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Topic Therapy 外用药物治疗. 昆明医学院第二临床学院 皮肤性病学教研室 邓丹琪 教授. How to use them. ?. Before. After. Contents. Characteristic of topic agents( 外用药的性能 ) Vehicles for topical agents( 外用药的剂型 ) Therapeutic principle of topic agents ( 治疗原则 ) Caution( 注意事项 ). Characteristic of topic agents.

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Topic therapy

Topic Therapy外用药物治疗

昆明医学院第二临床学院

皮肤性病学教研室

邓丹琪 教授



Before

After


Contents
Contents

  • Characteristic of topic agents(外用药的性能)

  • Vehicles for topical agents(外用药的剂型)

  • Therapeutic principle of topic agents (治疗原则)

  • Caution(注意事项)


Characteristic of topic agents
Characteristic of topic agents

  • 清洁剂 (clearing agents):

  • Function:Use to clear effusion(渗出物), scale(鳞), crust and residue.

    Examples :3%硼酸 Boric Acid Solution

    Sodium Chloride生理盐水

    Liquid Paraffin液体石蜡


Characteristic of topic agents1
Characteristic of topic agents

  • 保护剂 (protective agents)

    Fouction: Protect skin, reduce friction(摩擦), prevent effect of external irritant

    Examples: Talc Powder (滑石粉)

    Zinc Oxide Powder(氧化锌粉 )

    Amylum(淀粉)


Characteristic of topic agents2
Characteristic of topic agents

  • 止痒剂 (antipruritic agents)

    Function: Reducing the itching

    Examples:5% 苯唑卡因 Benzocaine

    0.5-2% 薄荷 Menthol

    2% 樟脑 Camphor

    glucocorticoid


Characteristic of topic agents3
Characteristic of topic agents

  • 角质促成剂(keratoplastics)

    Function :Promote corneum epidermidis to become nomal. Anastole vascellum(收缩血管), relieve effusion and infiltrating.(减轻炎性渗出和浸润)(

    Examples:焦油 empyreumatic oil

    3%水杨酸 Salicylic Acid

    3%一5%硫磺 Sulfur


Characteristic of topic agents4
Characteristic of topic agents

  • 角质剥脱剂(keratolytics)

    Function:Make hyperkeratosis(过度角化)cell amotic(脱落).

    Examples:10% 硫磺 Sulfur

    5%~10% 水杨酸 Salicylic Acid

    0.01%~0.1%维A酸 Tretinoin


Characteristic of topic agents5
Characteristic of topic agents

  • 收敛剂(astringents)

    Function:Inhibit externalization of sweat gland and coil gland.凝固蛋白质、减少渗出

    抑制分泌、促进炎症消退

    Examples:5%甲醛 Formaldehyde

    0.2%~0.5%硝酸银 Silver Nitrate


Characteristic of topic agents6
Characteristic of topic agents

  • 腐蚀剂(caustics)

    Function:Destroy and removal hyperplastic(增生)granulation tissue and ecphyma(赘生物).

    Examples:苯酚 Phenol

    硝酸银 Silver Nitrate

    5-20%乳酸 Lactic Acid


Characteristic of topic agents7
Characteristic of topic agents

  • 抗菌剂(antiseptics)

    Function:Have disinfection or bacteriostasis.(杀灭或抑制细

    Exzamples:3%硼酸 Boric Acid Solution

    1%红霉素Erythromycin Ointment

    2%莫匹罗星 Mupirocin Ointment


Characteristic of topic agents8
Characteristic of topic agents

  • 抗真菌剂(antifungal agents)

    Function:Have kill or fungistasis(抑制真菌)

    Examples:2%~3%克霉唑 Clotrimazole

    1%益康唑 Econazole

    1%~2.5%硫化硒 Selenium Sulfide

    Benzoic Acid, (笨甲酸)

    Glacial acetic acid,(冰醋酸)

    Allylamine(丙烯胺)


Characteristic of topic agents9
Characteristic of topic agents

  • 抗病毒剂(antiviral agents)

    Function: antiviral

    Examples:2%~3%阿昔洛韦 Aciclovir

    0.5%~1%疱疹净

    Indo-Deoxyuridine


Characteristic of topic agents10
Characteristic of topic agents

  • 杀虫剂(insecticides)

    Function:Kill parasite such as vermiform acari(蠕形

    螨),pediculus(虱).

    Examples:5%~10%硫磺 Sulphur

    2%甲硝唑 Metronidazole


Characteristic of topic agents11
Characteristic of topic agents

  • 遮光剂 (sunscreen agents)

    Function:Absorb and prevent ultraviolet.

    Examples:5%二氧化钛 Titanium Dioxide

    10%氧化锌 Zinc Oxide


Characteristic of topic agents12
Characteristic of topic agents

  • 脱色剂 (Depigment agents)

    Function:Relieve hyperpigmentation,(色素沉着).

    Examples: 3%氢醌 Hydroquinone

    20%壬二酸 Azelaic Acid


Characteristic of topic agents13
Characteristic of topic agents

  • 维A酸类 (retinoids)

    Function:调节表皮角化

    抑制表皮增生

    调节黑素代谢

    Examples:0.025%~0.05%维A酸霜

    Tretinoin


Characteristic of topic agents14
Characteristic of topic agents

  • 外用糖皮质激素 (glucocorticoid)

  • Function:Have anti-inflammatory, anaphylaxis, relieving itching.作用: 有明显的抗炎症作用

    低效 氢化可的松、地塞米松

    中效 去炎松、 氟轻松

    强效 氯氟舒松 、氯倍他索 、 倍氯米松


Vehicles for topical agents
Vehicles for topical agents

1 溶液(solution)

组成:药物的水溶液

Solution of medicine.

Function:dephlogisticate(消炎), loss of heat 散热, reduce effusion(收敛)

Examples:硼酸 Boric Acid cold wet compresses


Vehicles for topical agents1
Vehicles for topical agents

2 酊剂和醑剂 (tincture and spiritus)

酊剂:非挥发性药物的酒精溶液

Fixed medicine dissolved in alcohol

醑剂:挥发性药物的酒精溶液

Volatility medicine dissolved in alcohol

Function :dephlogisticate, sterilize(杀菌) and reliev itching.

Examples:斑秃酊 Alopecia Areata、

樟脑醑 Camphor


Vehicles for topical agents2
Vehicles for topical agents

3 粉剂 (powder) :Medical powder

Function:They also cool the skin, reduce friction, and smooth the skin surface.

Examples:氧化锌粉 Zinc Oxide

They are effective in preventing

miliaria ( 痱子)and intertrigo(擦烂).


Vehicles for topical agents3
Vehicles for topical agents

4 洗剂(lotion)

Insoluble medicine powder mixed

with water

Function:anti-itching ,bring cooling, astringent and protective effects.

Examples:Lotion Sulphur硫磺洗剂


Vehicles for topical agents4
Vehicles for topical agents

5 油剂 (oi1)

Insoluble medicine powder mixed with vegetable oil

Function:clearing, softening crust, protecting and moist skin lesion.

Examples: seed fat,

mineral oil,

animal oil.

25%~40%Zinc oxide oil


Vehicles for topical agents5
Vehicles for topical agents

6 乳剂 (emulsion): Emulsifyingmixture of oil and water.

Two types of emulsion: one type are water-in-oil

emulsive vehicles(脂), they are mostly applied on dry lesions.

The other are creams(霜), called oil-in-water emulsive vehicles.


Function: protecting and moist skin lesion.

Examples:糖皮质激素Glucocorticoids


Vehicles for topical agents6
Vehicles for topical agents

7 软膏 (ointment):Medicine mixed with

lipidic groundsubstance, such as vaseline、simple

ointment (vegetable oil add Beeswax )or animal

fat.

Function:softening crust, protecting and moist skin lesion.

Examples:红霉素软膏 Erythromycin Ointment


Vehicles for topical agents7
Vehicles for topical agents

8 糊剂(paste):

Ointment with 25%-50%powder.

Function: astringent

Examples:

氧化锌糊 Paste Zinc Oxide


Vehicles for topical agents8
Vehicles for topical agents

9 硬膏 (plaster)

Medicine dissolved or mixed , attached to

groundsubstance,such as cloth, paper or

pellicle with hole.

Function:protecting and moist skin lesion.

Examples: 肤疾宁硬膏


Vehicles for topical agents9
Vehicles for topical agents

10 涂膜剂(film)

Film-former of high molecular compound dissolving

organism menstruum(溶剂)or water add medicine.

Function: protecting and moist skin lesion.


Vehicles for topical agents10
Vehicles for topical agents

11 凝胶(gel)

Mixed with high molecular compound and

organism solvent.

Examples:Gel adapalane阿达帕林凝胶

过氧苯甲酰凝胶


Vehicles for topical agents11
Vehicles for topical agents

12 气雾剂(aerosol)

Medicine mixed with aerosol

,film-former of high molecular

Compound.

Examples:牛纤维细胞生长因子气雾剂


Vehicles for topical agents12
Vehicles for topical agents

13 Others

如二甲基亚砜(DMSO)可溶解多种水溶性和脂溶性药物,是皮肤渗透促进剂。



Therapeutic principle of topic agents
Therapeutic principle of topic agents

Characteristic of topic gents

Etiology and pathogenesis:

Bacteria- antiseptics

Allergic disease- glucocorticoid、antihistamine

Symptom: antipruritic agents

Pathology: hyperkeratosis-- keratolytics

parakeratosis--keratoplastics



Therapeutic principle of topic agents2
Therapeutic principle of topic agents

Acute dermatitis:

without exudation: powder or lotion

more exudation: solution

less exudation : oils or paste

Subacute dermatitis:

without exudation: emulsion orpaste

Less exudation: oils or paste

Chronic dermatitis: ointment, plaster, emulsion, film

Itaching: film, mulsion



Caution
Caution

  • Suitable consistency

  • Considering sex, age and lesion location

  • Method

  • Observation the efficacy and side-effect



Discussion 1

1、Dermatitis stage ?

2、What vehicles should be used for this

dermatitis ?


Discussion 2
Discussion 2

1、 Dermatitis stage?

2、What vehicles can be elected?


1、Dermatitis stage ?

2、What vehicles can be elected ?


Discussion 3

1、Dermatitis stage ?

2、What vehicles can be elected ?


Question

1.What is the Therapeutic principle of topic agents?How to

choice vehicles for chronic dermatitise?

2. Could we use ointment for acute dermatitise ?Why?



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