1Second semester 15 - 16

Chapter 33

Topical and Inhalant Medications

Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

2Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Topical Route Administered of medication to skin or mucous membranes

externally or internally; local or systemic effect

Cutaneous Applications rubbed into or placed in contact with the skin, scalp, or

mucous membrane

1. Inunction Application Medication incorporated into an agent (ointment, oil, cream)

and rubbed into skin

2. Transdermal Applications applied to skin via patch/paste and allowed to absorbed

Topical Route

3Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Pathway for Absorption From a Transdermal Skin Patch

4Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Topical Route (cont’d)Ophthalmic Applications

Appling drugs onto mucous membrane of one or both eyes (conjunctiva) as drops or ointment ,blink it but don't rub

5Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Topical Route (cont’d)Otic applications

Drug is instilled into outer ear, used to moisten impacted cerumen or treat infections.

Technique for straightening canal 1. In an adult ( pull the ear up and back)2. In young child ( pull the ear down and back)

Technique for irrigation of the external auditory canal or instillation of ear drops. Note the difference in direction of pull on the pinna between (A) the adult (up and back) and (B) the child (down and back).

6Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Topical Route (cont’d)

Nasal applicationsdropped or sprayed in nose; watch for rebound

inflammation Sublingual and buccal applications

under tongue or between cheek and gum Instruct the client not to chew or swallow the

medication

Vaginal applicationsUsed most often to treat local infection

as yeast

Rectal applicationsto or within rectum; suppositories, ointments

7Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Inhalant Route

Administers drugs to lower airways

This method is effective because the lungs provide extensive area from which the circulatory system can quickly absorb the drug

Educate patients to clean devices appropriately

8Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Inhalant Route (cont’d)Inhaler

is handheld device for delivering medications into respiratory passages.

Types 1.Dry Powder Inhaler

holds reservoir of drug and a carrier substance; dependent on inhalation effort

9Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

•Inhalant Route (cont’d)

2. Metered-Dose Inhaler• delivers aerosolized medication

forced through a narrow channel via a chemical propellant

Nebulizer • breathing machine; converts

liquid to mist; used with those who have difficulty coordindinating inspiration with the inhaler

Spacer • chamber; provides an aerosol

reservoir

10Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Spacer and Inhaler

11Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Sample DocumentationTime and date ( 11/21/2015 5:42:58 PM)

Prescribed eye medication

instilled into left eye before cataract surgery .

Conjunctiva appears pink and intact . Lens is opaque .

Eyelashes have been clipped ( cut )

Signature/ Title

12Second semester 15 - 16 Bader A. EL Safadi BSN , MSc Fundamental of Nursing – B Topical and Inhalant

Nursing Implications• Nursing diagnoses

– Deficient knowledge

– Ineffective therapeutic regimen management

– Impaired gas exchange

– Impaired skin integrity

– Impaired tissue integrity