U

U



undecylenic acid


(un-de-sill-enn’-ik as’-id)


OTC: Caldesene Medicated Powder, Cruex Antifgungal Cream, Cruex Antifungal Powder, Cruex Antifungal Spray Powder, Decylenes Powder, Desenex Antifungal Cream, Desenex Antifungal Liquid, Desenex Antifungal Ointment, Desenex Antifungal Penetrating Foam, Desenex Antifungal Powder, Desenex Antifungal Spray Powder, Gordochom Solution


Chemical Class: Hendecenoic acid derivative


image Clinical Pharmacology:


Mechanism of Action: An antifungal whose mechanism of action is not well understood. Therapeutic Effect: Fungistatic.


Available Forms:


• Aerosol Powder: 10% (Cruex Antifungal Spray Powder, Desenex Antifungal Spray Powder).

• Aerosol Foam: 10% (Desenex Antifungal Penetrating Foam).

• Cream: 20% (Cruex Antifungal Cream, Desenex Antifungal Cream).

• Solution, Topical: 10% (Desenex Antifungal Liquid), 25% (Gordochom Solution).

• Ointment: 20% (Desenex Antifungal Ointment).

• Powder: 10% (Caldesene Medicated Powder, Cruex Antifungal Powder, Decylenes Powder), 19% (Desenex Antifungal Powder).

image Indications and Dosages:


Tinea pedis, tinea corporis: Topical Apply 2 times/day to affected area for 4 wk.

image Contraindications: Hypersensitivity to undecylenic acid or any component of its formulation



image Side Effects



Occasional

Skin irritation, rash


image Serious Reactions



• Hypersensitivity reactions characterized by rash, facial swelling, pruritus, and a sensation of warmth occur.


Special Considerations



• Newer topical antifungals more effective

• Powders are generally used as adjunctive therapy, but may be useful for primary therapy in very mild cases


image Patient/Family Education



• Avoid contact with the eyes

• Separate personal items that come in direct contact with affected area

• Rub the topical form well into the affected area


image Monitoring Parameters



• Skin for itching, rash, and urticaria

image Geriatric side effects at a glance:


image CNS

image Bowel Dysfunction

image Bladder Dysfunction

image Falls


image U.S. Regulatory Considerations



image FDA Black Box

image OBRA regulated in U.S. Long Term Care


unoprostone isopropyl


(yoo-noh-prost’-ohn eye-se-pro’-pel)


image Brand Name(s): Rescula


image Clinical Pharmacology:


Mechanism of Action: An ophthalmic agent that increases the outflow of aqueous humor. Therapeutic Effect: Decreases intraocular pressure.

Pharmacokinetics: Peak response occurs in 4-8 wk. The duration of a single dose is about 10 hr. Hydrolyzed to unoprostone free acid form in the cornea. Rapidly eliminated from plasma. Excreted as metabolites in urine. Half-life: 14 min.

image Available Forms:


• Ophthalmic Solution: 0.15% (Rescula).

image Indications and Dosages:


Glaucoma, ocular hypertension: Ophthalmic Instill 1 drop in affected eye(s) 2 times/day.

image Contraindications: Hypersensitivity to unoprostone isopropyl, benzalkonium chloride, or any other component of the formulation



image Side Effects



Frequent (25%-10%)

Burning, stinging, dry eyes, itching, increased eyelash length, and redness.

Occasional (less than 10%)

Abnormal vision, eyelid disorder, foreign body sensation.


image Serious Reactions



• Elevated intraocular pressure occurs rarely.

image Geriatric side effects at a glance:


image CNS

image Bowel Dysfunction

image Bladder Dysfunction

image Falls


image U.S. Regulatory Considerations



image FDA Black Box

image OBRA regulated in U.S. Long Term Care


urea


(yoor-ee’-a)


image Brand Name(s): Carmol-40, Epimide 50, Gordon’s Urea, Urea Rea, Vanamide


OTC: Topical: Aqua Care, Carmol, Gormel, Lanaphilic, UltraMide, Ureacin


Chemical Class: Carbonic acid diamide salt


image Clinical Pharmacology:


Mechanism of Action: A diuretic which rapidly increases blood tonicity causing a greater urea concentration gradient in the blood than in the extravascular fluid resulting in movement of fluid from the tissues, including the brain and cerebrospinal fluid into the blood. A keratolytic that dissolves the intercellular matrix and thereby softens hyperkeratotic areas by enhancing the shedding of scales. Therapeutic Effect: Decreases ocular hypertension and cerebral edema.

Pharmacokinetics: None known

image Available Forms:


• Cream: 22% (Gordon’s Urea); 40% (Gordon’s Urea, Carmol-40, Vanamide)

• Gel: 40% (Carmol-40)

• Lotion: 40% (Carmol-40)

• Paste: 50% (Epimide 50)

• Powder: 100% (Urea Rea)

image Indications and Dosages:


Reduction in intracranial/intraocular pressure: 1-1.5 g/kg. Maximum 120 g daily.

Skin/nail debridement: Topical Apply urea cream, 40% to affected areas. If desired, cover with occlusive dressing. Keep dry and occlusive for 3-7 days.


image Unlabeled Uses: None known.

image Contraindications:

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Jun 8, 2016 | Posted by in GERIATRICS | Comments Off on U

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