Introduction: Understanding pharmacology related to skin and mucous membrane health is crucial for nursing students in providing comprehensive care to patients with dermatological and mucosal conditions. This guide offers essential knowledge on pharmacological interventions, including medications, treatments, and nursing considerations, to promote skin and mucous membrane wellness and manage various dermatological and mucosal disorders effectively.

1. Drug used in skin
and mucus
membrane

2. Drugs used in skin & mucous membrane are:
• Corticosteroids:
1. Glucocorticoids.
2. Mineralocorticoids.
• Antipruritics:
1. Anti-inflammatory.
2. Anti-Bacterials.
3. Antivirals.
4. Anti-fungals.
5. Anti-paracitics.
6. Antiacne.
7. Keratolytics &Antipsoiatics.
Drug used for Eye, Ear & Nose
Enzymes used in Therapy

3. Corticosteroids

4. Introduction
• Corticosteroids are steroid hormones that are either produced by
the body or are man – made. Naturally occurring corticosteroids,
hydrocortisone and cortisone are produced by the outer portion
of the adrenal gland known as cortex, so, corticosteroids are
classified as:
• Glucocorticoids.
• Mineralocorticoids.
• Synthetic corticosteroids mimic the actions of naturally
occurring corticosteroids and may be used to replace
corticosteroids in people with adrenal gland insufficiency.

5. Mechanism of action
• Glucocorticoids produce various
metabolic effects, suppress
inflammation and alter the normal
immune response, they also promote
water and sodium retention and
potassium excretion.
• Mineralocorticoids (Salt
retaining) regulate the balance
of salt and water in body.

6. Drug example and doses.
S. NO. Drugs Doses
Glucocorticoids
1 Betamethasone 0.5 – 9mg daily.
2 Dexamethasone 0.5 – 16mg daily.
3 Prednisone 2.5 – 60mg daily.
4 Prednisolone 5 – 60mg daily.
5 Triamcinolone 4 – 48mg daily.
6 Methylprednisolone 4 – 48mg daily.
7 Hydrocortisone 50 – 200mg daily
Mineralocorticoids
8 Fludrocortisone 100 microgram

7. Indications/uses
• Glucocorticoids drugs are used as
replacement therapy for adrenocortical
insufficiency.
• To treat neoplastic diseases.
• Septic shock.
• Cerebral edema.
• Inflammatory conditions of joint,
gastrointestinal tracts, respiratory tract
and skin.
• Mineralocorticoids are used as
replacement therapy in primary and
secondary adrenal insufficiency.

8. Contraindications/ precautions
•Serious infections.
•Mineralocorticoids use cautiously with
cardiovascular and hypertension disease
patients.

9. Adverse effects
• Muscle wasting.
• Growth retardation.
• Hypertension.
• Increased blood glucose level.
• Sodium and fluid retention.
• Acute adrenal insufficiency after abrupt
withdrawal.
• Osteoporosis.
• Peptic ulcer.
• Glaucoma.
• Altered fat distribution.

10. Drug interactions
Concurrent use with orally hypoglycemics or insulin
may increase blood sugar levels, there by increasing
insulin or oral hypoglycemic requirements.
Phenobarbital, phenytoin and rifampicin may
enhance the metabolism of glucocorticoids.
Hormonal contraceptives may block the metabolism
of glucocorticoids.

11. Nursing responsibilities
• Administer drug daily doses in the morning time.
• Monitor adverse effects of drug therapy.
• Monitor regularly for weight changes and also monitor fluid and
electrolyte imbalances.
• Teach the patient to avoid such foods as fresh fruits and raw
vegetables because they tend to have higher levels of
bacteria than cooked foods, therapy increasing the risk of
infection in an already immunosuppressed patients.
• Nurse should warn the patient not to stop drug abruptly
because this may cause life threatening adrenal insufficiency.

12. Antipruritics

13. Introduction
Antipruritic agents used to preventing and relieving
itching i.e. decreasing sensitivity of local nerve ending,
reducing local edema, cooling skin and counteracting
histamine release.

14. Mechanism of action
• They have anti-inflammatory, anti-allergies, anti-infective
properties thus show. Their actions in two different ways:
• Anti-inflammatory decreases the inflammation
and itching cause vasoconstriction.
• Anti-infective kills or inhibit the growth of micro-organism
(Bacteria, virus, fungi, parasitic).
• Antipruritics relieve itching of the skin and mucous
membrane.
• Antiacne clear and dry the skin, reduce bacteria and
reduce the size of activity of sebaceous glands.
• Keratolytics breakdown protein in keratin causing the loss of
the stratum corneum skin layer.

15. Drug Classification
Drugs Classification Drugs Classification
Anti-inflammatory Antiparasitic
Betamethasone Dexamethasone Malathion Permethrin
Hydrocortisone Triamcinolone Lindane
Antibacterial Antifungals
Gentamicin Sulfate Neomycin sulfate Ketoconazole Clotrimazole
Silver sulfadiazine Polymyxin B Miconazole nitrate Griseofulvin
Bacitracin Nystatin
Antivirals Keratolytics & Antipsoriasis
Acyclovir Penciclovir Salicylic acid Resorcinol

16. Drugs Classification
Antipruritics
Cyproheptadine Calamine lotion
Diphenhydramine
Antiacne
Clindamycin Erythromycin
Tetracycline Benzoyl peroxide
Isotretinoin Tretinoin
Azelaic acid (Cleanses/Antiseptics)

17. Indications
• Dermatitis (Anti-inflammatory).
• Allergic skin reactions (Anti-inflammatory).
• Bacterial skin infection (Antibacterial).
• To treat fungal infections (Antifungal)
• To treat herpes simplex virus infections (Antiviral)
• To treat scabies pediculosis (lice) (Antiparasitic)
• To treat pruritic (Antipruritics)
• To treat acne vulgaris and acne rosacea (Antiacne)
• To treat superficial fungal functions Psoriasis, corns, cellulitis
(Keratolytics).

18. Contraindications/ Precautions
•Hypersensitivity.
•Pregnancy.
•Breast feeding.

19. • Skin irritation.
• Bone marrow suppression.
• Behavioral changes.
• Suppressed immune response.
• Hemolytic anemia.
• Leukopenia.
• Fluid and electrolyte imbalances.
• Antiacne may cause burning,
itching, redness of the eye & scaling
pain of lips also may cause
photosensitivity reactions.
Adverse Effects

20. Drug
interactions
•Excessive use of antiacne
products may increase
skin
reactions.

21. Nursing Responsibilities:
• Nurse should assess before applying topical drug, assess skin and
remove any previous applied medications.
• Always use aseptic technique while applying medications to open lesions.
• Instruct to patient that topical drugs are for external use only and to avoid
contact with the eyes.
• Teach the patient how to apply drugs.
• Remember that if we are giving anti parasitics to control spread of
infestation to other fly members.And if, need to be treated.

22. Nursing Responsibilities:
•Follow these guidelines when applying acne products.
Clean and asses the affected area before applying acne
preparations.
Teach the patient using tetracyclines to be careful to cover
the entire affected area not to go in sunlight.
Advise the patient isotretinoin and tretinoin to apply
sunscreen and wear protective clothing to prevent
photosensitivity reactions.
Advise women using isotretinoin and tretinoin to use
contraception.

23. Topical Drugs used for disease of Eye.
Drug Preparations Uses
Ciprofloxacin 0.3% Drops & ointment Bacterial conjunctivitis
Gentamycin 0.3% Drops Bacterial conjunctivitis
Acyclovir 0.3% ointment Herpes simplex keratitis
Betamethasone 0.1% Drops & ointment Allergic and inflammatory conditions of the eye.
Dexamethasone 0.01% Drops Allergic and inflammatory conditions of the eye.
Diclofenac 0.1% Drops Post operative ocular inflammation
Azelastine 0.05% Drops Allergic conjunctivitis
Dorzolamide 2% Drops Glaucoma
Timolol 0.25% Drops Glaucoma
Pilocarpine 0.5% & 2% drops Glaucoma
Tropicamide 1% drops Uveitis, as mydriatic for refraction testing.
Atropine 1% Drops & ointment Uveitis, as mydriatic for refraction testing.

24. Topical Drugs used for disease of Nose
Drug Preparations Uses
Azelastine 0.1% Nasal spray Allergic rhinitis
Beclomethasone 500 mcg/ puff nasal spray Allergic rhinitis
Oxymetazoline 0.05% nasal drops Nasal Decongestant

25. Drug Preparations Uses for diseases of Ear.
Drug Preparations Uses
Ciprofloxacin 0.2% drops Bacterial infection.
Clotrimazole 1% drops Fungal infection.
Gentamicin 0.3% drops Bacterial infection
Betamethasone 0.1% drops Eczema of Ear, as an anti-
inflammatory agent
Sodium Bicarbonate 5% Drops To soften ear wax.

26. Drugs used in the treatment of scabies and pediculosis
Drug Formulations Details
Permethrin 1% & 5% Cream
5% lotion
5% Gel
1% soap.
Most efficacious and most frequently used drug for scabies and
pediculosis (head and pubic lice)
For Scabies: 5% permethrin is applied to the skin over the body from
neck to toes; thorough hot water bath after 10-12 hours to wash off the
drug.
For pediculosis: 1% Permethrin is applied to the scalp/pubis and
washed off after 10 mins. Treatment may be repeated, if necessary after
1week. Side effects are skin rashes, redness, itching, burning etc.
Gamma
Benzene
Hexachloride
(Lindane)
1% emulsion
1% lotion
1% cream
1% ointment
1% soap
Very effective drug for both pediculosis & scabies.
For Scabies: 1% Lindane is applied to the skin from neck to toes; a
thorough scrub bath is given is given after 12 hours to wash off drug
from the body. Application can be repeated if necessary after 7 days.
For pediculosis: 1% Lindane is applied over the scalp and hair
carefully without touching the eyes. Side effects include skin rashes,
headache, restlessness, convulsions and cardiac arrhythmias.
Contraindicated in children, epileptics and pregnant women.

27. Continued
Drug Formulations Details
Benzyl
Benzoate
25% emulsion
25% lotion
25% Emulsion/lotion is applied to the skin over the body from neck to
toes twice at 12 hours interval after a scrub bath; wash off 12hours after
the 2nd application. Side effect are skin rash and dermatitis.
Crotamiton 10% lotion.
10% cream
It has scabicidal, pediculicidal and Antipruritics activities. It is applied
to skin over body below the chin twice at 24hrs interval after a scrub
bath. It is less efficacious, hence requires repeated administration. It can
be used in children. Side effects include skin rashes, itching, dermatitis
etc.
Sulphur 10% ointment It is used for scabies, it is less efficacious, requires repeated
applications, has bad odour, hence is rarely used at present.
DDT
(Dicophane)
1-2% lotion
1-2% ointment
It is toxic, hence is rarely used for scabies and pediculosis.
Ivermectin Tablet (Oral)
0.2mg/kg.
Anti-filarial drug used orally for scabies and pediculosis. Single dose
produces almost complete cure. It is contraindicated in children,
pregnant and lactating women.

28. Enzymes used in therapy

29. Hyaluronidase
• Source: Mammalian.
• Availability & Routes: Topical SC/IM and
intraarticular.
• Action: Depolymerizes hyaluronic acid and
increases the permeability of the tissues.
• Uses:
• To promote the absorption of
drug and fluids given SC /IM and
intraarticularly.
• To aid the reabsorption of
extravasated fluid or blood in
hematoma or post operative edema.
• To facilitate the diffusion of local
anesthetic in ophthalmology.

30. Chymotrypsin
Source: OX pancreas.
Availability & Routes: Tablet
(PO) and topical ointment.
Action: Proteolytic enzyme.
Uses:
1. To reduce post
operative edema..

31. α-Chymotrypsin (Alfa – Chymotrypsin)
•Source: OX pancreas.
•Availability & Routes: Injection & Tablet (PO).
•Action: Mucolytic & Proteolytic action.
•Uses:
1. During cataract surgery to facilitate removal of the lens.
2. To reduce inflammatory edema due to trauma, injection, surgery etc.

32. Serratiopeptidase
• Source: Serratia species.
• Availability & Routes: Tablet (PO).
• Action: Anti-inflammatory activity.
• Uses:
• To relieve pain and inflammation due
to surgery, trauma, injection and
chronic condition like osteoarthritis,
rheumatoid arthritis, etc.

33. Urokinase
•Source: Isolated from human fetal kidney cell culture.
•Availability & Routes: IV
•Action: Fibrinolytic (Dissolve clot)
•Uses:
Acute MI, Deep vein thrombosis, Pulmonary embolism, etc.

34. Tissue plasminogen activator (t-PA)
•Source: Derived from recombinant DNAtechnology.
•Availability & Routes: IV
•Action: Fibrinolytic (Dissolve clot)
•Uses:
Acute MI, Deep vein thrombosis, Pulmonary embolism, etc.

35. L – Asparaginase
•Source: Escherichia coli.
•Availability & Routes: IV
•Action: Catalyzes the hydrolysis of asparagine to aspartic acid
•Uses:
Acute Lymphoblastic leukemia.

36. Reference:
1. Dr. P.K. Panwar, Essentials of pharmacology for nurses,AITBS pub.
2017, India, Pg no. 85 – 79.
2. Dr. Suresh k sharma, Textbook of pharmacology, pathology & genetics for
nurses, Jaypee pub. 2016 India Pg no 253 – 255.
3. Tara v. Shanbhag, Smita shenoy, Pharmacology preparation manual for
undergraduate, Elsevier pub. 2014. Pg no. 490 – 492.
4. Marilyn Herbert –Ashton, Nancy Clarkson, Pharmacology, Jones & Barlet
pub 2010 India, Pg no 194-201.
5. Govind s. mittal, Pharmacology at a glance, Paras medical book pub. 2009
India 51 – 56.
6. Madhuri Inamdar, Pharmacology in nursing, Vora medical pub. 2006 India
1st edition, Pg no 240.

37. THANKS