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OTC for drug disorders

WINNI NG 11

Over-the-counter (OTC) drugs

are medicines that may be sold to a customer without a prescription since these items can often be found on the shelves of stores and bought like any other packaged product in some countries in contrast to prescription drugs which are more likely to literally be passed over a counter from the pharmacist to the customer. Some medicines considered safe in general terms may be available in general stores, supermarkets, gas stations etc. The rules vary considerably from country to .country

Now we must know about skin Skin is the largest organ of your body, and your skin’s anatomy reveals a lot . of information about you to the rest of the world

Function of skin The actual thickness of skin varies throughout the body, the thinnest skin (approximately 0.5mm) is found on the eyelids, and the thickest skin .(approximately 4mm) is on the palms of your hands and the soles of your feet :Despite this lack of density, your skin protects your body in remarkable ways . Skin protects body tissues and organs against injuries The nerves in your skin receive the stimuli that tell your brain when your skin .has been touched The nerves in your skin also help your brain respond to sensations of hot and .cold Your skin helps to regulate your body’s temperature by making your pores .smaller when it’s cold, and making pores larger when it’s hot Your skin is the “armor” that helps to protect your immune system from .bacteria and disease Skin keeps your essential body fluids (blood, water and lymp ) from . evaporating Your skin protects you from the sun’s harmful ultraviolet rays. The amount of sun protection you have depends on the amount of melanin you inherited

PHARMA MAGAZINE

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Skin anatomy Your skin anatomy is composed of three layers, the epidermis, the dermis, and subcutaneous fat

Epidermis This is the top layer of skin, and it is somewhat translucent, so light can partially pass through it. There are no blood vessels in the epidermis, so this top layer gets it’s nutrients and oxygen from the deeper layers. The epidermis is attached to the next layer, the dermis, via a membrane

Dermis This is the second, deeper layer of your skin. The dermis is where your hair roots and sweat glands reside, and the dermis also contains with some blood vessels and nerves

Subcutaneous fat This is the bottom or lowest layer of your skin, and this is where your larger blood vessels and nerves reside. The subcutaneous fat layer is composed of fat-filled cells call adipose cells, and the depth of the subcutaneous fat layer is different from one person to another Subcutaneous fat is attached to your bones and muscles by connective tissue which is loose, allowing skin to move. If you have too much subcutaneous fat, the connection points of your connective tissue become more obvious. This . causes a pockmarked or rippled appearance--the dreaded cellulite

PHARMA MAGAZINE

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WARTS What are warts? Warts are non-cancerous skin growths caused by a viral infection in the top layer of the skin. Viruses that cause warts are called human papilloma virus (HPV). Warts are usually skin-colored and feel rough to the touch, but they can be dark, flat and smooth. The appearance of a wart depends on where it is growing.

How many kinds of warts are there? There are several different kinds of warts including: • • •

Common warts Foot (Plantar) warts Flat warts

Common warts usually grow on the fingers, around the nails and on the backs of the hands. They are more common where skin has been broken, for example where fingernails are bitten or hangnails picked Foot warts are usually on the soles (plantar area) of the feet and are called plantar warts. When plantar warts grow in clusters they are known as mosaic warts. Most plantar warts do not stick up above the surface like common warts because the pressure of walking flattens them and pushes them back into the skin. Like common warts, these warts may have black dots. Plantar warts have a bad reputation because they can be painful, feeling like a stone in the shoe.

Flat warts are smaller and smoother than other warts. They tend to grow in large numbers - 20 to 100 at any one time. They can occur anywhere, but in children they are most common on the face. In adults they are often found in the beard area in men and on the legs in women. Irritation from shaving probably accounts for this.

Why do some people get warts and others don't? Some people get warts depending on how often they are exposed to the virus. Wart viruses occur more easily if the skin has been damaged in some way, which explains the high frequency of warts in children who bite their nails or pick at hangnails. Some people are just more likely to catch the wart virus PHARMA MAGAZINE

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than are others, just as some people catch colds very easily. Patients with a weakened immune system also are more prone to a wart virus infection.

Do warts can be treated at home? Treat your warts with salicylic acid (Adhesive pads treated with salicylic acid A bottle of concentrated salicylic acid solution), which acts as an irritant to eat away at the build- up of the wart (collomak salicylic &lactic acid )

Luna soap

salicylic acid

keratolytic remove warts

Cover warts with a few layers of adhesive tape and keep them covered for up

to six days at a time, for as long as a month . Applying the tape after salicylic acid, moistening the wart before application, and filing the wart with an emery board between "tapings" can enhance the removal of dead skin from the wart. Duct tape, scotch tape, masking tape are all viable choices . Soak warts in hot water to soften the skin and possibily kill the papilloma virus . Using

very hot water, as hot as you can get without burning yourself, soak the wart directly for as long as possible. The water will soften the wart, which can then be worn down further by filing with an emery board . Keep warts covered, clean, and as dry as possible to limit the spread of the papilloma virus and get rid of warts faster . Wash your warts several times a day with hot

soapy water and dry them thoroughly afterwards. Use a bandaid or adhesive tape (above) to keep your warts covered. Wash your hands before and after touching any one else. Change your socks to reduce sweat build-up on plantar warts .

How do dermatologists treat warts? Dermatologists are trained to use a variety of treatments, depending on the age of the patient and the type of wart. Warts may be treated by "painting" with cantharidin in the dermatologist's office. Cantharidin causes a blister to form under the wart. The dermatologist can then clip away the dead part of the wart in the blister roof in a week or so. For adults and older children cryotherapy (freezing) is generally preferred. This treatment is not too painful and rarely results in scarring. However, repeat treatments at one to three week intervals are often necessary. Electrosurgery (burning) is another good alternative treatment. Laser treatment

PHARMA MAGAZINE

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Foot warts are difficult to treat because the bulk of the wart lies below the skin surface so laser surgery, electrosurgery, or cutting are used .

PRICKLY HEAT Also known as sweat retention syndrome or miliaria rubra, prickly heat is a common disorder of the sweat glands. It is a skin rash caused by trapped sweat under the skin.Sweat can become trapped when the narrow ducts through which sweat travels to the surface become clogged. Prickly heat tends to be more common in warmer, more humid climates. The condition usually appears on the torso and thig

Causes of prickly heat : Blocked sweat glands Prickly heat occurs when your sweat glands become blocked. If you are visiting a hot country, or find yourself in a hot environment, you may sweat more than usual. If you sweat excessively, it is easier for dead skin cells and bacteria on your skin to collect in your sweat glands. If these glands become blocked, the sweat is trapped underneath your skin, and seeps into the nearby tissue. Trapped sweat irritates your skin and causes tiny pockets of inflammation which also contain sweat. When these pockets burst and release the sweat, it causes a stinging, prickling sensation that gives the condition its name.

Cool environments PHARMA MAGAZINE

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Prickly heat is more common in hot environments, but it can sometimes occur in cooler climates as well. For example, people who have to spend prolonged periods of time in bed (usually because of an illness, or a long-term health condition) may get prickly heat, particularly on their back. This is because moisture and sweat can sometimes form when you do not move around for long periods of time.

:Symptoms of prickly heat 1- Small, fluid-filled blisters on the skin. 2- Red, irritating or itchy rash. 3- Occurs in a tropical or subtropical hot, wet environment 4- More common in fair-skinned people 5- Irritation to areas where perspiration is heavy 6- Triggers include being overweight, using soap too often and overproduction of sebum 7- Red, bumpy rash on areas of skin which are covered by clothing.

Treatment Cold water baths twice every day will also help in getting rid of prickly heat .rash Gently clean the prickly heat rash area with a mild body soap (dettol-protexbody guard ) to remove germs, sweat and dirt. After soaking in the tub, .gently pat the area dry with a clean towel Apply hydrocortisone cream to relieve itching. Gently rub the cream into to )skin until it is fully absorbed (Micort – Vioderm - Terracortil Spread a product that contains salicylic acid (such as acne treatment padsacne vera) over the bumps. This will assist in drying the rash and unclogging .the pores application of topical antiseptics like hexachlorophene(setavlon) almost .completely prevents prickly heat rashes .Calamine lotion BP and natural oatmeal based creams can be soothing )Anti-histamine creams or medications will relieve the itch (fenestil-allergex PHARMA MAGAZINE

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Try to avoid synthetic clothing like polyester and go for cotton instead. Cotton .allows heat to escape and not get trapped under the clothing

DRY SKIN PHARMA MAGAZINE

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Dry skin (also called Xerosis) is a common problem. Your skin needs moisture to stay smooth and supple, and retaining moisture becomes difficult as we .age Impaired barrier function of the stratum corneum (the outer layer of the skin) is .perhaps the most significant cause of moisture loss from the skin

Dry skin is common. It happens more often in the winter when cold air outside and heated air inside cause low humidity. Forced-air furnaces make skin even drier Simple daily routines, such as bathing and towel drying, may actually remove moisture from the skin. Modifying your bathing routine will help preserve your skin's moisture. Bathing provides the skin with moisturize temporarily, but it removes the skin's oily lipid layer and in the long run causes more moisture loss than gain .

:Dry skin may be prevented or treated by PHARMA MAGAZINE

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Step1 Drink water. Hydrating yourself is essential to beautiful younger looking skin. Step 2 While washing dishes or cleaning using harsh products,always wear gloves. Products like bleach and other chemicals can really do a number on your skin. Step3 Moisturize every morning after a shower and at night.using hot water in a bath or shower can dry your skin. be sure to use a bath oil or lotion. Before you dry gently rub some on to seal in moisture. Step4 Be sure to take your vitamins. Omega 3 is wonderful for maintaining soft supple skin.

:Some important products to be used Chamomile

-olive oil

-Lavender

Rose

-Sandalwood

-glycerol

Honey mask

-all vitamins

-dry skin

Acne Acne: is a common skin condition that occurs when the oil-secreting glands and hair follicles in the skin get clogged and cause bacteria to grow in the pores. You can get blackheads, whiteheads, and pimples as a result. Acne PHARMA MAGAZINE

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blemishes are more likely to be found on the face and neck, but can appear .on other areas like the back, chest, and upper arms

Causes:

The cause of pimples is unknown. The process by which a pimple develops is highly intricate. While we do know that a pore collapses on itself and blocks sebum (oil) from escaping, we do not fully understand why this .process takes place in one sebaceous gland versus another

Causes of adult acne and teen acne may include hormones, diet, evolutionary biology, vitamin deficiency, stress, and more. The real explanation may be a .complex mix of many of these factors Types of Acne

NON-INFLAMMATORY ACNEWhitehead: If the plugged follicle stays below the surface of

the skin, the lesion is called whitehead. They usually appear on .the skin as small, whitish bumps

black head: If the plug enlarges and pushes through the

surface of the skin, it's called blackhead. The plug's dark appearance is not due to dirt, but rather to a buildup of .melanin, the skin's dark pigment

:INFLAMMATORY ACNE

PHARMA MAGAZINE

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Papule: The mildest form of inflammatory acne is the papule, which appears on the skin as a small, firm pink bump. These can be tender to the touch, and are often considered an intermediary step between non.inflammatory and clearly inflammatory lesions Pustule: Like papules, pustules are small round lesions; unlike papules, they are clearly inflamed and contain visible pus. They may appear red at the base, with a yellowish or whitish center. Pustules do not commonly contain a great deal of bacteria; the inflammation is generally caused by chemical .irritation from sebum components such as fatty free acids

Cyst: Large and usually very painful, nodules are inflamed, pus-filled lesions lodged deep within the skin. Nodules develop when the contents of a comedo have spilled into the surrounding skin and the local immune system responds, producing pus. The most severe form of acne lesion, nodules may persist for weeks or months, their contents hardening into a deep cyst. Both nodules and cysts often leave .deep scars

You can help prevent pimples from forming by keeping your face clean and keeping your hands away from your face. Gently wash the affected area two .to three times a day, using any good soap or cleanser There are many different over-the-counter acne products available. The two most commonly used over-the-counter acne medications are Benzoyl peroxide: such as Clean & Clear Benzoyl Peroxide is an antibacterial agent that kills Acnes bacteria. It is available in cream, gel, lotion, or stick form. Before applying, wash the affected area with non medicated soap and water or with a mild cleanser and then gently pat dry with a towel. Apply enough medicine to cover the affected .areas, and rub in gently salicylic acid: Salicylic Acid is best on acne-prone and sensitive skin types. The pore-cleansing properties of salicylic acid make it a more effective comedone fighter. Salicylic acid helps stop the shedding of the skin cells lining the oil glands and also helps exfoliate the skin. Those with sensitive skin who cannot tolerate alpha hydroxy acids may find that they are able to use salicylic .acid with good results :Sulfur Sulfur works by breaking down blackheads and whiteheads. It is available in the form of Sulfur cream, lotion, ointment, and bar soap. Sulfur ointment is used to treat seborrheic dermatitis and scabies PHARMA MAGAZINE

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:Resorcinol Resorcinol fights acne by helping to remove hard, scaly, or roughened skin. It is useful for the treatment of black heads as well as white heads.

Products Acne vera

resorcinol &salicylic acid

Acne free

retinoic acid

Akneroxide

benzoylperoxide

Kapritage

sulfokonzentoal

CONTACT DERMATITIS Definition: Contact dermatitis is an inflammation of the skin caused by direct contact with an irritating substance. PHARMA MAGAZINE

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Contact dermatitis is an inflammation of the skin caused by direct contact with an irritating or allergy-causing substance (irritant or allergen). Reactions may vary in the same person over time. A history of any type of allergies increases the risk for this condition. -Irritant dermatitis: the most common type of contact dermatitis, involves inflammation resulting from contact with acids, alkaline materials such as soaps and detergents, solvents, or other chemicals. The reaction usually resembles a burn. -Allergic contact dermatitis: the second most common type of contact dermatitis, is caused by exposure to a substance or material to which you have become extra sensitive or allergic. The allergic reaction is often delayed, with the rash appearing 24-48 hours after exposure. The skin inflammation varies from mild irritation and redness to open sores, depending on the type of irritant, the body part affected, and your sensitivity. Common allergens associated with contact dermatitis include:

• •

• • • • • •

Nickel or other metals Medications o Antibiotics, especially those applied to the surface of the skin (topical) o Topical anesthetics Rubber Cosmetics Fabrics and clothing Detergents Solvents Fragrances, perfumes

Contact dermatitis may involve a reaction to a substance that you are exposed to, or use repeatedly. Although there may be no initial reaction, regular use (for example, nail polish remover, preservatives in contact lens solutions, or repeated contact with metals in earring posts and the metal backs of watches) can eventually cause sensitivity and reaction to the product. Some products cause a reaction only when they contact the skin and are exposed to sunlight (photosensitivity). These include shaving lotions, sunscreens, sulfa ointments, some perfumes, coal tar products, and oil from the skin of a lime. A few airborne allergens, such as ragweed or insecticide spray, can cause contact dermatitis. PHARMA MAGAZINE

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• • • • •

Itching of the skin in exposed areas. Skin redness or inflammation in the exposed area. Localized swelling of the skin. Warmth of the exposed area. Skin lesion or rash at the site of exposure o Lesions of any type: redness, rash, vesicles, and blisters. o May involve oozing, draining, or crusting. Treatment: Your doctor usually will treat contact dermatitis with the following:



An oral (by mouth) antihistamine to control the itch: Common



antihistamines cetirizine (Zyrtec), loratadine (Claritin -aerius) and fexofenadine (Allerfen – Telfast). A corticosteroid to relieve skin inflammation In most cases, the corticosteroid can be applied as a cream or ointment containing one of the following :

Hydrocortisone – hydrocortisone acetate – dermotar •

A moisturizer to help restore the normal texture of the skin

CALAMYL LOTION Expectations (prognosis) Contact dermatitis usually clears up without complications within 2 or 3 weeks, but may return if the substance or material that caused it cannot be identified or avoided. A change of occupation or occupational habits may be necessary if the disorder is caused by occupational exposure. Complications Secondary bacterial skin infections may occur.

Prevention Avoid contact with known allergens. Use protective gloves or other barriers if contact with substances is likely or unavoidable. Wash skin surfaces thoroughly after contact with substances. Avoid over treating skin disorders. Products Derma cure PHARMA MAGAZINE

benzoic acid & salicylic acid Page 14

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Atopic dermatitis Eczema often occurs along with allergies and frequently runs in families in which other family members have asthma or hay fever. About three out of four children who have signs and symptoms of atopic dermatitis later develop asthma or hay fever

PHARMA MAGAZINE

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Symptom Red to brownish-gray colored patches Itching, which may be severe, especially at night Small, raised bumps, which may leak fluid and crust over when scratched Thickened, cracked or scaly skin While any region of the body may be affected by eczema, in children and adults, eczema typically occurs on the face, neck, and the insides of the elbows, knees, and ankles. In infants, eczema typically occurs on the .forehead, cheeks, forearms, legs, scalp, and neck

DIAGNOSIS A doctor makes the diagnosis based on the typical pattern of the rash and often on whether other family members have allergies.

Treatment Treatments for atopic dermatitis aim to reduce inflammation , relieve itching and prevent future flare-ups. Over-the-counter (nonprescription) anti-itch creams, along with other self-care measures, may help control mild atopic . dermatitis

PREVENTION

PHARMA MAGAZINE

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Certain other measures can help. Avoiding contact with substances known to irritate the skin or foods that the person is sensitive to can prevent a rash. The skin should be kept moist, either with commercial moisturizers or with petroleum jelly or vegetable oil. Moisturizers are best applied immediately after bathing, while the skin is damp. Products Salibat

salicylic acid & beta methasone

Derma cure

benzoic acid & salicylic acid

Survey for OTC drugs for skin disorders ……… :Occupation ..……… :Your age :Please answer the following question 1-

Do you believe in otc for skin preparation?

PHARMA MAGAZINE

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OTC for drug disorders Yes

WINNI NG 11 No

?If NO……………..why

-2

Don’t trust the pharmacist Feel the doctor more trusty Don’t know ..……………………… Other ?Do you currently or have in the past lived with skin disorder -3 Yes

No

?If yes which of the following have you lived with -4 Acne

Warts ……

Contact dermatitis

Prickly heat Other

When you get skin disorder, you will go to -5 Pharmacy

Clinic

?Had you use an OTC drug and it didn’t give good result -6 Yes

PHARMA MAGAZINE

No

Page 18

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