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Topic Therapy 外用药物治疗 PowerPoint PPT Presentation


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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 外用药物治疗

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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


Topic therapy

How to use them

?


Topic therapy

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.


Topic therapy

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。


Topic therapy

皮炎的分期


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 agents1

Therapeutic principle of topic agents


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


Therapeutic principle of topic agents3

Therapeutic principle of topic agents


Caution

Caution

  • Suitable consistency

  • Considering sex, age and lesion location

  • Method

  • Observation the efficacy and side-effect


Topic therapy

Summary


Topic therapy

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?


Topic therapy

1、Dermatitis stage ?

2、What vehicles can be elected ?


Topic therapy

Discussion 3

1、Dermatitis stage ?

2、What vehicles can be elected ?


Topic therapy

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?


Topic therapy

Thank You !


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