoralNizoral

Candidiasis InfectionsCandidiasis Infections

RingwormRingworm TopicalsTopicals

ClotrimazoleClotrimazole MiconazoleMiconazole

OralOral GriseofulvinGriseofulvin Itraconzaole (Sporanox)Itraconzaole (Sporanox)

Pulse DosePulse Dose

Terbinafine (Lamisil)Terbinafine (Lamisil)

Diaper RashDiaper Rash

Atopic Dermatitis EruptionAtopic Dermatitis Eruption

TreatmentsTreatments Topical/PO CortisoneTopical/PO Cortisone Topical (Doxepin)Topical (Doxepin) Topical CalcineurinTopical Calcineurin ImmunosuppressantsImmunosuppressants Emollients/AntihistamEmollients/Antihistam Coal TarCoal Tar

ECZEMAECZEMA

AtopicAtopic Doxepin (Zonalon)Doxepin (Zonalon)

ContactContact Pimecrolimus (Elidel)Pimecrolimus (Elidel) Tacrolimus (Protopic)Tacrolimus (Protopic)

Scaly skin lesion caused Scaly skin lesion caused by too much sun can by too much sun can lead to skin cancerlead to skin cancer

Actinex (masoprocol)Actinex (masoprocol) Efudex (fluorouracil)Efudex (fluorouracil)

Triggers:Triggers: Sun, Stress, Hot Weather/BathSun, Stress, Hot Weather/Bath Wind, Exercise, Etoh, Wind, Exercise, Etoh, Metrogel/crm (metronidazole)Metrogel/crm (metronidazole)

Acne Vulgaris and WrinklesAcne Vulgaris and Wrinkles

Overactive sebaceous Overactive sebaceous glandsglands

Azithromycin (qd)Azithromycin (qd) TretinoinTretinoin Benzoyl peroxideBenzoyl peroxide Tazarotene (Tazorac)Tazarotene (Tazorac) Ortho Tri-CyclenOrtho Tri-Cyclen Differin/AzelexDifferin/Azelex

Retin A Retin A Tretinoin, retinoic acid, Tretinoin, retinoic acid,

vitamin A acidvitamin A acid RenovaRenova

Lower dose for fine Lower dose for fine wrinkleswrinkles

Moisturizing baseMoisturizing base KineraseKinerase TazoracTazorac BotoxBotox

Scar ManagementScar Management

Pressure/CompressionPressure/Compression Stimulates production of collagenase, reduces Stimulates production of collagenase, reduces

height of scar thru local tissue hypoxiaheight of scar thru local tissue hypoxia Occlusive/Silicone SheetingOcclusive/Silicone Sheeting

Provides hydrationProvides hydration CortisoneCortisone

Reduces pain and itchingReduces pain and itching Vitamin EVitamin E

MoisturizesMoisturizes

Viral InfectionViral Infection

Shingles, cold soresShingles, cold sores OTC Docosanol (Abreva)OTC Docosanol (Abreva) Rx oral anti-viralsRx oral anti-virals

WartsWarts OTC CryotherapyOTC Cryotherapy Rx AldaraRx Aldara

MolesMoles

LICE and their NitsLICE and their Nits

Pediculicides and ScabicidesPediculicides and Scabicides

Human Lice & scabies are external parasitesHuman Lice & scabies are external parasites Transmission by direct contactTransmission by direct contact TypesTypes

Body liceBody lice Head liceHead lice Pubic lice (Crabs)Pubic lice (Crabs)

TreatmentsTreatments Permethrin (Nix/Elimite)Permethrin (Nix/Elimite)

Louse Life CycleLouse Life Cycle

ScabiesScabies

What are they?What are they? Sites of Scabies InfestationSites of Scabies Infestation SymptomsSymptoms EtiologyEtiology TreatmentsTreatments

Hair LossHair Loss

Rogaine (Minoxidil)Rogaine (Minoxidil) MOAMOA SESE EfficacyEfficacy

Diseases of the EyeDiseases of the Eye

GlaucomaGlaucoma CataractCataract VascularVascular

RetinophathiesRetinophathies

RetinopathyRetinopathy

A LookA Look

InsideInside

The EYEThe EYE

Why DoesWhy Does

GlaucomaGlaucoma

Happen?Happen?

Risk FactorsRisk Factors

AgeAge DiabetesDiabetes Family HistoryFamily History Eye InjuryEye Injury Far & NearsightednessFar & Nearsightedness Drugs (cortisone)Drugs (cortisone)

Agents for GlaucomaAgents for Glaucoma Goal of TreatmentGoal of Treatment Therapeutic AgentsTherapeutic Agents

Alpha-agonist Alpha-agonist –reduce production & increase –reduce production & increase drainagedrainage

Brimonidine (Alphagan)Brimonidine (Alphagan) Beta-blockers Beta-blockers –reduce aqueous fluid–reduce aqueous fluid

Betaxolol (Betoptic)Betaxolol (Betoptic) Carbonic Anhydrase InhibitorsCarbonic Anhydrase Inhibitors –reduce –reduce

productionproduction Dorzolamide (Trusopt)Dorzolamide (Trusopt)

Prostaglandin AnalogsProstaglandin Analogs –increase drainage –increase drainage Latanoprost (Xalatan)Latanoprost (Xalatan)

Infections of the EyeInfections of the Eye Conjunctivitis-pink eyeConjunctivitis-pink eye

Inflammation of the Inflammation of the lining & inner surface of lining & inner surface of eyelideyelid

Allergic,Bacterial,ViralAllergic,Bacterial,Viral StyeStye

Infection of sebaceous Infection of sebaceous gland (hordeolum) in lid gland (hordeolum) in lid marginmargin

BlepharitisBlepharitis Eyelid margins, scales Eyelid margins, scales

crusts, ulcerscrusts, ulcers

AntibioticsAntibiotics Tobramycin,gentamycin, Tobramycin,gentamycin,

sulfacetamidesulfacetamide AntihistaminesAntihistamines

Zaditor, AlamastZaditor, Alamast CorticosteroidsCorticosteroids

Dexamethasone, Dexamethasone, FlurometholoneFlurometholone

AntiviralsAntivirals Vira-A (vidarabine)Vira-A (vidarabine)

Anatomy of the EARAnatomy of the EAR

Hearing LossHearing Loss Age relatedAge related 65-75 years of age65-75 years of age EnvironmentalEnvironmental GeneticGenetic

Commonly Used Otic AgentsCommonly Used Otic Agents

AnalgesicsAnalgesics Antipyrine-benzocaine (Auralgan)Antipyrine-benzocaine (Auralgan)

AntibioticsAntibiotics Cortisporin HC Solution or SuspensionCortisporin HC Solution or Suspension CiproDexCiproDex

Wax dissolversWax dissolvers Cerumenex (Rx)Cerumenex (Rx) DebroxDebrox (OTC) (OTC)

Summary SlideSummary Slide

Common Disease of the SkinCommon Disease of the Skin Antiseptics and DisinfectantsAntiseptics and Disinfectants Topical Antibiotics, Topical CorticosteroidsTopical Antibiotics, Topical Corticosteroids Hair LossHair Loss Diseases of the EyeDiseases of the Eye Agents for GlaucomaAgents for Glaucoma Conjunctivitis “Pink Eye”Conjunctivitis “Pink Eye” Commonly Used Otic AgentsCommonly Used Otic Agents