Introduction

1. Powder as a dosage form. Characteristics and properties

2. The use of powders in medicine

2.2 Powders in surgery

3. Other types of powders

3.1 Powder as a pediatric dosage form

3.2 Other uses of powders

Conclusion

Application

Powders are a solid dosage form for internal and external use, consisting of one or more bulk medicinal substances, homogeneous when viewed with the naked eye.

Powders can be simple and complex, dosed or undosed. The latter are prescribed only with an indication of medicinal substances and their mass.

Powders have advantages over other dosage forms. They are accurately dosed, easy to manufacture, relatively cheap, and most of them can be stored. long time. However, in the powder it is not recommended to prescribe substances that are hygroscopic and easily decomposed under the influence of light.

In the recipe for dosed powders, the mass of medicinal substances per dose is given, and then the number of doses is indicated.

Sometimes tinctures, extracts, essential oils. The physico-chemical properties of the incoming ingredients determine the techniques and methods for preparing powders.

To achieve the desired therapeutic effect powders must be crushed to a certain degree of dispersion, because what smaller size powder particles, the larger its contact surface, that is, the better absorption and bioavailability.

Powders- this is a dosage form, which is a non-dosed powder or a mixture of several powders for external use, intended for powdering the skin for medicinal, hygienic and cosmetic purposes. Powders are tiny powders therapeutic effect which depends on the degree of dispersion, and therefore they must be rubbed in the most thorough way. They usually contain talc, starch, bentonite, lycopodium, white clay and targeted drugs.

Powders are prescribed for injections, preparation of rinses, lotions and other liquids for external use.

Relevance of the topic. Powders are used in various fields of medicine and pharmacology. They are used as a pediatric dosage form, they are used in acute inflammatory conditions of the skin, with hygienic purpose with increased perspiration and sebum secretion, to protect the skin from external irritations, sometimes for better fixation of ointments and pastes on the skin. For powders, chemically indifferent vegetable and mineral powdered substances are usually used. In the composition of the powders, if necessary, substances are introduced that have pharmacological action. Various fats, special dyes, fragrances, essential oils are also added to cosmetic powders.

Powder, as a dosage form, refers to non-dosed powders for external use. Powders are one of the most ancient and at the same time the most commonly used dosage forms. More than 30% of all drugs currently manufactured and dispensed from pharmacies are powders.

A wide variety of substances are used in the form of powders: organic compounds, mineral salts, crushed parts of plants and their processed products, preparations of animal origin, etc. Powders can contain not only solid, but thick and liquid substances in quantities that do not affect their fluency.

The widespread use of powders in medical practice is associated with positive aspects them as a dosage form. Powders are easy to take, they can be accurately dosed. In the form of powders, a combination of medicinal substances of different composition and properties is possible. Powders are convenient for transportation and storage, their preparation is relatively simple. Powders are classified according to composition, dosage and medical use.

Depending on the composition, powders are distinguished simple and complex .

Plain powders contain only one of any medicinal substance.

Complex, or mixed, powders are a mixture of two or more drugs. They are released from pharmacies only after thorough grinding and mixing.

Powders may be undivided, or underdosed dispensed from a pharmacy without division into separate doses and dosed by the patient himself, and divided, or dosed containing separate single (single) doses of the drug.

According to medical use, powders are divided into powders for internal use and powders for outdoor use. Powders for internal use are prescribed mainly divided into separate doses, and for external use - not divided.

Powders for external use depending on their medical purpose in its turn subdivided into :

Powders - the smallest powders used to treat wounds and various lesions of the skin or mucous membranes;

Powders for injection used for injection into body cavities (nose, ear, nasopharynx, etc.);

Tooth powders;

Snuffs;

Powders used for the preparation by patients at home of various solutions for rinsing, lotions, washings, etc.

Undosed powders for outdoor use are very diverse. Among them, powders, powders for blowing, sniffing, powders for preparing lotions, rinses and other solutions at home, etc. are distinguished. Their weight, depending on the purpose, varies widely from 5 to 200 g.

When prescribing undosed powders, the prescription indicates the weight amount of each medicinal substance to be dispensed.

Rp.: Acidi borici subtilissimi pulverati 15.0

Hexamethylentetramini

Zinci oxydati aa. 7.5

Misce fiat pulvis

Da. signa. Powder for sweaty feet

Powders usually consist of several powdery substances - talc, starch, zinc oxide, lycopodium, tannin, etc. The quality of the powder depends on its ingredients, the size of their particles. The smaller this value, the higher the quality of the powder.

The powder applied to the skin increases the surface of its evaporation, enhances heat transfer, due to which it produces a cooling, anti-inflammatory and drying effect. Powders have integumentary properties, protect against injury by some external factors(atmospheric, mechanical, etc.).

Some powdery substances that make up powders perceive water: starch, bentonite, diatomaceous earth, others perceive oils - zinc oxide, titanium dioxide, others - oils and water - white clay.

Powders containing starch should not be applied to wet skin surfaces, as starch gelatinization will occur and dermatitis may develop from irritation with paste, and conditions for skin infection by pyococci are also created.

Powders should not be applied to weeping areas of the skin, as they will mix with the exudate. In this case, layers of crusts are formed, under which exudate can accumulate with its subsequent decomposition and exacerbation of the process.

Remove powders with a swab, dry or moistened with alcohol, gasoline, ether or water.

To enhance the cooling and anti-inflammatory effect of the powder, add 1-2% menthol to it. The addition of a certain amount of red clay, ocher, makes the color of the powder close to the color of the skin, which is of cosmetic importance and, in addition, gives it protective properties when exposed to solar radiation. Powders can serve as the basis for the inclusion of medicines in them.

Apply powders from mineral (zinc oxide, talc) and herbal preparations(starch) or mixed. Powders contain various medicines: 0.5-2% menthol, 5-10% anestezin (for itching), 2-3% salicylic and boric acid, formalin (for hyperhidrosis), for cauterization of genital warts - resorcinol. For disinfectant action in the form of powders, dermatol, iodoform, xeroform and others are used (on ulcerative surfaces). If liquid drugs are introduced into the composition of the powder, then in quantities that do not violate the flowability of the powder.

Vegetable powders should not be used on weeping rubbing surfaces (with diaper rash under the mammary glands, in the scrotum), as they quickly decompose, but it is better to use mineral powders with the addition of fat. For dry skin with cosmetic purpose apply the so-called fatty powders.

AT medical cosmetics use powders - deodorants. These include:

Powders to combat hyperhidrosis;

Powders for fungal diseases;

For drying the skin;

For the treatment of diaper rash in children.

These powders should be as small as possible so as not to cause irritation and chafing of the skin.

They include sliding, adsorbing substances: talc, starch, lycopodium with the addition of antiseptic substances. Powders to combat hyperhidrosis contain adsorbing substances, disinfectant additives (boric acid, salicylic acid, menthol, iodine, and others). They are often injected with astringents (tannin and alum), which reduce the release of sweat or exudate. Flavoring additives are also added (lavender oil, lemon oil, cloves and others). Powders are applied to clean, dried skin, without rubbing them, but lightly powdering.

2.1 Powders in the treatment of dermatosis

The main objectives of treatment skin diseases They consist in eliminating the causes and predisposing factors that caused the disease, and in raising the body's resistance. Physical Methods treatments for skin diseases are increasingly being used, complementing other methods.

Rational use of ointments

L. V. Derimedved, I. M. Pertsev, G. V. Zagoriy, S. A. Gutorov
National Pharmaceutical Academy of Ukraine

The external method of using drugs with a plastic-elastic-viscous dispersion medium (gels, creams, ointments, liniments, etc.) allows you to maximize the concentration of drugs directly in the lesion, for example, at the site of violation of the integrity of the skin, diaper rash, bedsores, burns, damaged mucous membranes, etc. The transdermal route of drug administration is considered the safest, since most of the dose is on the surface and can be easily changed by partial removal ointments.

Methods for applying ointments to the skin and mucous membranes are very diverse, which is used to optimize local or general effects on the body or individual organs and systems, and are also characterized in individual cases long duration of use (sometimes lasting 2-3 or more months).

In some cases, for example, in the treatment of mycoses, the drug is continued for another one (mycogel-CMP) or 2 weeks (clotrimazole) in excess of the period specified in the instructions.

Gels, creams and ointments proper, which are often combined under the general term "ointments", are applied to the problem area in the same way, but depending on their composition (nature active ingredient), properties drug system, purpose, as well as the location and condition of the problem area, application methods may differ, which affects their clinical effectiveness.

Distinguish the following ways applying ointments:

• regular application in the form of a thin or thicker layer;
• application in the form of several layers (in the presence of several dosage forms). For example, first a layer of gel is applied, and then a layer of ointment;
• application of the ointment after preliminary treatment of the problem area (simple hydration; treatment with surfactants, volatile solvents, hydrogen peroxide, antiseptic solutions, removal of necrotic areas, etc.);
• active rubbing of the ointment into the skin, into the area of ​​\u200b\u200bthe joints, muscles or other problem areas;
• application in the form of napkins or tampons pre-impregnated with ointment;
• in the form of an occlusive dressing;
• application followed by the use of various devices (electrophoresis) that enhance the conductivity of medicinal substances;
• application with a syringe (catheter), etc.

Regardless of the method used, the ointment should be applied whenever possible to clean (not contaminated) areas, which significantly increases its effectiveness and reduces the treatment time as a whole.

Dermatological ointments most often applied by application to the affected surface of the skin thin layer, usually with a sterile swab or plastic spatula (hydrocortisone ointment, deperzolon, karboderm-Darnitsa, clobederm, kremgen, zincundan, ultralan, etc.). The method of applying a thin layer is typical for ointments containing glucocorticosteroids, and along with other factors (the solubility of the substance, the degree of its release from the carrier, the state of the problem area) mainly determines its local action.

In order to exclude the general effect of the ointment with hormonal means do not use under an occlusive dressing, as their activity may increase by an order of magnitude or higher, and the drug may cause systemic side effects or cause local skin disorders (atrophy, striae, telangiectasia, etc.), which is highly undesirable.

The thickness of the applied layer of ointment depends on physical and chemical properties and concentration of the medicinal substance, as well as the properties of the carrier (ointment base).

Phyto-ointments containing extracts or components from medicinal plants with lower activity, as a rule, are applied in a thicker layer, for example, calendula ointment by Dr. Theiss, ointments containing vitamins A, D, etc., which accumulate mainly in upper layers epidermis, hair follicles and penetrate transfollicularly.

Penetrating ointments applied by rubbing. With phlebitis, ointments are rubbed with light massaging movements (venoruton, heparin ointment, ginkor gel, kremgen, etc.). With thrombophlebitis, the ointment is applied carefully without rubbing. Ointments apizartron, ben-gay, viprosal B, cream for rheumatism, etc. Theiss and others are carefully rubbed into the painful area (for neuralgia, myalgia, arthritis) or in the area of ​​​​the upper and middle parts chest and interscapular region of the back (for respiratory diseases).

The absorption of medicinal substances from ointments, as a rule, increases significantly if they contain “activators” of absorption, for example, dimethyl sulfoxide, hyaluronidase, etc. (acic, drapolen, iricar, calendoderm, canesten, lamisil, etc.).

Sometimes for a raise therapeutic effect, especially in hyperkeratosis, an occlusive dressing is used (Carboderm-Darnitsa, Klion, Dermovate, Clobederm, Laticort, Lokoid, Lorinden A, Fluorocort, etc.).

To soften dense tissues (dense scabs), a wet dressing (iruksol) is preliminarily used or soda-soap baths are used to steam the keratinized masses (clotrisal-KMP, mycospor kit for treating nails). However, it should be remembered that before applying ointments containing antiseptics that are destroyed in the presence of soap (drapolen, betadine, plivasept), the skin is washed, traces of soap are removed and thoroughly dried.

After applying drugs with local irritants (ungapiven, finalgon, eucalyptus balm for colds, etc. Theiss, efkamon, etc.), it is recommended to close the area with the ointment woolen cloth(warm bandage).

Ointments-balms in the treatment of infectious and inflammatory diseases of the respiratory tract, in addition to applying to the skin (in the upper and middle parts of the chest and interscapular region), are used for inhalation. For example, a strip (3–5 cm) of emulsion (eucabal balm C is mixed in 1–2 l hot water). For infants prepare baths for 10 minutes by adding 8–10 cm of this preparation to 20 liters of water at a temperature of 36–37 ° C.

Preparations such as mikanol and cygnoderm are applied to certain time(5–30 minutes), and then the remaining ointments are removed with cotton wool and the skin is washed with warm water and plenty of soap. Before each repeated application of the drug "Dermazin" remove the remnants of the cream with water or an antiseptic solution.

Depending on the etiology of the disease, the frequency of application of the same ointment can vary significantly. For example, streptonitol-Darnitsa ointment for the treatment of skin infections (pyoderma, acne) is applied 2 times a day, and for the treatment of burns - 1 time in 1-2 days.

For some drugs, the instructions give the recommended amount of ointment for application. For example, when using the Finalgon ointment, “an ointment column of no more than 0.5 cm for a palm-sized area of ​​skin” is indicated. In the sets of preparations "Finalgon", "Mycospor set for nails" there is a distributing device. To remove an excess amount of Finalgon ointment, use a cotton swab dipped in oil. Wash your hands thoroughly with soap and water after applying this ointment. If the drug gets into the eyes, the nose and mouth occurs unpleasant feeling burning. In this case, the ointment should be washed off immediately with water. People with sensitive skin should not be taken hot shower or a bath before and after using the drug.

For the treatment of scabies, the ointment is applied once a day (at night after washing) to the entire skin, excluding the face and hairy part heads. The ointment is rubbed with hands, and hands are not washed until morning. On the 4th day, the ointment is applied again. After rubbing the ointment, disinfected linen is used. On the 5th day, wash the patient, change underwear and bed linen. One rubbing consumes 30-40 g of ointment, the course of treatment consumes an average of about 60-80 g of ointment.

Ointments of resorptive action(divigel, isoket, nitro ointment) are applied in the form of certain doses. A special paper dosing scale is attached to the nitro ointment, on which a certain amount of ointment is applied in a thin layer (from 2 to 8 cm), then placed on the skin of the upper left side of the chest or forearm (where there is no hair). To improve the absorption of the ointment, a plastic film is applied on top and secured with a bandage. The effect occurs in 30-40 minutes and usually lasts more than 7 hours.

Ointment "Izoket" (the initial dose is 1 g - 2 single doses) is applied to the chest area, inner surface forearms or on the abdomen in the evening before going to bed and rubbed. The minimum surface area for applying the ointment should be 20x20 cm. If the effect is insufficient, the drug can be used in the morning (clothing is put on a few minutes after application). The daily dose (0.5–1.5 mg) of the Divigel gel is rubbed into the skin of the lower part of the anterior abdominal wall or applied to the inner thighs, alternating the right and left side on an area the size of 1-2 palms. After rubbing, the skin should dry out within a few minutes. The course of treatment can be cyclic (28 days) or continuous (up to 3 months).

Ear ointments for otitis externa (locacorten, sofradex, etc.) are applied in a thin layer, and Tolmitsen cream is lightly rubbed into the affected surface. Before using pimafucin (with otomycosis), the external auditory canal is pre-cleaned, and after applying the cream, a cotton swab is placed in the auditory canal.

Ointments and gels for the nose applied to the mucous membrane (having previously cleaned the nasal cavity) with a small cotton swab, and then moderately squeeze the wings of the nose (for even distribution throughout the mucous membrane). Gel "Vibrocil" has a special tip for the introduction of the drug as deep as possible into the nasal cavity. And the drugs "Xylometazoline" and "Galazolin" are instilled directly from the tube.

Dental ointments with local anesthetics (dentol 7.5% benzocaine, dentol 10% benzocaine, international camistad-gel) are applied to the gums and rubbed lightly. Ointments with antiseptic agents (kliostomy, metrogil denta) are applied after brushing the teeth with a swab or soft toothbrush on the gums and between the teeth. After applying the ointment to the surface for 15 minutes, you can not rinse your mouth and eat. Solcoseryl dental adhesive paste is applied in a thin even layer to the affected area, dried with a cotton or gauze swab, and then slightly moisten the site of application of the drug.

Eye ointments and gels carefully lay a pea-sized amount with a special glass spatula (previously boiled), pulling back the lower eyelid, inner corner eyes. The eye is closed, a cotton swab is applied, the closed eyelids are lightly massaged so that the ointment is evenly distributed over the eyeball. If the drug is placed in a tube with a special tip (Actovegin eye gel, Solcoseryl eye gel, etc.), then it is used by squeezing out of the tube, evenly distributing it over lower eyelid and then lightly massage closed eyelids.

Ointments containing non-steroidal anti-inflammatory substances- diclak gel, longevity, dolobene, mobilizik, etc., can be applied by electrophoresis, applying under the cathode.

Protective pastes (furatsilin, etc.) are used to prevent occupational skin diseases when working in aggressive environments. The preparations are applied before starting work on cleanly washed hands in the amount necessary to form a thin film, and evenly distributed over the surface of the hands. After the applied layer has dried, work begins. At the end of the work, the drug is washed off with cold water.

Cosmetic ointments used mainly by applying a thin layer of the drug to the skin. So, for example, Talita therapeutic and cosmetic cream is applied, removing the remains of the cream with a napkin after 20 minutes. To achieve the effect, the cream should be applied once every 7-10 days to cleansed and steamed skin.

In the treatment of acne vulgaris, the drug (airol, retin-A) is applied to the washed dry skin surface with a very thin layer once a day, after 6 hours it is washed off with running water. For persons with light and dry skin, the exposure time at the beginning of treatment is 30 minutes, then it is gradually increased. Completely softened comedones and pustules can be carefully removed. AT preventive purposes apply once a week (after a warm bath).

Ointments for the treatment of wounds have their own application features, which consist in the need to take into account the phases of the course of the wound process, since it takes place in several clearly alternating stages (phases), each of which has its own clinical picture and requires a different approach to treatment.

Ointments for the treatment of a complicated infected wound are, as a rule, multicomponent compositions created on hydrophilic polymer bases, each of which contains properties that best correspond to a certain phase of the wound process.

Because of this, ointments for the treatment of the first phase have various influences on the wound process, antimicrobial, anti-inflammatory, analgesic, dehydrating and necrotic, absorb exudate, thereby contributing to the speedy cleansing of the wound.

In the 2nd phase of the wound process, ointment compositions have a weaker ability to suppress the microflora, but contribute to the formation and growth of granulations. At this stage, ointments with strong osmotic properties are not used: levosin, levomekol, iodopyrone ointment, oflokain-Darnitsa, nitatsid-Darnitsa, etc.

On the pharmaceutical market available a wide range of surgical ointments that can be successfully applied in full logical sequence in the treatment of wounds, taking into account the clinical characteristics of the development of the wound process (table).

Local treatment of infected wounds

The phase of the wound process and its characteristics	medicinal product	Main pharmacological action
1 phase a) alteration stage b) stage of exudation The wound is characterized by the presence of necrotic tissue and purulent discharge. The edges of the wound are swollen and infiltrated. Characteristic high level bacterial contamination, increased osmotic pressure in the tissues surrounding the wound.	levosin; metrocaine	antimicrobial, anti-inflammatory, analgesic, dehydrating, osmotic
	oflokain-Darnitsa	antimicrobial, analgesic, osmotic, anti-inflammatory
	levomekol	antimicrobial, dehydrating, osmotic
	nitatsid-Darnitsa	antimicrobial, anti-inflammatory, osmotic
	Miramistin-Darnitsa	antimicrobial, osmotic
	iodopyrone ointment; argosulfan; dermazin	antimicrobial, osmotic
	iruksol	lyses necrotic tissue
Phase 2 - the phase of regeneration, formation and maturation of granulation tissue. The wound is mostly clear of purulent-necrotic contents, and purulent exudation can only be preserved in places.	betadine; Miramistin-Darnitsa	antimicrobial, osmotic
	methyluracil-Darnitsa	reparative, antimicrobial
	methyluracil ointment	reparative
	oxycort	antimicrobial, anti-inflammatory, antipruritic, antiallergic
	hyoxysone	antimicrobial, anti-inflammatory, antipruritic, antiexudative, antiallergic
	streptonitol-Darnitsa	antimicrobial, moderate osmotic, anti-inflammatory
	pantestin-Darnitsa	antimicrobial, promotes wound epithelialization
	Kalanchoe ointment	reparative, antimicrobial, analgesic
	calendula	reparative, antimicrobial
	armon	reparative, analgesic, anti-inflammatory
	wundahil; balm "Rescuer"	reparative, anti-inflammatory
	exalb	anti-inflammatory, reparative
3 phase - phase of epithelialization	pantestin-Darnitsa; bepanthen plus	promotes wound epithelialization, antimicrobial
	actovegin, bepanthen, solcoseryl	promotes epithelialization of the wound

Before applying the ointment in the 1st phase of the wound process, pus and necrotic masses are removed from the damaged surface with tweezers or a swab and the wound is washed with an antiseptic solution (furacilin 1:5000, chlorhexidine digluconate 0.05%, etc.). Then apply a thin layer of ointment with prolonged action (in order to reduce the number of dressings), and apply a sterile gauze bandage. More often, a gauze swab is impregnated with ointment, which is applied to the wound. This is how ointments are used: miramistin-Darnitsa, nitacid, oflokain-Darnitsa, streptonitol-Darnitsa, etc. If the dressing with ointment dries to the wound surface before removal, it is recommended to soak it with an antiseptic solution (furacilin, hydrogen peroxide) in order to avoid traumatization of the surface epithelium and bleeding of the wound .

Ointments "Levosin", "Levomekol" are applied to the wound surface in the form of applications of napkins, on which a layer of the preparation of 2–3 mm is applied, or the wound cavity is filled with swabs soaked in ointment. It is possible to administer the drug (warmed up to 35–36 ° C) into the wound passage or fistula using a syringe or catheter. These drugs are effective for radiation skin lesions.

Success local treatment burns also depends on the correct choice of drugs. They should effectively influence the inflammatory response and respond to the stages of development of the wound process. Therapeutic efficacy and a noticeable reduction in the duration of treatment can only be observed with the correct treatment regimen using various formulations in the form of gels, creams or ointments containing the active substance in various concentrations. For example, in the case of using Actovegin gel in the first 4 days after the burn (exudation stage), a 20% gel is used, which reduces pain syndrome, promotes cleansing of the wound surface. Then, in the phase of cleansing the wound from necrotic tissues and the growth of granulations (from 4 to 10–11 days), 5% Actovegina cream is used and at the final stage of treatment - the epithelization phase - 5% Actovegin ointment, which contributes to the final recovery normal functions of affected tissue areas. Gel "Actovegin" for burns, radiation injuries is applied in a thin layer, for ulcers - in a thicker layer, followed by the application of a layer of ointment, which acts as a compress and prevents the dressing from sticking to the wound surface.

For resorption of keloid scars, the Kontratubex gel is lightly rubbed into the scar tissue until completely absorbed, several times a day. With coarsened old scars, the drug is left under the bandage for the night. Taking into account the condition of the problem area of ​​the skin, various dosage forms of Bepanten are also used. The cream is used for wet burn, wound areas, and the ointment is for dry skin.

Depending on the site of application and the structural features of the skin, the same preparation can also be used in various dosage forms. So, the drug "Bactroban" for application to the nasal mucosa is used in the form of an ointment, and in dermatology - ointment and cream. Dalacin for the treatment of acne vulgaris is produced in the form of a gel, and vaginal - in the form of a cream. Mycospor for application to the hair is used in the form of a gel, on the skin - in the form of a cream, on nail plates- in the form of an ointment. Solcoseryl is produced in the form of an eye gel, dental adhesive paste, and for application to the skin - in the form of a gel, ointment and cream.

Rectal and vaginal ointments administered using a tampon pre-impregnated with the drug (heparin ointment, Kalanchoe ointment, oxycort, etc.).

Many drugs, especially imported ones, have an applicator in their kit (antihemorrhoids, gyno-pevaril, proctosedil, etc.). Preparations "Dalacin vaginal cream", "Norgalax", "Prepidil" and others are administered in doses. For example, 3 g of Prepidil gel (the entire contents of the syringe), using the supplied catheter, is injected into cervical canal below the level of the internal os. In the treatment of external lesions - areas are lubricated with a thin layer. Sometimes, for example, heparin ointment (for hemorrhoids) is applied to a calico pad and applied to the strangulated nodes.

During catheterization and drainage Bladder, cystoscopy and other urological procedures for anesthesia, 7-10 ml of xylocaine jelly is preliminarily injected.

Thus, ointments, depending on the composition and purpose, are used in different ways and their effectiveness depends on correct application. The mode, duration and peculiarity of the application of the ointment depend on the physicochemical properties of the substance and carrier, the state of the surface on which they are applied, as well as the nature of the disease and other factors. Before using the ointment, you should carefully read the recommendations set out in the instructions or other special information.

Literature

1. Compendium 2000/2001 - drugs / Ed. V. N. Kovalenko, A. P. Viktorova.- K: MORION, 2000.- 1456 p.
2. Mashkovsky M.D. Medicines: A guide for doctors. In two volumes. Ed. 13th.- Kharkov: Torsing, 1997.- T. 1.- 560 p.; T. 2. - 592 p.
3. Pertsev I. M., Zupanets I. A. Biological pharmacy - modern theory optimal production and use of medicines // Clinical Pharmacy. - 1999. - V. 3, No. 2. - P. 128–132.
4. RLS - Encyclopedia of drugs / Ch. editor Yu. F. Krylov. Publishing house 8.- M: RLS, 2001.- 1503 p.
5. Theory and practice of local treatment of purulent wounds (problems of drug therapy) / Ed. prof. B. M. Datsenko.- K: Health, 1995.- 384 p.
6. Pharmaceutical and biomedical aspects of drugs. In 2 volumes / Pertsev I. M., Zupanets I. A., Shevchenko L. D. and others - X: UkrFA Publishing House, 1999.- T. 1.- 464 p.

Powder application

Equipment: gloves, powder, water container, sterile wipes.

I. Preparation for the procedure

1. Ask the patient if they need to be fenced off during the procedure.
2. Wash your hands, put on gloves.
3. Read the name of the drug (as a rule, powder for powder is packaged in containers with pinholes).

Rice. 9.12.

II. Performing a procedure

1. Carefully wash and dry with a gauze cloth with blotting movements the area to which the drug will be applied.
2. Turn the powder container upside down and apply the powder evenly to the desired surface (“powder” the skin) with shaking movements.

III. End of procedure

1. Remove gloves, wash hands.
2. Remove screen.

Unction

Equipment: gloves, ointment, device for erasing ointment.

I. Preparation for the procedure

1. Clarify the patient's awareness of the drug, the course of the procedure and consent.
2. Ask the patient if he needs to be fenced off for the duration of the procedure (if he is not alone in the ward).
3. Help the patient to take a comfortable (necessary) position.
4. Wash the hands.
5. Examine the skin area for rubbing the ointment.

Rice. 9.13.

II. Performing a procedure

1. Apply the correct amount of ointment to special device; in its absence, rub the ointment only with gloves.

Remember! Do not rub the ointment on the patient with bare hands, it is not safe for your health.

1. Rub the ointment lightly in a circular motion on a doctor-specified area of ​​the body until the ointment disappears (in some cases, there are precise instructions on when to stop rubbing).
2. Cover the patient warmly if instructed to do so.

III. End of procedure

1. Make sure that the patient does not experience discomfort after the procedure.
2. Remove gloves, wash hands.
3. Remove screen.
4. Make a record of the procedure and the patient's response to it in the "Medical Record".

If the ointment does not have a strong irritant on the skin, the patient can independently rub the ointment with fingertips. Finger movements should be light, rotational. When teaching the patient how to perform this procedure, he should be warned about the need to wash his hands before and after rubbing the ointment.

Applying ointment to the skin

Equipment: sterile spatula (spatula), medicine.

I. Preparation for the procedure

1. Clarify the patient's awareness of the drug, the course of the procedure and consent.
2. Wash the hands.
3. Read the name of the drug.

Rice. 9.14.

II. Performing a procedure

1. Squeeze out of the tube onto a glass spatula (or take with a sterile spatula from a large container) the amount of ointment needed for the patient. Close the tube (vial).
2. Apply the ointment in a thin layer on the skin using a glass spatula (spatula) (do not do this with your hands).
3. Warn the patient that clothing should not be worn on the part of the body with the ointment applied earlier than after 10-15 minutes.

III. End of procedure

1. Ask the patient if he or she is uncomfortable with the procedure.
2. Wash the hands.
3. Examine the skin, make sure that the ointment is absorbed.
4. Help the patient get dressed (if necessary).
5. Make a record of the procedure and the patient's response to it in the "Medical Record".

In surgical practice, dressings with various ointments are quite widely used.

Applying an ointment bandage to damaged skin

Equipment: gloves, sterile spatula, dressing material, tray, scissors.

I. Preparation for the procedure

1. Clarify the patient's awareness of the drug, the course of the procedure and consent.
2. Help the patient to take a comfortable position for the procedure.
3. Wash your hands, put on gloves.
4. Read the name of the ointment.

Rice. 9.15. Bandage with ointment

II. Performing a procedure

1. Apply to a napkin required amount ointment with a sterile spatula.
2. Place a napkin with ointment on the patient's skin (a small layer of cotton wool can be placed on top of a napkin with a strong smell or soiling clothes).
3. Fix the napkin with ointment (and cotton wool) with a bandage (gauze or tubular).

III. End of procedure

1. Ask the patient if he feels any discomfort due to the applied bandage.
2. Remove gloves, wash hands.
3. Warn the patient about how long he should wear a bandage.
4. Make a record of the procedure and the patient's response to it in the "Medical Record".

Remember!

When using the drug on the skin, you must:

examine the place of application of the medicine, make sure that there is no hyperemia, rash, swelling;

handle warm water or skin antiseptic;

dry the skin with a towel or gauze.

Powder application Target: healing process.

Indications: doctor's appointment.

Contraindications: individual intolerance to the powder, skin irritation, damage to the skin.

Equipment: gloves, powder, sterile wipes, water (37-38 ° C), tray, screen, container with disinfectant.

Sequencing:

Treat and dry the skin with blotting movements with napkins.

Apply the powder (“powder”) to the skin with evenly shaking movements.

Application of the plaster

Target: healing process.

Indications: doctor's appointment.

Contraindications: individual intolerance to the drug, skin irritation, damage to the skin.

Equipment: gloves, plaster, napkins, water (37-38 ° C), tray, screen, container with disinfectant.

Sequencing:

Prepare everything you need to perform the manipulation.

Inform the patient about the course of manipulation and about the drug. Obtain patient consent.

Shield the patient with a screen. Help the patient to get into a comfortable position.

Wash hands, put on gloves.

Treat and dry the skin with a napkin or towel (gently shave, if necessary, the area where the patch will be applied).

Open the patch package.

Take off protective layer without touching the inner surface with your hands.

Apply the patch to the prepared skin and press lightly, leaving no air bubbles (the size of the patch containing the medicinal substance should correspond to the area of ​​the lesion).

Remove gloves and discard in waste tray.

Provide a comfortable environment for the patient.

Put on gloves, disinfect the waste material. Remove gloves and sanitize hands.

Make a note of the assignment.

Application of ointment

Target: healing process.

Indications: doctor's appointment.

Contraindications: individual intolerance to the drug.

Equipment: gloves, ointment, sterile applicator, scissors, bandage or adhesive plaster, water (37-38 ° C), antiseptic solution for skin treatment (if necessary), tray, screen, container with des. solution, sterile: napkins, spatula, dressings, gloves.

Sequencing:

Rubbing the ointment into the skin

Inform the patient about the course of manipulation and about the drug. Obtain patient consent.

Shield the patient with a screen. Help the patient to get into a comfortable position.

Wash hands, put on gloves.

Treat and dry the skin with a napkin or towel.

Apply ointment from the tube to the applicator; in its absence, rub the ointment only with gloves.

Do not rub the ointment to the patient with unprotected hands - this is unsafe for your health!

Rub the ointment in with light swirling movements for 3-4 minutes until completely absorbed, in some cases there are precise instructions on when to stop rubbing (provide heat if indicated in the instructions for use of the ointment).

Applicator in waste tray.

Remove gloves and discard in waste tray.

Provide a comfortable environment for the patient.

Put on gloves, disinfect the waste material. Remove gloves and sanitize hands.

Make a note of the assignment.

Applying ointment to the skin

Carefully study the instructions for use of the ointment. Prepare everything you need to perform the manipulation.

Inform the patient about the course of manipulation and about the drug. Obtain patient consent.

If necessary, isolate the patient with a screen. Help the patient to get into a comfortable position.

Wash hands, put on gloves.

Examine the area of ​​​​skin to apply the ointment.

Squeeze the right amount of ointment from the tube onto the applicator.

Apply a thin layer of ointment to the skin and leave the skin open for 10-15 minutes until completely absorbed.

Remove gloves, discard in waste material container.

Treat hands.

After 10-15 min. examine the skin, make sure that the ointment is absorbed.

Make a note in the documentation about the assignment.

APPLICATION OF MEDICINES ON THE SKIN

Powder application (Fig. 9-12)

Equipment: gloves, powder, a container of water, sterile wipes.

I. Preparation for the procedure

Rice. 9-12. Powder application

II. Performing a procedure

5. Carefully wash and dry the area where the drug will be applied with a gauze cloth with blotting movements.

6. Turn the container with the powder upside down and apply the powder evenly on the desired surface (“powder” the skin) with shaking movements.

III. End of procedure

7. Remove gloves, wash hands.

8. Remove the screen.

9. Make a record of the procedure and the patient's response to it in the medical record.

Rubbing the ointment (Fig. 9-13)

Equipment: gloves, ointment, device for rubbing ointment.

I. Preparation for the procedure

1. Clarify the patient's awareness of the drug, the course of the procedure, obtain his consent.

2. Ask the patient if he needs to be fenced off for the duration of the procedure (if he is not alone in the ward).

3. Help the patient to take a comfortable (desired) position.

4. Wash your hands.

5. Examine the skin area for rubbing the ointment.

II. Performing a procedure

7. Apply the right amount of ointment to a special device; in its absence, rub the ointment only with gloves.

Attention! Do not rub the ointment to the patient with unprotected hands - this is unsafe for your health.

8. Rub the ointment in light circular motions on the area of ​​the body determined by the doctor until the ointment disappears (in some cases there are precise instructions on when to stop rubbing).

9. Warmly cover the patient if required by the instruction.

III. End of procedure

10. Make sure that the patient does not experience discomfort after the procedure.

Rice. 9-13. Unction:

a - applying the ointment to a special device for rubbing it; b - rubbing the ointment; c - position of the patient after the procedure; g - independent rubbing of the ointment with light circular movements

11. Remove gloves, wash hands.

12. Remove the screen.

13. Make a record of the procedure and the patient's response to it in the medical record.

If the ointment does not have a strong irritant effect on the skin, the patient can independently rub it with fingertips. Finger movements should be light rotational. When teaching the patient how to perform this procedure, he should be warned about the need to wash his hands before and after rubbing the ointment.

Applying the ointment to the skin (Fig. 9-14)

Equipment: sterile spatula (spatula), medicine.

I. Preparation for the procedure

1. Clarify the patient's awareness of the drug, the course of the procedure, obtain his consent.

II. Performing a procedure

Rice. 9-14. Applying ointment to the skin:

a - squeezing ointment from a tube onto a glass spatula; b - applying ointment to the skin; c - view after applying the ointment

5. Squeeze out the right amount of ointment from the tube onto a glass spatula (or take a sterile spatula from a large container). Close the tube (vial).

6. Apply the ointment in a thin layer on the skin using a glass spatula (spatula) (do not do this with your hands).

7. Warn the patient that you should not put on clothes on the part of the body with the applied ointment earlier than after 10-15 minutes.

III. End of procedure

8. Ask the patient if he feels any discomfort in connection with the procedure.

9. Wash your hands.

10. Examine the skin, make sure that the ointment is absorbed.

11. Help the patient get dressed (if necessary).

12. Make a record of the procedure and the patient's response to it in the medical record.

In surgical practice, dressings with various ointments are quite widely used.

Applying an ointment dressing to damaged skin (Fig. 9-15)

Equipment: gloves, sterile spatula, dressing material, tray, scissors. I. Preparation for the procedure

1. Clarify the patient's awareness of the drug, the course of the procedure, obtain his consent.

Rice. 9-15. Bandage with ointment:

a - equipment for the procedure; b - applying ointment on a napkin; c - applying a napkin with ointment to the patient's skin; d - fixing the napkin with a bandage

2. Help the patient to take a comfortable position for the procedure.

3. Wash your hands, put on gloves.

II. Performing a procedure

5. Apply the required amount of ointment to the napkin with a sterile spatula.

6. Put a napkin with ointment on the patient's skin (a small layer of cotton wool can be placed on top of a napkin with a strong-smelling or staining clothes ointment).

7. Fix the napkin with ointment (and cotton wool) with a bandage (gauze or tubular).

III. End of procedure

8. Ask the patient if he is experiencing any discomfort due to the applied bandage.

9. Remove gloves, wash hands.

10. Warn the patient about how long he should wear a bandage.

11. Make a record of the procedure and the patient's response to it in the medical record.

INHALATION ROUTE

The introduction of drugs into the body by inhalation is called inhalation. The drug is in a vial in the form of an aerosol. With the help of inhalation, drugs are administered through the mouth or nose.

Nurse should teach the patient this procedure, since he usually performs it himself.