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Course Code: PDA303T

Course Title:
Pharmacotherapeutics II

Course Leader: Mr. Subeesh K Viswam


subeesh.pp.ph@msruas.ac.in

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Course Details

Programme: Pharm D
Department: Pharmacy Practice
Head of the Department: Dr. E.Maheswari
Faculty: Pharmacy
Dean: Prof. (Dr.) V Madhavan (
dean.ph@msruas.ac.in)

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Lecture 6
Impetigo

At the end of this lecture, student will be


able to

Explain pathophysiology of impetigo


Describe clinical manifestations of impetigo
Explain the treatment of impetigo

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
IMPETIGO

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Introduction

Impetigo is a contagious bacterial skin


infection
Common against
Pre-school children
Sports men
regardless of age (not common in adults)

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Introduction

It is superficial disease
Most common in children
Common during hot , humid which
facilitates microbial growth
Minor trauma , such as scratches allows
entry of organism
Infection is of TWO TYPES Based on clinical
presentation
BULLOUS or NON-BULLOUS

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
BULLOUS
Children under
2yrs
Fluid filled blisters
On arms & legs
Surrounded by
RED & ITCHY skin
After they break ,
it leads to YELLOW
SCABS

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
NON BULLOUS
Common
Begins as red
sore near the nose
, which soon
breaks leaking pus
& forms HONEY
colored scar
No pain but itchy
Touching or
scratching lead to
spread

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Vilan

Infection is caused by
STAPHYLOCOCCUS AUREUS
STREPTOCOCCUS PYOGENS
Cause
infection when there is a CUT or WOUND
& in DERMATITIS
Person gets infection by , touching things
used by infected person (10 days)

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Pathophysiology

Skin -0.1-1.5mm
consists of five layers
Stratum corneum (flattened, non-
nucleated keratin composed cells)
Reasons--- high conc
Moisture
Blood supply
Availability of
nutrients
Faculty of Pharmacy
Damage to corneal 10
M. S. Ramaiah University of Applied Sciences
Diagnosis
Cotton swab is
wiped on skin &
cultured to know
whether the
disease is PRIMARY
or SECONDARY
And to give the
appropriate Anti-
Biotics
Culture mucous
membrane , where
it is harboring the
bacteria (re-current) 11
Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Ecthyma
Is a variant
form of
IMPETIGO ,
presenting at a
deeper level of
tissue

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Goals

To speed up healing
Improve the skin's appearance and
prevent complications and the spread
of infection
Treatment will depend on the type of
impetigo and the severity of
symptoms.

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Treatment

Antibiotics are applied directly onto the skin.


The doctor may prescribe mupirocin ointment
(Bactroban)
Before applying ointment, scabs need to be
gently removed so that the antibiotic can get
deep into the skin
It is important to first wash affected areas of
skin with warm, soapy water before applying
a topical antibiotic.
If possible, use latex gloves when applying
the cream. Afterwards wash your hands
thoroughly. 14
Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Oral Antibiotics

If not responded to Topical Anti Biotics (or)


used when the infection is widely spread
Course of antibiotics is usually for 7 days
(AMOXICILLIN-25O -500 mg )

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Complications
Cellulitis
when the infection goes into a deeper
layer of skincellulitis can occur, and can
cause symptoms of red, inflamed skin,
fever and pain.
The patient will need antibiotics and
sometimes painkillers
Scarlet fever- also calledscarlatina.
It is a rare bacterial infection characterized
by a fine pink rash across the body.
The patient may also have nausea,
vomiting and pain. Treatment includes 16
Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
SCARLET FEVER CELLULITIS

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Prevention
Wash the affected areas with a neutral
soap and running water
Then cover the area lightly with gauze
Encourage the patient not to touch the
sores
The patient's clothes, bedding, towels and
other toiletries should be washed daily
The patient's clothes must not be shared
or worn by other people

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Prevention
When applying antibiotic ointment wear
gloves, and wash hands thoroughly
afterwards
Keep the patient's nails short to reduce
scratching
Wash hands and the patient's hands often
Isolate the patient until sure they are not
contagious

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Conclusion

Impetigo is a contagious bacterial skin


infection most common among preschool
children
People who play close contact sports, such
as wrestling are also susceptible,
regardless of age
Antibiotic creams or pills are often used as
a remedy
Nonbullous impetigo most often begins as
a red sore near the nose or mouth which
soon breaks, leaking pus or fluid, and20
Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences
Conclusion

Bullous impetigo, mainly seen in children


younger than 2 years, involves painless,
fluid-filled blisters, mostly on the arms,
legs, and trunk, surrounded by red and
itchy (but not sore) skin
Ecthyma impetigo painful fluid- or pus-
filled sores with redness of skin, usually on
the arms and legs, become ulcers that
penetrate deeper into thedermis

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Faculty of Pharmacy M. S. Ramaiah University of Applied Sciences

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