Chapter 40: Integumentary Medications

The content addresses contact dermatitis and poison ivy exposure through agents like calamine lotion, topical corticosteroids, and antihistamines, alongside non-pharmacological interventions such as oatmeal baths. Atopic dermatitis treatment incorporates both topical immunosuppressants like tacrolimus and pimecrolimus and systemic options including cyclosporine, with attention to infection risk and sun protection requirements. Topical glucocorticoids receive comprehensive coverage regarding potency classifications, systemic absorption patterns particularly in sensitive skin areas, adverse effect profiles, and appropriate application techniques. The chapter details management of actinic keratosis using fluorouracil, diclofenac, and imiquimod alongside photodynamic therapy approaches. Sunscreen education encompasses chemical and physical blocking mechanisms, sun protection factor interpretation, proper application timing, and reapplication frequency for optimal skin cancer prevention. Psoriasis treatments span topical agents including coal tar and salicylic acid derivatives, systemic therapies such as methotrexate and acitretin, and biologic immunomodulators including adalimumab, etanercept, and ustekinumab. Acne management is stratified by severity with coverage of benzoyl peroxide, topical and systemic antibiotics, retinoid therapies including tretinoin and adapalene, hormonal agents such as oral contraceptives and spironolactone, and isotretinoin with its strict iPLEDGE program requirements, teratogenicity concerns, and triglyceride monitoring protocols. Burn wound treatment incorporates silver sulfadiazine with leukopenia surveillance and mafenide acetate with metabolic acidosis assessment. Throughout the chapter, emphasis remains on nursing considerations including application techniques, systemic absorption risks, medication interactions, adverse effect recognition, and patient adherence strategies essential for licensing examination preparation.