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Chapter 37: Principles of Dermatologic Therapy Buttaro: Primary Care: A Collaborative Practice, 6th Edition

Multiple Choice

1. When recommending an over-the-counter topical medication to treat a dermatologic condition, which instruction to the patient is important to enhance absorption of the drug?

a. Apply a thick layer of medication over the affected area.

b. A solution spray preparation will be more effective on hairy areas.

c. Put cool compresses over the affected area after application.

d. Use a lotion or cream instead of an ointment preparation.

ANS: B a. Cream b. Gel c. Ointment d. Powder

Hairy areas are difficult to penetrate, so in these areas, a solution, foam, spray, or gel may work better. Applying a thicker layer does not increase skin penetration or effectiveness of a medication. Warm or inflamed skin absorbs medications more readily; cool compresses will decrease absorption. Lotions and creams are not as readily absorbed as ointments, which have occlusive properties.

2. A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the body. Which vehicle type will the provider choose when prescribing this medication?

ANS: B

NURSINGTB.COM a. Initiate treatment with 0.1% triamcinolone acetonide. b. Monitor the patient closely for systemic adverse effects during use. c. Place an occlusive dressing over the medication after application. d. Prescribe 0.05% fluocinonide to apply liberally.

Gels are an excellent vehicle for use on hairy areas of the body. Creams and ointments are not recommended for hairy areas. Powders should be avoided in open wounds.

3. An adult patient has been diagnosed with atopic dermatitis and seborrheic dermatitis with lesions on the forehead and along the scalp line. Which is correct when prescribing a corticosteroid medication to treat this condition?

ANS: A

Treatment with 0.1% triamcinolone acetonide is appropriate in this case, because it is a class 4 corticosteroid and may be used on the face and is suggested for use for these conditions. Systemic side effects are rare when topical corticosteroids are used appropriately. Occlusive dressings increase the risk of adverse effects and are not recommended. 0.05% fluocinonide is a class III corticosteroid and should not be used on the face.

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