Friday, September 4, 2020

Topical Preparation in Hospital Keningau

 

TOPICAL PREPARATION

DOSING

PRESCRIBER CATEGORY

REMARK

BACTERIAL SKIN CONDITION

Impetigo (Superficial Skin Infection)

Fusidic Acid 2% Cream

q8-12h for 7 days

A

Do not use for more than 2 weeks.

May use again if infection relapse

Mupirocin 2% Ointment

q8-12h for 5 days

A

Cellulitis

Potassium  Permanganate 5%

OD-TDS

C

 

PARASITIC SKIN INFECTION

 

 

 

 

 

 

 

 

 

 

 

 

Scabies

 

Also may refer to this link: https://askdis.blogspot.com/2019/07/scabies-2019.html

Emulsion Benzyl Benzoate (EBB) 25%

OD x 2-3/7

Wash off after 24 hours (with a bath taken in between each application)

 

C

 

Permethrin 5%

Once , repeat 1 week later

Wash off after 8-12 hours

A/KK

  NOT available for JPL

Crotamiton 10%

Once daily up to 7 days

(for nodular scabies TDS for 7-14 days)

B

 

Calamine with 6% Sulphur

OD x 3/7

Wash off after 24 hours (with a bath taken in between each application)

 

C

 

 

Patient Category

Choices Available

Newborn to 2 months of age

Calamine with 6% Sulphur

Crotamiton 10%

Children (2 mo to 2 yrs)

   Calamine with 6% Sulphur

Crotamiton 10%

Permethrin 5%

Children (2-12yrs)

Emulsion Benzyl Benzoate (EBB) 12.5%

Crotamiton 10%

Permethrin 5%

Adult

Emulsion Benzyl Benzoate (EBB) 25%

Crotamiton 10%

Permethrin 5%

Pregnant Woman

Permethrin 5%

Calamine with 6% Sulphur

 

 

 

Head Lice

Permethrin 1%

Shampoo

Once, then reapply after 7-10 days

B

 

Benzene Hexachloride GBH 0.1%

Not available

FUNGAL SKIN INFECTION

 

Dermatophyte infections

(Dermatophytoses)

Miconazole cream 2%

Apply twice daily to affected area optimally for 4 weeks including 2 weeks after lesions have cleared.

B

Apply 2-3 cm beyond advancing margin of lesion.

Clotrimazole cream 1%

B

Miconazole powder

Not available

 

 

 

Pityriasis Versicolor

 

Selenium Sulphide

2.5 % Shampoo

Apply daily for 1 week to affected areas for 10-15 minutes followed by a shower & rinse off. Then apply 2-3 times per week.

 

A/KK

 

Ketoconazole

shampoo

Not available

Topical Imidazole

-Miconazole cream

-Clotrimazole cream

Apply twice daily to affected area optimally for 4 weeks including 2 weeks after lesions have cleared.

 

B

Apply 2-3 cm beyond advancing margin of lesion.

Cutaneous Candidiasis

Miconazole cream 2%

Apply twice daily to affected area optimally for 4 weeks including 2 weeks after lesions have cleared.

 

B

Apply 2-3 cm beyond advancing margin of lesion.

Clotrimazole cream 1%

Nystatin cream

Not available

Whitfield Ointment

Twice daily in a thin layer to the

affected parts of the skin.

C

Treatment              may                                       take

several weeks

 


VIRAL SKIN INFECTIONS

 

 

 

Warts

 

Salicylic Acid 1-20 %

 

Once to twice daily

 

C

**Prepared by HKGU , available in 1%, 2%, 5%, 10%, 20%

Podophyllum  10-20 %

Not available

Imiquimod 5% cr eam

Not available

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Eczema & Dermatitis

1) Emollient

Aqueous Cream

As a soap

To apply cream/ ointment on cotton wool. Then wet the body, smear the cotton wool onto the skin. Wash and then use the dry cotton wool to remove excess oil.

As an emollient

To apply after taking a bath or showering when the skin is moist.

To apply emollients liberally (at least 2-4 times a day).

C

 

Liquid paraffin

C

 

Glycerin + Aqueous Cream

 

 

C

**Prepared by HKGU , available as

Glycerin 10% + Aqueous cream or

Glycerin 20% + Aqueous cream

 

White soft paraffin

 

C

 

Cerbamide (Urea) 10% Cream

Not available

Emulsifying ointment

Not available

2) Topical corticosteroid

Hydrocortisone 1% cream

Three times daily over face, ear or flexural or elderly with thin skin

B

 

Mild potency

Betamethasone 1:10 cream (0.01%)

B

Betamethasone 1:4 cream (0.025%)

Two- three times daily over any site

B

Moderate potency

Betamethasone 1:2

Cream (0.05%)

 

Once daily over body and limbs

B

 

Potent

Betamethasone 1:1 Cream (0.1%)

A

3) Topical Calcineurin Inhibitors (TCIS)

Tacrolimus

0.03 %  &  0.1%  ointment

Not available

Silver nitrate

0.5% ,  2%, 5%, 10%

Not available

 

 

 

 

 

 

 

 

Psoriasis

1) Topical Corticosteroid  -  as mentioned above

2) Tar based preparation

 

 

Tar Ointment

 

Apply sparingly to affected areas 1-3 times daily starting with low strength preparation

 

 

B

**Prepared by HKGU , available in 1%, 2%, 3%, 6%, 8%

 

Usually apply at night due to unpleasant smell

Coal Tar 20% Solution

1 cap (15 ml) added to 10L of water in a pail. Soak diluted solution for 20 minutes

 

B

 

3) Vitamin D Analogue  -  Not available

4) Dithranol (Anthralin) -  Not available

 

 

Acne Vulgaris

 

1) Cetrimide 1%

Apply solution onto the face twice daily

 

B

Mix with water on palms,

rub hand together until froth, apply froth on face,

 rinse off with water

2) Benzyl peroxide

Not available

3) Adapalene,  Tretinoin

Not available

4) Azelaic acid 20%

cream

Not available

 

Remark

·       Availability may change from time to time depending on supplier, contract change, etc.

·       Please do consult pharmacist for latest availability.

·       Menthol may be added into certain preparation (usually aqueous cream) upon request.

·       Item maybe be kept by Hospital Keningau if allowed by Dermatology HQE.

 

References:  (1) Topical Preparations Counselling Guide for Pharmacist, 2018 ; (2) Hospital Keningau Drug Formulary, August 2020 ; (3) UptoDate ; (4) Bluebook

 Reviewed on 25/8/2020 by Nabiha  ; Edited on 04/09/2020 by JCK Ho

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