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Keratolytics: Nursing Pharmacology

Notes

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