Pharmacology - Nursing Flashcards
This article begins our coverage of integumentary system medications, specifically topical ointments to treat infections. These antibiotic ointments, topical antifungal agents, and topical medications used for burns are indicated for the surface of the skin, as opposed to the systemic versions of these antibiotic and antifungal medications, which we covered previously.
The Nursing Pharmacology video series follows along with our Pharmacology Second Edition Flashcards, which are intended to help RN and PN nursing students study for nursing school exams, including the ATI, HESI, and NCLEX.
When you see this Cool Chicken, that indicates one of Cathy's silly mnemonics to help you remember. The Cool Chicken hints in these articles are just a taste of what's available across our Level Up RN Flashcards for nursing students!
The integumentary system is the skin. More specifically, it is the set of organs forming the outermost layer of the body, i.e., the skin and its appendages, which act as a physical barrier between the external environment and the body’s internal environment.
Topical medications for bacterial skin infections
Two topical antibiotic ointments to be familiar with are bacitracin and mupirocin. These are used to treat localized bacterial infections and are effective against staphylococci and streptococci.
Note that many topical medications used to treat bacterial infections end in -cin.
Bacitracin
Bacitracin is used for minor skin injuries like cuts, scrapes, or minor burns.
Mode of action of bacitracin
Bacitracin inhibits cell wall synthesis.
Side effects of bacitracin
Side effects of bacitracin can include burning or stinging upon application, as well as pruritus (itchy skin). It is also possible that the patient may experience allergic contact dermatitis upon application.
Nursing care when applying bacitracin
Clean and dry the affected area before applying a small amount of medicine.
Bacitracin should be applied one to three times a day.
Mupirocin
Mupirocin is used to treat skin infections, including impetigo and beta-hemolytic streptococci. Mupirocin is thought of as the gold standard for treating impetigo, which is an infection that requires contact precautions.
Mode of action of mupirocin
Mupirocin inhibits bacterial protein synthesis.
Side effects of mupirocin
As with bacitracin, mupirocin can cause burning or stinging upon application, as well as pruritus.
Nursing care when applying mupirocin
Clean and dry the affected area before applying a small amount of medicine.
Mupirocin should be applied three times a day.
Topical medications for fungal skin infections
That “azole” touched me with his athlete’s foot. Now I might need clotrimazole. Many end in -azole.
Topical antifungal agents include clotrimazole (Lotrimin), miconazole (Monistat, Vagistat), and nystatin. They are used to treat tinea pedis (athlete’s foot), tinea cruris (jock itch), tinea corporis (ringworm), and cutaneous candidiasis.
Mode of action of clotrimazole, miconazole, and nystatin
These ointments affect the integrity of the fungal cell wall.
Side effects of clotrimazole, miconazole, and nystatin
Side effects are usually minimal and can include stinging or redness.
Nursing care when applying clotrimazole, miconazole, and nystatin
Patients should apply BID for 1-4 weeks (“BID” stands for “bis in die,” which is Latin for “twice a day”).
For patients diagnosed with tinea capitis (fungal infection on the scalp), a selenium sulfide (antifungal) shampoo may be used.
Topical medications for burns
Mafenide is like the mafia takin’ down the eschar!
Silver sulfadiazine and mafenide acetate are topical medications used to treat second- and third-degree burns. They may also be used to prevent wound sepsis.
Silver sulfadiazine (Silvadene)
Mode of action of silver sulfadiazine
Silver sulfadiazine provides broad antibacterial and antifungal activity through DNA disruption.
Side effects of silver sulfadiazine
Side effects can include leukopenia. Other side effects include rash, burning and itching, and possible skin necrosis.
Nursing care when administering silver sulfadiazine
Because of the side effect of leukopenia, monitor the patient’s CBC levels during therapy.
You can learn about CBCs and more with our Lab Values Study Guide & Flashcard Index, a list of lab values covered in depth in our Lab Values Flashcards for nursing students.
Mafenide acetate
Mode of action of mafenide acetate
This medication is a bacteriostatic; it can help penetrate eschar (necrotic tissue, usually brown or black), which can occur with certain burns.
Side effects of mafenide acetate
Side effects of mafenide acetate can include pain, burning and itching, as well as metabolic acidosis.
Nursing care when administering mafenide acetate
Because of the potential for metabolic acidosis, it is important to monitor the patient’s acid-base balance.
If you'd like in-depth studying on ABGs and to learn how to interpret ABGs, we have Arterial Blood Gas Interpretation Flashcards and a video series on ABG Interpretation.
1 comment
For mafenide acetate, you could expand on your chicken hint by saying the MAFenide is like the mafia who use acid (ACETate) to take down eschar.. that way you know it’s linked with metabolic acidosis. You can remember the metabolic because mafenide starts with an M.