This document discusses drugs used in special sensory and integumentary systems. It begins by outlining the main areas - eye, ear, nose, skin, and tongue. It then discusses topical formulations like drops, ointments, lotions, creams, and powders that are applied to body surfaces. Specific examples of eye drops, ear drops, nasal drops, and skin ointments are provided. The document then focuses on drugs acting on the skin, including emollients, keratoplastic agents, antipruritics, and glucocorticoids. It provides examples of conditions treated and drugs used for acne, scabies, psoriasis, and more. The document also

1. DRUGS USED IN SPECIAL SENSORY &
INTEGUMENTARY SYSTEM
• Special senses:
• Eye (Opthalmic)
• Ear (Otic)
• Nose (Nasal)
• Skin (Integumentary system)
• Tongue (Sublingual/Buccal)

3. Topical formulations
• Drugs that are applied to body surfaces such as
the skin or mucous membranes.
• Many topical medications are epicutaneous,
meaning that they are applied directly on the
skin.
• Other applications:
• Opthalmic Preparation: Applied to the eye
• Otic Preparation: Applied to ear
• Nasal Preparation: Applied to nose

4. Topical
Formulations
Properties Indications
Drops Medicated drops in a suitable
vehicle like normal saline
Eye drops, ear
drops, nasal drops
Ointments Semisolid preparations made of
hydrocarbon base (paraffin,
petrolatum) with high viscosity
Skin, eye, nose
Ocusert Ocular inserts containing drug
reservior
Eye (Pilocarpine
ocuserts)
Lotions/
Creams
Preparation of mixture of oil &
water in different proportion
Skin (moisturizer,
emollient)
Powders Finely divided particles for dusting
purpose
Skin surface
(talcum powder)

5. Nasal drops
Ear drops
Skin
ointment

6. DRUGS ACTING ON SKIN (DERMATOLOGIC DRUGS)
 Demulcents: Demulcents are the substances that are
applied to skin or mucosa to prevent from
irritation/inflammation. They act as protective barrier &
soothe irritant/inflammed area of skin or mucosa. e.g:
gum acacia, tragacanth, glycyrrhiza, methylcellulose, etc
 Emmolients: Emmolients are the oily preparation that
soothe & soften the skin. They form occlusive film over
the skin preventing evaporation & restoring the moist skin
from drying. e.g: olive oil, liquid paraffin, cocoa butter, etc
 Adsorbents: Adsorbents are finely divided powders that
binds with noxious & irritant substance & protects skin.
e.g: Magnesium stearate, talc, calamine, boric acid, etc

7.  Astringents: Astringents are substances that precipitate proteins
but do not penetrate cells. They toughen the surface making it
mechanically strong.
• Tannic acid & tannins
• Alcohol
 Keratoplastic & Keratolytic agents: It dissolves intercellular
substance in the horny layer of the skin like corns, warts,
psoriasis, etc. the epidermal cell swell, soften & desquamate.
• Salicylic acid
• Resorcinol
• Sulfur
 Antipruritics: Drugs used to control itching, a condition also
known as pruritus.
• Calamine lotion
• Diphenhydramine
• Hydrocortisone

8. WARTS
PSORIASIS
CORNS

9.  Glucocorticoids: Glucocorticoids have antiinflammatory,
immunosupressive, vasoconstrictor & antiproliferative actions.
• Beclomethasone 0.025% cream
• Dexamethasone 0.1% cream
• Hydrocortisone 0.1-1% cream
• Clobetasol 0.05% cream
 Acne vulgaris
• Benzoyl peroxide
• Clindamycin
• Tretinoin
• Adapalene
• Isotretinoin
 Antiscabies
• Benzyl benzoate 25%
• Gamma Benzene Hexachloride 1%
• Sulphur 5%
Psoriasis
•Glucocorticoids
•Calcipotriol
•Tars
•Methotrexate
Antipediculosis
•Permethrin 1%
•Malathion 0.5%
•Lindane 1%

11.  Dandruff & Antiseborrheics
• Selenium sulfide
• Zinc pyrithione
• Coricosteriods
• Ketoconazole
• Salicylic acid
 Melanizing agents
• Psoralen
• Methoxsalen
• Trioxsalen
 Demelanizing agents
• Hydroquinone
• Menobenzone
• Azelaic acid
Alopecia
•Minoxidil 5%,10%
•Finasteride

12.  Phototherapy
Ultravoilet B irradiation + Coal Tar
Covered by 1% coal tar ointment then exposed to short wave UV
radiation (UV B)
Photochemotherapy (PUVA : Psoralen UV A)
 Sunscreenings (absorb UV radiations)
• Para aminobenzoic acid (PABA)
• Cinnamates
• Salicylates
• Benzophenones
• Anthralinates
 Antiperspirants & Deodorants
• Aluminium chlorhydrate
• Aluminium chloride
• Aluminium Zinconium chlorhydrate

15.  Antiseptics & disinfectants
• Phenol
• Lysol
• Chloroxylenol (Dettol)
• Potassium permangnate
• Hydrogen peroxide
• Iodine
• Chlorine
• Chlorhexidine
• Cetrimide
• Ethanol
• Formaldehyde
• Mercurochrome solution
• Gentian violet solution
• Acriflavine

16.  Antibacterials
• Bacitracin
• Mupirocin
• Neomycin
• Polymixin B
• Fusidic acid
• Clindamycin
• Metronidazole
 Antifungals
• Clotrimazole
• Ketoconazole
• Terbinafine
• Nystatin
• Griseofulvin
• Miconazole
• Econazole
 Antivirals
• Acyclovir

17. ANTIBACTERIAL DRUGS
Common causative agent of skin infection are:
•Staphylococcus species (folliculitis, boils, impetigo)
•streptococcus pyogens (cellulitis, infectious gangrene)
•Corynebacterium spp.
•Brevibacterium spp.
•Acinetobacter
•Propionibacteria
•live in the hair follicles of adult skin and cause diseases
MUPIROCIN 2% OINTMENT/CREAM
MOA: It binds to the bacterial RNA synthetase resulting in inhibition of
protein synthesis
USES: superficial skin infections such as impetigo or folliculitis
ADVERSE EFFECT: local irritation including urticaria, pruritus, burning
sensation, rash
DOSE: apply upto 3 times daily

18. NEOMYCIN SULPHATE CREAM 0.5%, DUSTING POWDER
MOA: It binds to the 30s ribosomal subunit and interferes protein
synthesis.
Uses: bacterial skin infection, eczema
Side effect: allergic reaction
Doses: apply 3 times daily
Contraindication : hypersensitivity, neonates
BACITRACIN 500 IU OINTMENT, CREAM
MOA: It is a polypeptide antibiotic that interferes with peptidoglycan
synthesis in bacterial cell wall.
USES :Burn case, small cut, minor skin wound
Adverse reaction: hypersensitivity, nephrotoxicity
Contraindication: hypersensitivity reaction
Dose: apply 1-3 times daily

19. POLYMYXIN B 10000 IU OINTMENT
MOA: It is bactericidal that causes leakage of bacterial
membrane by binding to phospholipids
Uses: Skin infections, minor wounds (cuts, burns)
Contraindication: pregnancy, renal disease
Adverse reaction: hypersensitivity, nephrotoxicity
Dose: applied twice daily
FUSIDIC ACID 2% CREAM, OINTMENT
MOA: It is bacterial protein synthesis inhibitor, preventing
translation process from the ribosome.
Uses: Staphylococcal skin infection
Adverse effect: dark urine, jaundice, hepatic effect,
hypersensitivity
Contraindication: hypersensitivity

20. METRONIDAZOLE 0.75% GEL/CREAM
MOA: It inhibits bacterial nucleic acid synthesis by interfering with
bacterial DNA & electron transport chain.
USES: anaerobic infection, abscess formation, bacterial vaginosis
Adverse reaction: hypersensitivity reaction
Contraindication : first trimester of pregnancy
CLINDAMYCIN 1% GEL
MOA: inhibits protein synthesis by inhibiting ribosomal function
Uses: acne (clindamycin + adapalene)
Contraindication: allergy
Adverse effect: dryness, itching, burning, peeling of skin

21. ANTIFUNGAL DRUGS
Common fungal infection are : athlete’s foot, jack itch, ringworm, yeast
infection, fungal nail infection, vaginal thrush, severe dandruff
NYSTAIN 100000 UNIT OINTMENT/CREAM
MOA: Nystatin binds to ergosterol present in cell membrane & disrupts
membrane function leaking electrolytes and small molecule from
the cell resulting death.
Indication: monilial vaginitis, oral thrush, corneal conjunctival and
cutaneous candidiasis
Contraindications: hypersensitivity
Adverse effect: GI disturbance
Dose :Topical powder, Ointment, Cream
TERBINAFINE 1% CREAM
MOA: Terbinafine inhibits ergosterol synthesis by inhibiting the fungal
squalene epoxidase
Indication: Tinea pedis, Tinea cruris/corporis, cutaneous candidiasis
Adverse effects: hepatotoxicity, taste disturbance
Contraindications: hypersensitivity
Dose : apply thinly 1-2 times daily for upto 1 weeks in tinea pedis, 1-2
weeks in tinea corporis and tinea cruris, 2 weeks in cutaneous
candidiasis

22. GRISEOFULVIN 0.02%, 1%, 5% CREAM
MOA: It binds to tubulin, interferes with microtubules & inhibits
mitosis. Absorption is irregular, improved by taking with fats
USES: Tinea pedis, dermatophytes
Adverse Effects: Headache, Rashes, Leukopenia and Albuminuria
Preparation: Cream, spray, griseofulvin 400mcg/metered spray
CLOTRIMAZOLE 1% CREAM
MOA: It Inhibits the fungal cytochrome p450 enzyme lanosterol 14-
demythylase and thus impairs ergosterol synthesis.
Indication: ringworm, athelet’s foot, otomyocis, oral/vaginal candidiasis
Adverse drugs reaction: local irritation with stinging/burning sensation
Dose: apply 2-3 times daily
ECONAZOLE NITRATE 1% CREAM
• Locally active antifungal drugs
• Uses and MOA similar to clotrimazole
• Dose :apply twice daily for skin infection

24. KETOCONAZOLE 2% CREAM, 2%/1% SHAMPHOO
MOA: It is a broad spectrum antifungal that Inhibits the fungal
cytochrome p450 enzyme & impairs ergosterol synthesis.
INDICATION: dermatophytosis (effective in seborrhea of scalp and
dandruff), monilial vaginitis, systemic mycosis
ADVERSE EFFECT: nausea, vomiting, loss of appetite, headache,
hepatic dysfunction, rash and hair loss, menstrual irregularities
CONTRAINDICATION: pregnancy, lactation, liver disease
DOSE: apply twice daily
MICONAZOLE GEL 2%, 20GM IN OINTMENT
MOA: It is fungistatic (fungicidal at higher concentration). It Inhibits the
fungal cytochrome p450 enzyme and impairs ergosterol synthesis.
INDICATION: vulvovaginal candidiasis, tinea infection, otomycosis,
oncomycosis, pityriasis versicolor
CONTRAINDICATION: first trimester of pregmancy
ADVERSE EFFECT: irritation, pelvic cramp when applied intravaginally
DOSE: apply twice daily

25. ANTIVIRAL DRUGS
Common viral infection are recurrent labial and genital herpes
simplex infection
Most commonly used drugs:
• Acyclovir
• Valacyclovir
• drug of choice for herpes zoster
Acylovir 5% cream
MOA: it is a deoxyguanosine analogue that converts into active
form & inhibits DNA synthesis & viral replication.
Uses: Chicken pox, shingles, Herpes simplex, herpes simplex,
varicella zooster infection
Adverse effects: nausea, headache, muscle aches/itches

26. DRUGS USED IN EYE INFECTION

27. ANTIBACTERIAL AGENT
CHLORAMPHENICOL 0.5% DROPS, 1% EYE OINTMENT
MOA: It binds to 50s ribosomal subunit & interferes with bacterial
protein
USES: superficial infections of the eye
ADVERSE EFFECTS: Itching or burning, urticaria, contact conjunctivitis
CONTRAINDICATIONS: Hypersensitive patients, Neonates , premature
babies
CIPROFLOXACIN 0.3% DROPS
MOA: Ciprofloxacin enters bacterial cells via porins and inhibit
bacterial DNA gyrase thereby inhibiting DNA replication and
transcription.
USES: Conjuctivitis, Corneal ulcers
Adverse effects: burning, stinging sensation, bad taste, eyelid redness
Contraindications: Hypersensitivity to Ciprofloxacin, Pregnancy

29. GENTAMICIN 0.3% DROPS
MOA: It binds to 30s ribosomes and interferes with bacterial protein
synthesis.
USES: Superficial infections of the eye, middle ear infection
ADVERSE EFFECTS: irritation, burning ,allergic contact dermatitis,
superinfections, ototoxicity
CONTRAINDICATIONS: Hypersensitive patients, patient with impaired
renal function
NEOMYCIN 0.5% DROPS/OINTMENT
MOA: It binds to 30s ribosomes and interferes with bacterial protein
synthesis.
USES: Superficial infection of the eye
PRECAUTIONS: with Topical corticosteroids, hypersensitive patients,
neonates

30. SULFACETAMIDE 10/20/30% DROPS
MOA: It is a competitive inhibitor of bacterial para-aminobenzoic
acid(PABA) & block the synthesis of dihydrofolic acid by inhibiting the
enzyme dihydropteroate synthase.
USES: Superficial infections of the eye
ADVERSE EFFECTS: Burning, rash, urticaria
CONTRAINDICATIONS: Hypersensitive patients
TETRACYCLINES 1% EYE OINTMENT
MOA: They inhibit protein synthesis by binding to 30s ribosomes .
USES: Bacterial and chlamydial infections of the eye (Trachomatis).
ADVERSE EFFECTS: Dermatitis, increased lacrimation and transient
burning sensation
PRECAUTIONS: Pregnancy, lactation, children, renal and hepatic
insufficiency.
CONTRAINDICATIONS: hypersensitive patients

31. BACITRACIN 500IU OINTMENT
MOA: It is a polypeptide antibiotic that interferes with peptidoglycan
synthesis in bacterial cell wall.
USES: Superficial infections of the eye (conjunctivitis, cornea ulcer,
blepharitis, other eye injuries),burn case
ADVERSE EFFECTS: Rash, allergic anaphylactoid reactions
CONTRAINDICATIONS: hypersensitivity to bacitracin
POLYMYXIN B 10000 IU OINTMENT
MOA: It Alter bacterial outer membrane permeability by binding to
lipopolysacchride layer
USES: Superficial infections of the eye
ADVERSE EFFECTS: Irritation and contact dermatitis.
CONTRAINDICATIONS: hypersensitivity to Polymixin B

32. ANTIVIRAL AGENTS
Usually used for recurrent labial and genital herpes simplex infections
ACYCLOVIR 3% OINTMENT
MOA: It requires viral thymidine kinase to convert into active form &
inhibits DNA synthesis & viral replication.
USES: Corneal ulcer produced by herpes simplex. Genital herpes
simplex, Herpes zoster, Chicken pox, H.simplex keratitis
ADVERSE EFFECTS: stinging or burning sensation, erythema or itch
PRECAUTIONS: Hypersensitive patients
IDOXURIDINE 0.1% EYE DROPS,0.5% EYE OINTMENT
MOA: Anti-herpes virus drug that competes with thymidine, gets
incorporated in DNA, so that faulty DNA is formed which easily breaks.
USES: Herpes simplex keratoconjuctivities
ADVERSE EFFECTS: Irritation, pruritus and visual haze
CONTRAINDICATION: Hypersensitive patients

33. ANTI FUNGAL DRUGS
Common fungal eye infection are: infection caused by candida
albicans, fungal keratitis, fungal blepharirtis, conjunctivitis
NATAMYCIN 2% CREAM,1% OINTMENT, 5% DROPS
It has broad spectrum of action and is used only topically.
MOA: inhibits the fungal growth by binding to ergosterols in plasma
membrane and alter the cell membrane permeability
USES: Fungal blepharirtis and conjunctivitis, fungal keratitis
ADVERSE EFFECTS: Eye irritation
PRECAUTIONS: Patients who are allergic to natamycin.
FLUCYTOSINE 1.5% EYE DROPS
MOA: It is a narrow spectrum fungistatic that inhibits thymidylate
synthetase & interrupts nucleic acid synthesis
USES: Fungal eye infection caused by candida albicans.
ADVERSE EFFECTS: Leucopenia,thrombocytopenia,mild anemia,GIT
disturbances,mild liver dysfunction

34. DRUGS USED AS MYDRIATICS & MIOTICS
ARTIFICIAL TEARS
•Carmellose
•Hydroxyethylcellulose
•Hypromellose
•Polyvinyl alcohol
ANTI-INFLAMMATORY
•Betamethasone
•Dexamethasone
•Nedocromil sodium
•Sodium cromoglycate

36. DRUGS USED IN GLAUCOMA

37. DRUGS USED IN GLAUCOMA

38. DRUGS USED IN EAR INFECTION
ANIFUNGALS Indications Adverse effects Contraindications
Clotrimazole 1% Fungal otomycosis Local irritation Hpersensitivity
ANTIBACTERIALS Indications Adverse effects Contraindications
Chloramphenicol
5%
Ottitis media Hypersensitivity Lactation
Hpersensitivity
Ciprofloxacin
0.3%
Middle ear, outer
ear canal
infection
Hypersensitivity Pregnancy
Gentamicin 0.3% Ottitis externa Hypersensitivity Pregnancy
Neomycin
0.3-0.5%
Outer ear Hypersensitivity Pregnancy

40. Nasal
Decongestants
MOA Indications Adverse Effects
Ephedrine
Hydrochloride
0.5%-1%
Nasal drops
Sympathomimetic
αadrenergic agonist
and act as a
vasoconstrictor
common cold
sinusitis
hay fever
Allergies
burning and
stingling
sensation, dryness
of mouth and
throat, headache
Precaution:
Hypertension
Oxymetazoline
0.025-0.05%
Nasal drops
(NASIVION)
(SINAREST)
Sympathomimetic
or
αadrenergic agonist
vasoconstrictor
Nasal
congestion by
Common cold
Allergy
hay fever
burning and
stingling
sensation, dryness
of nose headache
DRUGS USED IN NOSE
Ephedrine HCl, Xylometazoline, Oxymetazoline,
Pseudoephedrine, Phenylephrine