Keratolytics: Nursing Pharmacology

Notes

KERATOLYTICS
DRUG NAME	salicylic acid (Compound W, Avosil, Betasal), pyrithione zinc (DermaZinc, Zincon), coal tar (Fototar, Medotar, Betatar), tretinoin (Retin-A), acitretin (Soriatane, Neotigason), glycolic acid, lactic acid
CLASS	Keratolytics
MECHANISM OF ACTION	Soften and shed the stratum corneum
INDICATIONS	Mild to moderate acne Seborrheic keratosis Warts Dandruff Psoriasis Skin hyperpigmentation
ROUTE(S) OF ADMINISTRATION	TOP
SIDE EFFECTS	Erythema Burning Itching Tingling Dry eyes and mouth, chapped lips, skin peeling (retinoids) Photosensitivity (retinoids and alpha-hydroxy acids)
CONTRAINDICATIONS AND CAUTIONS	Open wounds Burnt, cut, irritated or scraped skin areas Sensitive areas (e.g., near the eyes or mouth) Boxed warning (retinoids): pregnancy

NURSING CONSIDERATIONS: KERATOLYTICS
ASSESSMENT AND MONITORING	Symptom onset and duration Assess affected area Retinoids: confirm negative pregnancy test Side effects Therapeutic effect
CLIENT EDUCATION	Application Apply to affected area only; avoid mucous membranes Wear gloves Wash hands afterwards May experience effects like blistering, burning, stinging, itching, redness, dryness, peeling Avoid scratching or touching the affected area Wash their skin gently with a mild cleanser; avoid the use of harsh soaps or chemicals Retinoid or an alpha-hydroxy acid: increased risk of a sunburn Avoid sunlight as much as possible Wear protective clothing and sunscreen while outside Therapeutic effect may take two to three weeks

Sources

"Focus on Nursing Pharmacology" LWW (2019)
"Pharmacology: A patient-centered nursing process approach (8e)" Elsevier Health Sciences (2014)
"Mosby's 2021 Nursing Drug Reference (34e)" Mosby (2020)
"Goodman & Gilman's: The Pharmacological Basis of Therapeutics, 13e" McGraw-Hill Education (2018)
"Saunders Comprehensive Review for the NCLEX-RN Examination" Saunders (2019)

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