Persediaan Acne &

Kelimumur
PDMA 1207/2
 OBJEKT
IF
1. Memberi definisi persediaan akne
dan anti-kelimumur.
2. Menyatakan tujuan/ indikasi ubat.
3. Menyatakan dos dan contoh ubat.
4. Menyatakan kaedah pemberian
ubat.
1. Menyatakan tindakan ubat.
2. Menerangkan kesan sampingan
dan kontraindikasi ubat.
3. Memberikan nasihat spesifik
dalam pengambilan ubat.
Persediaan
Anti-Acne
 Acne vulgaris (Jerawat)

• Skin disease caused by

changes in the pilosebaceous
units (hair follicles &
sebaceous glands).
• Acne lesions are commonly
referred to as pimples.
 Persediaan Acne

• Ubat yang digunakan

bagi merawat dan
memulihkan acne.
 Persediaan Acne
• Terdapat 2 jenis terapi
acne:
• Terapi Topikal Acne
• Terapi Sistemik Acne
Terapi Topikal
Acne
 Jenis Persediaan
Topikal Acne
– Benzoyl compound
– Retinoic acid
– Sulphur
– Astringents
– Antiseptics
– Topical Antibiotics
 Benzoyl compound

• Benzoyl Peroxide 5% Gel

(Panoxyl)
1. Benzoyl Peroxide 5% Gel
(Panoxyl)
Category: B

Indication
• Acne vulgaris
 Tindakan

• Act as a bactericidal in acne

treatment.
• This drug introduces oxygen
into skin pores & reduces
acne bacteria (anaerobe
bacteria).
 Dose

• Apply 1-2 times daily to clean

skin
 Kesan sampingan
• Skin irritation
• Burning & Stinging
• Peeling of skin
• Allergic
• Dermatitis
• Edema
 Contraindication

• Allergic to Benzoyl
compound.
 Cautious

• Elakkan terkena mata, mulut

& membran mukus.
• Boleh melunturkan warna
pakaian.
 Interaction
• Not found
 Retinoic Acids

• Tretinoin 0.05%-0.1% cream

(Retin-A cream)
• Tretinoin 0.01% Gel (Retin-A
gel)
1. Tretinoin 0.05%-0.1% cream
(Retin-A cream)
Category: A

2. Tretinoin 0.01% Gel

(Retin-A gel)
Category: A
 Indication
• Acne vulgaris
 Dose
• Apply thinly to the affected
area once/twice daily
• Avoid exposure to sun.
• Duration of treatment: 8-12
weeks.
 Kesan sampingan
• Pruritis
• Rash
• Kulit Mengelupas
• Kulit kering
• Skin infection
 Contraindication

• Allergic to retinoic acids

• Dermatitis
 Cautious
• Liver disease
• Eczema
• Sunburn
• Pregnancy
• Lactation
• Avoid (eyes, nose, mouth &
mucous membrane)
Interaction
• Not found
 Sulphur

• Sulphur 2% &
salicyclic acid 2%
cream
1. Sulphur 2% & salicyclic
acid 2% cream
Category: C

Indication
• Acne vulgaris
 Dose

• Apply cream sparingly to

the affected area once daily
or alternate days (setiap
hari / selang sehari)
• Then once/ twice a week
 Kesan sampingan
• Local irritation
• Dermatitis
 Contraindication
• Allergic to sulphur
• Diabetes
• Peads < 2 yr

Cautious
• Elakkan terkena mata, mulut
& membran mukus.
 Interaction
• Bahan merkuri (mercury)
– Menghasilkan hydrogen
sulphide (berbau hangit &
may stain the skin black)
 Astringents
• Calamine with 2-6%
precipitated sulphur lotion
 1. Calamine with 2-6%
precipitated sulphur lotion

Category: C
 Indication
• Untuk mengeringkan
discajdan lelehan lepuh dan
abses jerawat
• Untuk merawat pruritic ringan
(panas matahari, ekzema,
ruam)
 Tindakan

• Is a mixture of zinc oxide and

iron (III) oxide.
• Tindakan:
– Mengurangkan lelehan &
rembesan.
 Dose
• Apply to the skin 1-3
times/day & allow to dry.
 Kesan sampingan
• Local irritation
• Rashes

Contraindication
• Allergic to
calamine lotion
 Cautious
• Elakkan terkena mata &
membran mukus.
• Peads < 2 yr

Interaction
• Not found
 Antiseptics
• Povidone Iodine
• Chlorhexidine Gluconate 5%
solution (Hibitane)
 1. Povidone Iodine
Category: B

Indication
• Skin disinfectant
2. Chlorhexidine Gluconate
5% solution
(Hibitane)
Category: C

Indication
• Skin disinfectant
 Dose

• Apply to the affected area

once/ twice daily.
 Kesan sampingan
• Local irritation
• Rashes
• Edema (local)

Contraindication
• Allergic to drugs
 Cautious
• Elakkan terkena mata
• Lactation (povidone)

Interaction
• Not found
Topical Antibiotics

1. Tetracycline
(Achromycin)
Category: B
2. Erythromycin Stearate/
Ethyl succinate
(Erythrocin/ EES)
Category: B

3. Clindamycin (Cleocin)
Category: A*
 Tindakan

• Bacteriostatic/ Bactericidal
 Indication
• Acne vulgaris

Dose
• Apply cream to the affected
area once/ twice daily.
Kesan sampingan

• Local irritation
• Dermatitis
• Rash
 Contraindication
• Allergic to drugs
• Pregnancy
• Lactation
• Child < 9 yr (tetracycline)
 Cautious
• Renal/ Hepatic dysfunction

Interaction
• Not found
Terapi Sistemik
Acne
 Jenis Persediaan
Sistemik Acne

• Systemic Antibiotics
• Steroids
 Systemic Antibiotics

• Tetracycline (Achromycin)
• Erythromycin Stearate/ Ethyl
succinate (Erythrocin/ EES)
1. Tetracycline (Achromycin)

Category: B

Indication
• Acne vulgaris
 Tindakan

• Bacteriostatic: menghalang
sintesis protein dan replikasi
sel.
 Dose
• 250mg q 6 hr
• Severe case: 500mg q 6-8 hr
• Duration: 1 month/ more
 Kesan sampingan
• GI disturbances
– Nausea, vomiting & Diarrhea
• Hypersensitivity
• Photosensitivity
• Discoloration of teeth (< 9
yrs)
• Superinfection
• Hepatic & renal toxicity
• Neutropenia
• Anemia
• Thrombocytopenia
 Contraindication
• Allergic to Tetracycline
• Severe renal failure
• Pregnancy
• Children < 9 yrs
 Cautious

• Renal/ Hepatic dysfunction

• Lactation
 Interaction
• Antacids & milk
– Penyerapan tetracycline
berkurang
• Anti-coagulants &
Sulfonylureas
– Tindakan tetracycline
meningkat
 2. Erythromycin Stearate/
Ethyl succinate (Erythrocin/
EES)
Category: B
 Indication

• Acne vulgaris
• Alternative for penicillin
allergic patients
 Tindakan

• Bacteriostatic/ Bactericidal:
Memusnahkan membrane
sel dan protein sel bakteria.
 Dose
• Stearate:
– 250-500mg q 6 hr PO
• Ethyl succinate:
– 400-800mg bd PO
 Kesan sampingan

• GI disturbances
– Nausea, vomiting, Diarrhea &
abdominal pain
• Hypersensitivity
• Liver dysfunction
 Contraindication
• Allergic to Macrolides

Cautious
• Hepatic dysfunction
 Interaction

• Warfarin, theophylline &

carbamazepine
– Meningkatkan kepekatan
plasma ubat-ubat di atas
 Steroids

• Cortisone Acetate
(Cortef)
1. Cortisone Acetate 5mg
tablet
(Cortef)

Category: B
 Indication

• Mengurangkan kemerahan
dan keradangan
• Mendatar jerawat
• Membantu dalam proses
penyembuhan
 Tindakan
• Enter target cells & produce
anti-inflammatory reactions.

Dose
• 25-30mg/d PO
 Kesan sampingan
• Allergic
• Headache
• Hypertension
• Peptic ulcer
• Insomnia
• Depression
• Diabetes mellitus
 Contraindication

• Allergic to drugs
• Systemic fungal infections
 Cautious

• Renal/ hepatic disease

• Peptic ulcer
• Hypertension
• Diabetes mellitus
 Interaction
• Aspirin
– Meningkatkan paras plasma
aspirin
– Meningkatkan ulcer salur
gastro-usus
 Soalan
1. Senaraikan contoh ubat dan
cara tindakan persediaan acne
topikal dan sistemik?
2. Nyatakan kesan sampingan
dan kontraindikasi ubat
persediaan acne?
Persediaan Anti-
Kelimumur
 Kelimumur

• Oleh kerana
pengeluaran berlebihan
sel-sel kulit mati dari
kulit kepala.
 Persedian kelimumur

• Ubat yang digunakan

untuk merawat
masalah kelimumur.
 Tindakan ubat

• Menanggalkan keruping dari

rambut & kulit kepala.
• Membersihkan dan mencuci
rambut & kulit kepala.
 Contoh ubat

• Ketaconazole 2% (Nizoral
Shampoo)
• Coal Tar (Polytar liqiud)
• Cetrimide 2% (Cetavlon Lotion)
• Selenium Sulphide 2.5%
(Selsun Shampoo)
1. Ketaconazole 2 %
(Nizoral Shampoo)
Category: A

Indication
• Resistant Dandruff
(kelimumur) only
 Dose
• Apply twice weekly for 2-4
weeks
• Prophylaxis: Once every 1-
2 weeks
 Kesan sampingan
• Irritation
• Pruritus
• Alopecia
• Photosensitivity
2. Coal Tar Solution
(Polytar liqiud)
Category: B
 Indication
• Dandruff
• Eczema & scaling of the
scalp
• Psoriasis
 Dose

• Massage into wet hair,

rinse & repeat.
• Use once/twice a week.
 Kesan sampingan

• Allergic
• Skin ulcer
• Dermatitis
 3. Cetrimide 2%
(Cetavlon Lotion)
Category: C

Indication
• Dandruff control
• Antiseptic
• Napkin rash
 Dose
• Add ½ tablespoon in a pint
of water.
• Use as a shampoo/ cleanser.
Kesan sampingan
• Allergic
4. Selenium Sulphide 2.5%
(Selsun Shampoo)
Category: A

Indication
• Dandruff control
 Dose
• Cuci & bersihkan rambut.
• Sapu 5-10ml ubat pada
rambut & akar rambut.
• Biarkan selama 2-3 minit &
cuci rambut.
• Ulang sekali lagi & cuci
rambut dengan bersih.
 Kesan sampingan

• Oily hair & scalp (kulit

kepala)
• Hair discolouration
• Alopecia
 Contraindication
• Allergic to drugs
• Severely Inflamed skin
• Broken skin
• Weeping eczema
• Psoriasis
 Cautious

• Elakkan terkena mata,

mulut & membran mukus
• Inflamed skin
• Long term use of topical
corticosteroids
Interaction
• Not found
 Soalan
1. Berikan definisi ubat anti-
kelimumur?
2. Senaraikan contoh ubat
persediaan kelimumur?
3. Nyatakan kesan sampingan
dan kontraindikasi ubat anti-
kelimumur?