TRIAMCINOLONE ACETONIDE

Indications eczematous inflammation in otitis externa

With antibacterial
Tri-Adcortyl Oticc (Squibb)AU
Ear ointment, triamcinolone acetonide 0.1%, gramicidin
0.025%, neomycin 0.25% (as sulphate), nystatin
100 000 units/g in Plastibasec. Net price 10 g = £1.58
Dose ear, ADULT and CHILD over 1 year, apply 2–3 times daily

Nasal staphylococci
Elimination of organisms such as staphylococci from the
nasal vestibule can be achieved by the use of a cream
containing chlorhexidine and neomycin (Naseptinc),
but re-colonisation frequently occurs. Coagulase-positive
staphylococci are present in the noses of 40% of the
population.
A nasal ointment containing mupirocin is also available;
it should probably be held in reserve for resistant
cases. In hospital or in care establishments, mupirocin
nasal ointment should be reserved for the eradication
(in both patients and staff) of nasal carriage of meticillinresistant
Staphylococcus aureus (MRSA). The ointment
should be applied 3 times daily for 5 days and a sample
taken 2 days after treatment to confirm eradication. The
course may be repeated if the sample is positive (and the
throat is not colonised). To avoid the development of
resistance, the treatment course should not exceed 7
days and the course should not be repeated on more
than one occasion. If the MRSA strain is mupirocinresistant
or does not respond after 2 courses, consider
alternative products such as chlorhexidine and neomycin
cream.

Naseptinc (Alliance)A
Cream, chlorhexidine hydrochloride 0.1%, neomycin
sulphate 0.5%, net price 15 g = £1.58
Excipients include arachis (peanut) oil, cetostearyl alcohol
Dose for eradication of nasal carriage of staphylococci, apply to
nostrils 4 times daily for 10 days; for preventing nasal carriage of
staphylococci apply to nostrils twice daily
Afecciones de la piel:
 Vehículo:
Both vehicle and active ingredients are important in the
treatment of skin conditions; the vehicle alone may have
more than a mere placebo effect. The vehicle affects the
degree of hydration of the skin, has a mild anti-inflammatory
effect, and aids the penetration of active drug.

Creams are emulsions of oil and water and are generally

well absorbed into the skin. They may contain an antimicrobial
preservative unless the active ingredient or
basis is intrinsically bactericidal and fungicidal. Generally,
creams are cosmetically more acceptable than
ointments because they are less greasy and easier to
apply

Gels consist of active ingredients in suitable hydrophilic

or hydrophobic bases; they generally have a high water
content. Gels are particularly suitable for application to
the face and scalp

Ointments are greasy preparations which are normally

anhydrous and insoluble in water, and are more occlusive
than creams. They are particularly suitable for
chronic, dry lesions. The most commonly used ointment
bases consist of soft paraffin or a combination of soft,
liquid and hard paraffin. Some ointment bases have both
hydrophilic and lipophilic properties; they may have
occlusive properties on the skin surface, encourage
hydration, and also be miscible with water; they often
have a mild anti-inflammatory effect. Water-soluble ointments
contain macrogols which are freely soluble in
water and are therefore readily washed off; they have
a limited but useful role where ready removal is desirable.

Pastes are stiff preparations containing a high proportion

of finely powdered solids such as zinc oxide and
starch suspended in an ointment. They are used for
circumscribed lesions such as those which occur in
lichen simplex, chronic eczema, or psoriasis. They are
less occlusive than ointments and can be used to protect
inflamed, lichenified, or excoriated skin.

Excipients in topical products rarely cause problems. If a

patch test indicates allergy to an excipient, products
containing the substance should be avoided (see also
Anaphylaxis, p. 173). The following excipients in topical
preparations are rarely associated with sensitisation; the
presence of these excipients is indicated in the entries
for topical products. See also Excipients under General
Guidance, p. 2.

Ointments may exacerbate acne and

folliculitis. Some ingredients rarely cause sensitisation
(section 13.1.3) and this should be suspected if an
eczematous reaction occurs.

Urea is a hydrating agent used in the treatment of dry,

scaling conditions (including ichthyosis) and may be
useful in elderly patients. It is occasionally used with
other topical agents such as corticosteroids to enhance
penetration of the skin.

Preparaciones barrera:
Las preparaciones barrera a menudo contienen sustancias hidrófobas tales como la
dimeticona (dimeticona) u otras siliconas. Se utilizan en la piel alrededor de estomas,
escaras, y áreas de presión en los ancianos donde la piel está intacta. Cuando la piel
se ha roto, las preparaciones barrera tienen un papel limitado en la piel. No son
sustitutivos de una atención de enfermería adecuada y es dudoso que sean más
eficaces que los Ungüentos de zinc.

Erupción del pañal: Las cremas de barrera y los ungüentos se utilizan para protección
contra la erupción del pañal, que suele ser una dermatitis. La primera línea de
tratamiento es asegurar que los pañales se cambian con frecuencia y se eviten los
pantalones a prueba de agua. La erupción puede exponer al aire y puede ser útil una
preparación de barrera
Si la erupción se asocia con una infección por hongos, una crema antifúngica como la
crema de clotrimazol (sección13.10.2) es útil. Un corticosteroide suave como la
hidrocortisona 1% es útil en la inflamación moderada a grave, pero debe evitarse en
neonatos. La preparación barrera se aplica después de la preparación de
corticosteroides
Para evitar mayores daños. La hidrocortisona puede ser
Utilizado en combinación con antifúngicos y antibacterianos
(Sección 13.4) si hay una inflamación considerable,
Erosión e infección. Preparaciones que contengan
La hidrocortisona no debe ser más de un
semana; La hidrocortisona debe interrumpirse
Tan pronto como la inflamación disminuye. El efecto oclusivo
De pañales y pantalones a prueba de agua puede aumentar la absorción

Zinc Cream, BP (Formulario Nacional Británico)

Crema de óxido de zinc
Oxide de zinc 32%
Aceite de arachis (maní) 32%,
Hidróxido de calcio 0.045%,
Ácido oleico 0.5%,
Grasa de lana 8%,
Agua purificada c.s.p 100%

For nappy and urinary rash and eczematous conditions