Therapeutic ointments

The use of Thera Wise bioactive natural therapeutic ointment, so-called Miracle oil obtained from Tamanu oil in the South Pacific has been reported.This ointment has been used as a skin healing remedy in the treatment of skin burns, eczema and can be used both for infants and adults. The wide range of the Thera Wise agents include the SHO Natural Skin Healing Ointment which has been reported to be an excellent alternative to corticosteroids, anti-itches and antibacterials, while the HmR Natural Hemorrhoidal Ointment has been reportedly used in the treatment of hemorrhoids and hemorrhoids associated with pregnancy. The Ac-f Natural Acne Ointment has been employed as a gentle, balanced supportive care for the treatment of acne. 

In addition to suspensions, pharmaceutical products may be emulsions or foams. In any case the rheological properties have to be tailored to suit the nature of the application [215], Therapeutic ointments are usually not very viscous and encounter only moderate shear rates upon application, about 125 s-1 when gently smeared on with fingers, and about 210 s-1 when smeared on with a spatula [215], An opthalmic ointment is usually very soft, with a viscosity of about 20-30 mPas, whereas a medicated ointment needs to be soft enough to apply easily but stiff enough to remain on the area to which it was applied, with a viscosity of about 30-40 mPas [215], A protective ointment like zinc oxide paste needs to be hard and stiff enough to stay in place where applied, even when moist. 

Uses Emollient, w/o emulsifier, moisturizer, stabilizer, plasticizer for therapeutic ointments, burn preps., dermatological prods., hypoallergenic preps., cosmetics, pharmaceuticals, absorp. bases, bar soaps, textile finishes Properties Pale cream soft solid, faint, char, sterol odor oil sol. HLB 9.0 m.p. 40-46 C acid no. 1 max. sapon. no. 1.0 max. 100% cone. 

Galen, a physician whose views outUved him by about a thousand years, died about 200 AD. He beUeved that mercurials were toxic, and did not use any mercury compound therapeutically. However, as a result of Arabian influence, the therapeutic uses of mercury were slowly recognized by Western Europe. In the thirteenth century mercury ointments were prescribed for treating chronic diseases of the skin. Mercury and its compounds, such as mercurous chloride, mercuric oxide, mercuric chloride, and mercuric sulfide, were used widely from the fifteenth to the nineteenth centuries, and to some extent in the twentieth century. During the first half of the twentieth century, the primary therapeutic uses of mercury included bactericidal preparations, such as mercuric chloride, mercuric oxycyanide, and mercuric oxide and diuretics, such as aryl HgX (Novasural) and mercurated ahyl derivatives (14). 

The ointment is particularly convenient when an eye pad is used. It also may be the preparation of choice for patients in whom therapeutic benefit depends on prolonged contact of the active ingredients with ocular tissues. FLUOROMETHALONE Consult a physician if there is no improvement after 2 days. Do not discontinue therapy prematurely. In chronic conditions, withdraw treatment by gradually decreasing the frequency of applications. 

Several tests with silicon containing compounds as therapeutics in human medicine have already been crowned with success. In France certain organosilicon preparations, DNR and RDN (compare Chap. 5.5), are used in the treatment of cardiovascular diseases, cancer and virus infections. In the Soviet Union extensive clinical tests with ointments of l-(chloromethyl)- and 1-ethoxysilatrane as possible drugs for treatment of different typs of alopecia were successful (compare Chap. 5.1). Further clinical studies showed that l-(chloromethyl)silatrane is also very promising in treatment of wounds and bums. In a Swedish hospital patients with poorly differentiated prostatic carcinoma were treated with 2,6-c/s-diphenyl-hexamethyl-cyclo-tetrasiloxane (Cisobitan ) the clinical study also yielded promising results (compare Chap. 5.3). 

Organopolysiloxanes (silicones) are very important materials for therapeutic applications because of their good physicochemical properties and their inertness to biochemical processes. For example, silicones are employed as ointments (especially for burns), prosthetic materials (e.g. replacement of blood vessels), and plastic surgery (e.g. augmentation of soft tissue or loose skin). 

Common treatments for eye exposure to white phosphoms fumes/vapors include holocaine and epinephrine ointments, a camphor and epinephrine solution, and a solution with epinephrine alone. All of these have been suggested as successful therapeutic agents following exposure of the eye, but their effect on absorption through the eye area is unknown (Scherling and Blondis 1945). 

Therapeutic uses An ophthalmic ointment of the drug is used topically in the eye for the chronic treatment of open-angle glaucoma. The effects may last for up to one week after a single administration. [Note Echothiophate [ek oe THI oh fate] is a newer drug that covalently bonds to acetylcholinesterase. Its use is the same as isoflurophate.]... 

A therapeutic preparation of colloidal silver is known as collargol. Crede s ointment also contains this form of silver, and is employed in the treatment of certain types of septic infection. An astringent antiseptic is prepared by the action of an alkaline tannin solution on aqueous solutions of silver salts.11... 

Antibiotic therapy should be limited to periods of disease exacerbation, with the eyelid hygiene providing the daily maintenance regimen. Occasionally, topical erythromycin, bacitracin, or bacitracin-polymyxin B ointment applied at bedtime for several weeks proves beneficial as part of the therapeutic protocol. This type of chronic therapy, however, always carries the risk of fitster-ing overgrowth of resistant organisms. 

Descemet s membrane, reestablishing stromal deturges-cence. Conservative therapeutic measures may be instituted during this resolution period, including the use of topical 5% sodium chloride drops during the day and 5% sodium chloride ointment instilled into the conjunctival sac at bedtime. Broad-spectrum topical ophthalmic antibiotics may be instituted to protect the compromised cornea from secondary bacterial infection. 

Some practitioners prefer not to recommend the use of therapeutic soft contact lenses during episodes of bullae eruption. When a patient presents with corneal epithelial defects due to ruptured bullae, a prophylactic antibiotic ointment such as 0.3% tobramycin or 0.3% ciprofloxacin four times a day can be administered, along with a cycloplegic agent (e.g., 5% homatropine two times a day). 

During acute episodes a broad-spectrum topical prophylactic antibiotic ointment, such as 0.3% tobramycin or 0.5% moxifloxacin, protects the cornea from secondary infection while it heals. The use of a therapeutic contact lens and topical NSAIDs, such as diclofenac sodium 0.1% solution or ketorolac 0.5% solution, provide symptomatic relief. The therapeutic soft contact lens also protects the regenerating epithelium and temporarily provides epithelial stability. A cycloplegic agent, such as 5% homatropine, should be instilled to decrease ciliary spasm and pain. Oral analgesics can be prescribed as needed (see Chapter 7). The eye should be examined in 24 hours and the therapy continued until the epithelial defect is healed. 

Unlike dendritic keratitis, indolent ulcers are typically very difficult to treat. Instillation of a prophylactic antibiotic, such as polymyxin B-bacitracin ointment two to four times a day, and a cycloplegic agent, such as 5% homatropine two to three times a day, is indicated. Therapeutic soft contact lens use with appropriate antibiotic therapy can also be considered as alternatives. These patients must be monitored carefully to ensure that no secondary infection develops. If the ulcer deepens, a new infiltrate forms, or if there is an increase in the anterior chamber reaction while the patient is being treated, cultures should be performed to rule out bacterial or fungal infection. Cyanoacrylate glue, conjunctival flap surgery, or tarsorrhaphy may be required if healing does not occur. 

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