Anorectal preparations include emollients, foams, and gels for topical anesthesia or healing of the rectal area. They are used for symptomatic relief of discomfort from hemorrhoids. They may be used on a long-term basis or briefly for hemorrhoids associated with pregnancy, prolonged sitting, or other temporary problems. Table 23-1 presents a summary of these preparations.

Products are available in mouthwashes, sprays, solutions, troches, lozenges, and disks. The patient should be taught the appropriate administration technique for the drug form being used. Patients should not take these products for longer than 3 or 4 days for normal therapy. Table 23-2 presents a summary of these products.

A wide variety of preparations are used for eye problems (Table 23-3). Local anesthetics are useful in procedures such as tonometry, gonioscopy, cataract surgery, and removal of foreign bodies from the cornea. Antiseptics are compounds capable of preventing infection. They are used for the prevention of gonorrheal ophthalmia neonatorum when babies are born or any time germicidal or astringent (tissue constricting) action is needed. Antiinfectives are used to treat common eye infections caused by bacteria, fungi, or viruses. Artificial tears provide lubrication to relieve dry eyes, eye irritation secondary to wearing contact lenses, or deficient tear production caused by a wide variety of disorders. Diagnostic products include topical fluorescein stains, which are used to detect foreign bodies or scratches.

Table 23-3

Ophthalmic Preparations

GENERIC NAME	TRADE NAME	COMMENTS
Local Anesthetics
benoxinate	Fluress	Often used when suturing of eye is required. Use before eye procedures.
proparacaine	Alcaine	Use immediately before tonometry, 2-3 min before suture removal or removal of foreign body.
tetracaine	Pontocaine	Use drops or ointment to lower conjunctival area.
Antiseptic Ointments
silver nitrate	Silver Nitrate	After birth, clean infant’s eyes with cotton ball and use 2 gtt 1% solution once.
Ophthalmic Antiinfectives (Preparations Must be Labeled “Ophthalmic”)
Alpha2-Adrenergic Agonist
brimonidine	Alphagan P	Use 1 drop in the affected eye(s) q8h.
Antibiotics
bacitracin	AK-Tracin	Apply sparingly into conjunctival sac 2 to 3 times daily.
chloramphenicol		Apply small amount of ointment to lower conjunctival sac, or use 2 drops of solution q3h for the first 48 hr, then PRN. Continue for at least 48 hr after the eye appears to be normal.
ciprofloxacin	Ciloxan	Put into conjunctival sac, close eyes, and apply light pressure over lacrimal sac for 1 minute.
erythromycin	Ilotycin	Apply to affected eye 3 times daily or more often, depending on severity of infection.
gentamicin	Garamycin Genoptic Gentacidin	Put drops into affected eye q4h. In severe infections, dosage may be increased to hourly. Apply ointment sparingly 2 to 3 times daily.
levofloxacin	Quixin Levaquin	Use drops in the affected eye(s) q2h while awake, up to 8 times/day for 2 days. Then use drops in affected eye(s) q4h while awake, up to 4 times/day for days 3 through 7.
norfloxacin	Noroxin	Put into conjunctival sac, close eyes, and apply light pressure over lacrimal sac for 1 min after.
ofloxacin	Ocuflox	Put into conjunctival sac, close eyes, and apply light pressure over lacrimal sac for 1 min after.
polymyxin B	polymyxin B	Use very hour PRN.
sulfacetamide sodium	AK-Sulf Sodium Sulamyd	Use drops q2-3h during day, less at night. May also apply ointment in lower conjunctival sac at night.
tobramycin	Tobrex AK-Tob	Use drops 4 to 6 times daily.
Antiviral Agents
fomivirsen		Adults: Use a single intravitreal injection every other week for 2 doses followed by maintenance dose once every 4 wk in treatment of cytomegalovirus retinitis.
ganciclovir	Vitrasert	Used in treating cytomegalovirus retinitis in patients with AIDS. Provided as a 4.5-mg insert designed to release drug over a 5- to 8-mo period. May be repeated as needed.
trifluridine	Viroptic	Put onto ulcerated cornea of eye q2h while awake for a maximum of 9 drops/day. Continue until reepithelialization, then for 7 days give q4h while awake.
Artificial Tears
—	Isopto Tears Liquifilm Forte Refresh Plus Systane Tearisol Tears Plus	Drops may be used in eyes 3 to 4 times daily or PRN. Some preparations, such as Tearisol, are not to be used with soft contact lenses. Keep solution free from contamination.
—	Lacrisert	Insert once a day into inferior cul-de-sac beneath base of tarsus.
Antiglaucoma Agents
Sympathomimetics
apraclonidine	Iopidine	Use solution before laser surgery.
dipivefrin	Propine	Put into eyes q12h.
epinephrine		Use drops into affected eyes daily to twice daily.
		Use daily or twice daily.
Beta Blockers
betaxolol	Betoptic	Use drops twice daily.
carteolol	Ocupress	Use drops twice daily.
levobetaxolol	Betaxon	Use drops twice daily.
levobunolol	Betagan Liquifilm	Use drops daily.
metipranolol	OptiPranolol	Use drops twice daily.
timolol	Timoptic	Use drops twice daily.
Miotics, Direct-Acting
acetylcholine Cl	Miochol-E	Use drops 3 times daily.
carbachol	Isopto-carbachol	Use drops up to 3 times daily.
pilocarpine	Pilocar Pilostat	Use drops up to 6 times daily.
pilocarpine ocular therapeutic system	Ocusert	The system is placed in and removed from the eye by the patient, according to instructions in the package. Releases 20 or 40 mcg pilocarpine per hour for 1 wk.
Miotics, Cholinesterase Inhibitors
demecarium		Put drops into eyes daily.
echothiophate	Phospholine Iodide	Use drops daily.
Carbonic Anhydrase Inhibitors
brinzolamide	Azopt	Use 3 times daily.
dorzolamide	Trusopt	Use 3 times daily.
Mydriatic-Cycloplegics
atropine		Use solution daily to 3 times daily, or ointment daily to 3 times daily.
cyclopentolate	Cyclogyl	Use 1% or 2% solution; repeat in 5 min. Refraction can occur in 40-50 min.
homatropine	Isopto-Homatropine	Use 2% or 5% solution; repeat 2 to 5 times until desired results occur.
scopolamine	Isopto Hyoscine	Use 0.25% solution daily to 3 times daily.
tropicamide	Mydriacyl	Use 1% solution; repeat in 5 min.
Mydriatic
phenylephrine	Neo-Synephrine	Mydriasis: Use 2.5%-10% solution topically on conjunctiva. Repeat in 5 min PRN. Mydriasis: Use 2.5%-10% solution topically on conjunctiva. Repeat in 5 min PRN. Conjunctivitis: Use qh until condition improves, and then 1 drop 3 to 4 times daily.
Other Ophthalmic Preparations
Alpha-Adrenergic Blocking Agent
dapiprazole		Use drops, followed 5 min later by additional drops.
Prostaglandin Agonists
bimatoprost	Lumigan	Use daily in the evening to reduce IOP.
latanoprost	Xalatan	Use drop in affected eye(s) once daily in the evening. Do not exceed prescribed dose.
travoprost	Travatan	Use drop daily in the evening to reduce IOP.
unoprostone		Use drop twice daily. May be used with other drops if administered at least 5 min apart.
Antihistamines
azelastine	Optivar	Use drops twice daily to reduce itching from allergic conjunctivitis.
emedastine	Emadine	Use drops in affected eye(s) 4 times daily. Do not use if patient is wearing contact lenses.
olopatadine	Patanol	Use drops twice daily at intervals of 6-8 hr.
Vasoconstrictors and Mydriatics
hydroxyamphetamine		Use drops in conjunctival sac.
naphazoline		Use drops 2 to 3 times daily PRN to relieve irritation or redness. Mydriasis occurs within 1 hr, recedes within 6 hr of administration. NOTE: DO NOT GIVE TO PATIENTS WITH ANGLE-CLOSURE GLAUCOMA OR NARROW ANTERIOR ANGLE.
oxymetazoline		Use drops q6h.
tetrahydrozoline	Murine Tears Plus Visine	Use drops in each eye 2 to 3 times daily PRN. Mydriasis occurs in 1 hr, recedes within 6 hr. NOTE: DO NOT GIVE TO PATIENTS WITH NARROW-ANGLE GLAUCOMA.
Eye Diagnostic Products
fluorescein	Fluor-I-Strip Ophthifluor Fluorescite AK-Fluor Ful-Glo	For examination of corneal and conjunctival epithelium, pour 1 drop sterile water on strip, touch to cornea, and close lid for 60 sec. Use Wood lamp to visualize. Add drops; patient should blink. Examine eye under fluorescing light, and areas of foreign body or abrasion should fluoresce bright green or yellow.
Nonsteroidal Antiinflammatory Drugs
diclofenac	Voltaren	Use drops in affected eye 4 times daily beginning 24 hr after cataract surgery and continuing throughout first 2 wk of postoperative period.
flurbiprofen	Ocufen	For inhibition of intraoperative miosis, for inflammation after cataract, glaucoma, or laser surgery and uveitis syndromes: Use every 30 min beginning 2 hr before surgery.
ketorolac	Acular	For relief of ocular itching caused by seasonal allergic conjunctivitis and treatment of postoperative inflammation of postcataract extraction: 1 drop to affected eye(s) 4 times daily beginning 24 hr after cataract surgery and continuing for 2 wk.
suprofen	Profenal	For treatment of postoperative inflammation after cataract extraction: On day before surgery, put drops into conjunctival sac every 4 hr while awake; on day of surgery at 3 hr, 2 hr, and 1 hr before surgery.
Mast-Cell Stabilizers
nedocromil	Alocril	Use drops in each eye twice daily to treat itching of allergic conjunctivitis.
pemirolast	Alamast	Use drops in each eye 4 times daily to prevent itching from allergic conjunctivitis.
Ophthalmic Decongestants
cromolyn sodium	Crolom	Use drops 4 to 6 times daily.
lodoxamide	Alomide	For patients with vernal conjunctivitis or vernal keratitis: Use drops in each eye 4 times daily for up to 3 mo.
ketotifen	Zaditor	Use drops q8-12h to prevent itching of eye from allergic conjunctivitis.
levocabastine	Livostin	Use drops in affected eye(s) 4 times daily for up to 2 wk.
Ophthalmic Corticosteroids
dexamethasone	AK-Dex Maxidex	Sol: Use drops qh during the day and q2h at night until symptoms reduce; then q4h.
fluorometholone	Flarex Fluor-Op	Suspension: Shake well and use drops in conjunctival sac 2 to 4 times daily. Ointment: Apply ribbon of medication into conjunctival sac 1 to 3 times daily.
loteprednol	Lotemax Alrex	Use drops 4 times daily. Shake well before using.
medrysone	HMS	Shake well and put drops into conjunctival sac up to every 4 hr.
prednisolone	AK-Pred Pred Forte Pred Mild Inflamase	Shake well and put drops in conjunctival sac 2 to 4 times daily.
rimexolone	Vexol	Put drops in affected eye 4 times daily beginning 24 hr after ocular surgery and for 2 wk.

AIDS, Acquired immune deficiency syndrome; IOP, intraocular pressure; PRN, as needed; Sol, solution.
Indicates “Must-Know Drugs,” or the 35 drugs most prescribers use.

Increased intraocular pressure is a sign of the eye condition called glaucoma. This condition results from either excess production or reduced outflow of aqueous humor (ocular fluid). There are three major forms of glaucoma. Primary glaucoma includes narrow-angle glaucoma and wide-angle glaucoma. Patients with narrow-angle glaucoma have a shallow anterior chamber, possibly because of the anatomy or physiologic action they were born with. Drugs are used to control the acute problem before there is a permanent surgical solution. Wide-angle glaucoma has a gradual onset, and its control depends on permanent drug therapy. Secondary glaucoma may result from other eye problems such as cataract extraction; it is treated with medication. Congenital glaucoma is a birth defect requiring surgical correction. Medications for treating glaucoma use a variety of mechanisms to increase outflow of aqueous humor.

Antiglaucoma agents make up a large class of medications with a variety of actions. Mydriatic-cycloplegics block the action of acetylcholine. The sphincter of the iris is paralyzed, causing mydriasis, or abnormal dilation (opening) of the pupil, and the ciliary muscles are paralyzed, blocking accommodation (the ability to switch from near to far vision and back), or adjustment of the focus of the eye. These agents are used in some tests for glaucoma. Atropine and scopolamine are long-acting agents that produce complete cycloplegia, or paralysis. Homatropine, cyclopentolate, and tropicamide have shorter durations of action and are most useful for diagnostic procedures. Long-acting cholinesterase inhibitors include miotic-antiglaucoma agents that inactivate acetylcholinesterase. This provides iris sphincter contraction, leading to miosis (small pupils), and ciliary muscle constriction, which leads to increased aqueous humor outflow. Parasympathomimetic or miotic drugs, such as carbachol, act as cholinergic agonists to reduce intraocular pressure by causing iris sphincter contraction, leading to miosis. This allows an increased outflow of aqueous humor by opening up the anterior chamber angle. Cholinesterase inhibitors such as physostigmine salicylate briefly inactivate acetylcholinesterase to allow acetylcholine to accumulate, which increases parasympathetic tone. This causes iris sphincter contraction, resulting in miosis, increased ciliary muscle constriction, and an increase in aqueous humor outflow. Timolol is a beta blocker that reduces intraocular pressure, probably by reducing the formation of aqueous humor. Sympathomimetic agents such as epinephrine produce vasoconstriction (narrowing of the blood vessels) and decreased intraocular pressure in open-angle glaucoma, probably as a result of decreased production of aqueous humor. Phenylephrine acts as a mydriatic, causing constriction of the dilator muscles of the pupil, leading to mydriasis and vasoconstriction of the arterioles of the conjunctiva. Vasoconstrictors such as naphazoline cause direct stimulation of the alpha receptors of vascular smooth muscle, leading to vasoconstriction. This action lasts for several hours.

Before administering any ophthalmic agent, it is especially important for the nurse to learn whether the patient has a history of glaucoma. Dilating the pupils of a patient who may have glaucoma could provoke angle closure and lead to a surgical emergency.

Topical antibiotics are used to control superficial infections of the ear through bactericidal or bacteriostatic mechanisms. Other products may be used for prophylaxis of infections in swimmers and for removing cerumen (earwax) plugs. There are also some steroid products available for ear problems. Check the package inserts of individual products for precautions, contraindications, and adverse effects. Table 23-4 presents a summary of otic preparations.

Antipsoriatics accelerate scaling and healing of dry lesions in chronic psoriasis. Antiseborrheic shampoos promote shedding and softening of the horny cell layer and inhibit the growth of microorganisms in seborrhea and dandruff. There are now antiviral agents used to treat herpes simplex. These agents help reduce the severity of symptoms and lengthen the time between outbreaks. Scabicides are applied to the skin and in the hair to treat scabies, a condition caused by the microscopic mite Sarcoptes scabiei. Pediculicides are used to treat pediculosis, an infestation with lice seen mostly in children. There are also a variety of burn preparations, cauterizing agents, emollients, keratolytics, and wet dressings and soaks on the market. These agents all have their own individual precautions, adverse reactions, and drug interactions. The specific product information should be consulted. These preparations are summarized in Table 23-5. Any of the chemicals in these products may interact with other medications the patient may be taking.

Table 23-5

Topical Skin Products

GENERIC NAME	TRADE NAME	COMMENTS
Acne Products
adapalene	Differin	Wash face then apply a thin film of gel once daily to affected areas. An exacerbation of acne may initially be seen; therapeutic results usually seen in 8-12 wk.
azelaic	Azelex	Wash face and dry thoroughly. Then apply thin film twice daily to affected areas and gently massage into skin. Results usually seen in 4 wk.
benzoyl peroxide cream and soaps	Clearasil Desquam-X Oxy Oil-Free Acne Wash	Apply daily to affected areas after cleansing skin. After 3-4 days, if redness, dryness, and peeling do not occur, increase application to twice daily. Use instead of soap. These products promote drying of skin and provide a gentle abrasive action when applied. If undue skin irritation develops, stop use and contact nurse, physician, or other health care provider. Available OTC.
isotretinoin	Accutane	This product must not be taken by women who are pregnant, because severe fetal abnormalities may be produced. Women in childbearing years should be protected by adequate contraception methods during the course of therapy. Cystic acne: Dosage may adjusted for individual weight and severity of disease.
sulfur preparations	Liquimat	Thin film of medication should be applied daily or twice daily to clean skin. Used to treat oily skin and mild acne.
tazarotene	Tazorac	Wash face and then apply a thin film to affected areas once daily.
tretinoin	Retin-A Vesanoid	Wash face and apply to affected area daily at bedtime. Start with low doses; may irritate skin initially. Makes individuals more sensitive to the sun, necessitating sunscreen. Evidence suggests that this product restores skin collagen and turgor, reversing fine wrinkles. Not for use by pregnant women.
Topical Antiinfectives
bacitracin	Baciguent	Apply small amount to infected area 3 times daily; comes as cream.
chloramphenicol	Chloromycetin	Apply small amount to infected area 3 times daily; comes as cream.
clindamycin	Cleocin T	Apply small amount to infected area twice daily.
erythromycin	Akne-Mycin	Apply small amount to infected area 3 times daily; comes as cream.
gentamicin		Apply small amount to infected area 3 times daily; comes as cream.
mupirocin	Bactroban	New topical antibiotic. Used to treat impetigo; may produce superinfection. Apply small amount to affected area 3 times daily. May cover with gauze. Must be reevaluated within 3 days.
neomycin sulfate		Apply small amount to infected area 3 times daily; comes as cream.
Combination Products
polymyxin B, neomycin, and bacitracin	Neosporin	Apply small amount to infected area 3 times daily; comes as ointment.
polymyxin B	Polysporin	Apply small amount to infected area 3 times daily; comes as ointment.
Topical Corticosteroids
alclometasone	Aclovate	For relief of inflammatory and pruritic manifestations of corticosteroid-responsive dermatoses. Apply sparingly to affected areas 2 to 4 times daily.
amcinonide	Cyclocort	Apply sparingly to affected areas 2 to 4 times daily.
betamethasone dipropionate	Diprolene	Fluorinated product, relatively expensive. Comes as cream, lotion, ointment, or topical aerosol. Use sparingly for dermatoses needing antiinflammatory medication.
betamethasone valerate	Beta-Val Valisone	Fluorinated product that may be used with occlusive dressings; comes as cream, lotion, or ointment. Apply sparingly daily to 3 times daily for adults.
desonide	Tridesilon	Gently rub in medication 2 to 4 times daily.
desoximetasone	Topicort	Do not use near eyes; apply sparingly daily to twice daily.
diflorasone	Maxiflor	Apply sparingly to affected areas 2 to 4 times daily.
fluocinolone acetonide	Synalar	Rub cream in gently, 2 to 4 times daily. Apply very sparingly; use less frequent applications for children.
fluocinonide	Lidex	Comes as cream, gel, or ointment; apply 3 to 4 times daily.
flurandrenolide	Cordran	Shake lotion well; protect from light, heat, and freezing. Also comes as a film tape. Apply sparingly 2 to 3 times daily.
halcinonide	Halog	Ointment, cream, solution; protect ointment from light. Apply sparingly 2 to 3 times daily.
hydrocortisone	Cortizone Hycort	One of the few steroids that can be used safely on the face, axilla, and groin, and under the breasts. Comes as ointment, cream, or lotion. Apply thin coat once daily to 4 times daily; increase strength as indicated by condition.
hydrocortisone acetate	Cortaid Lanacort 5	This form is more expensive. Apply thin coat of ointment or apply the cream gently and sparingly. Apply once daily to 4 times daily as needed by condition. The lowest doses are available without a prescription.
hydrocortisone plus antibiotics	Cortisporin	Comes with neomycin sulfate and polymyxin B. Apply to affected area 2 to 3 times daily; withdraw gradually if medication has been used for a long time.
methylprednisolone	Medrol	Very expensive; apply ointment once daily to 4 times daily.
triamcinolone acetonide	Aristocort Kenalog	Fluorinated steroid, highest potency; has many precautions to use. Apply to affected area 2 to 4 times daily. Do not use on face.
triamcinolone plus antifungals	Mycolog II	Many precautions and warnings. Apply ointment to affected areas 2 to 3 times daily. Ototoxicity (damage to the ear) and nephrotoxicity (damage to the kidney) have been reported if preparation is overused.
Anesthetics for Mucous Membranes and Skin
benzocaine	Solarcaine Babee Teething lotion	Used for sunburn, wounds, toothaches, mouth ulcers, and lesions of oral mucosa. Apply 20% aerosol or gel to affected areas 2 to 3 times daily.
dibucaine	Nupercainal	For abrasions, minor burns, sunburn, and hemorrhoids. Apply ointment or cream sparingly to affected area 2 to 3 times daily.
tetracaine	Pontocaine	Used in treating hemorrhoids and minor skin disorders. Apply sparingly 3 to 4 times daily.
Antipsoriatics
acitretin	Soriatane	Systemic psoriasis therapy for severe disease.
anthralin	Anthra Forte	Apply thin layer of 0.1% ointment once to twice daily for 2 wk.
calcipotriene	Dovonex	Synthetic vitamin D3 derivative indicated for topical treatment of moderate plaque psoriasis. Calcipotriene is similar to vitamin D3 in its effects on keratinocyte proliferation and differentiation, yet it has a less potent effect on calcium metabolism. Also modifies immune activity of monocytes, macrophages, and T lymphocytes. In clinical trials, improvement in psoriasis noted within 2 wk of initiating topical therapy (twice-daily application). Approximately 70% of patients have shown marked improvement after 8 wk of therapy, with 10% showing complete clearing. Apply thin layer twice daily and rub in completely.
tazarotene	Tazorac	For topical treatment of patients with stable plaque psoriasis with approximately 20% body surface area involvement. The 0.1% gel also is indicated for mild to moderately severe facial acne vulgaris.
Antiseborrheic Products
povidone-iodine	Betadine	Shampoo with 2 tsp to hair and scalp. Lather with warm water and rinse. Repeat application and allow to remain on scalp 5 min; rinse thoroughly. Use twice weekly until improvement, then once weekly.
selenium	Selsun Blue	Massage 1-2 tsp into wet scalp. Allow medicated shampoo to remain on scalp for 2-3 min; rinse thoroughly; repeat application and rinse. Use twice weekly for 2 wk, then weekly for 2 wk.
Antiviral Agents
acyclovir	Zovirax	For treatment of herpes simplex. Cover all lesions q3h, 6 times per day for 6 days. Approximately -inch ribbon of ointment per 4 square inches of surface area should be used. Oral forms are available for treatment of herpes labialis (cold sores).
penciclovir	Denavir	Apply cream q2h while awake for 4 days. Start treatment as early as possible to reduce symptoms.
Burn Preparations
mafenide	Sulfamylon	Apply once or twice daily to a thickness of approximately inch. No dressing required.
nitrofurazone	Furacin	Soluble dressing: apply directly to lesions daily; topical cream: apply directly to lesion once daily or every few days.
silver nitrate	Silver Nitrate	Saturate dressing with warmed solution and apply to burn wound. Mold dressing to body surface and cover with dry dressing. Reapply solution q2h. Change dressing at least once daily.
silver sulfadiazine	Silvadene	Apply once or twice daily to a thickness of approximately inch. No dressing required.
Scabicides and Pediculicides
crotamiton	Eurax	Used in scabies and very pruritic skin conditions. Massage into skin of the whole body; apply a second coating 24 hr later. Clothing and bed linen should be changed after 24 hr. Bath should be taken 48 hr after the last application.
malathion	Ovide	Apply to hair and let hair dry naturally. Wash after 8-12 hr and comb hair. Repeat in 7-9 days, if necessary.
permethrin	Elimite Nix Acticin	Massage into skin from scalp to soles of feet. Wash off after 8-14 hr. For pediculosis capitis in infants, wet hair, shampoo, and then apply medication to hairline, neck, scalp, temple, and forehead, and wash off after 10 min
Miscellaneous Skin Preparations
Cauterizing Agents
dichloroacetic acid	Bichloracetic Acid	Apply petrolatum to tissue surrounding area to be treated. Solution should then be carefully applied to lesion. A kit is provided with detailed instructions.
monochloroacetic acid	Mono-Chlor	Used for removing verrucae or warts. Do not drip solution on normal tissue or mucous membranes. Apply solution with cotton-tipped applicator or capillary tube. Cover with bandage and allow to remain in place for 4-6 days. May require more than one application.
podofilox	Condylox	Apply solution or gel to venereal warts morning and evening with a cotton-tipped applicator.
podophyllum resin	Podofin Podocon-25	Applied to venereal warts only by health care provider. Cleanse area and then apply sparingly to lesion. Leave on 30-40 min to check sensitivity, and no longer than 4 hr. Remove with alcohol or soap and water.
silver nitrate solution or sticks		Apply to local area as needed.
trichloroacetic acid	Tri-Chlor	Use on débrided skin to remove verruca. Apply to wart, then cover for 5-6 days. Peel off wart tissue.
Emollients
colloidal baths	Alpha Keri Aveeno	Bath additives for treating widespread eruptions. Limit bath time to 30 min; patient should be aware that preparations often make tub slippery. Follow directions on packet or bottle.
dexpanthenol	Panthoderm	Stimulates epithelization and granulation. Aids in the healing of skin lesions and relieves pruritus. Apply directly to clean skin once to twice daily.
salicylic acid	Mediplast-Salacid Wart-Off	Use creams for corns and calluses. Apply directly to area daily for 2 wk. Cut out piece of plaster to fit callus or apply gels to well-hydrated skin. Check callus q24h; discontinue if irritation develops.
urea	Aquacare Nutraplus	Hydrates skin and aids in removing scales and crusts. Apply directly to clean skin 2 to 3 times daily, affected area only.
vitamin E	Vite E Cream Vitec	Apply cream or ointment to skin to hydrate.
Vitamins A, D, and E	Retinol Clocream	Apply cream or ointment to skin.
Smoking Cessation Products
nicotine transdermal system	Nicoderm CQ Nicotrol	Used to decrease withdrawal symptoms as part of smoking cessation program. No serious side effects. In association with behavior modification programs, use patch daily. Use 2 wk at each of 3 strengths in decreasing order of strength.
nicotine gum	Nicorette	Use 2- or 4-mg gum to reduce cravings. Chew gum steadily, and then place gum against buccal membranes.
nicotine inhalation system	Nicotrol Inhaler	4-mg inhaler. Used as part of withdrawal system.
nicotine nasal spray	Nicotrol NS	Spray 0.5 mg into nostril to reduce symptoms of withdrawal.
Wet Dressings and Soaks
Burow’s solution	Domeboro	Used for open wet dressings in inflammatory conditions of skin; cool and dry through evaporation, which causes local vasoconstriction. Moisten dressing and apply multiple layers to prevent rapid drying and cooling. Reapply every 15-30 min as indicated for 4-8 hr.

OTC, Over the counter.
Indicates “Must-Know Drugs,” or the 35 drugs most prescribers use.