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Ceutics2 - Midterm 1 > 1/2 - Creams, Ointments & Transdermal Products Theory > Flashcards

1/2 - Creams, Ointments & Transdermal Products Theory Flashcards

1
Q

Functions of the skin

DRY SKIN

Impedes Electrical Current

A

ELECTRICAL BARRIER

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2
Q

What type of steroid?

used for atopic dermatitis / severe dermatitis

xerotic​/nummular eczema

lichen sclerosis

SCABIES

A

Moderate Steroids

5-4-3

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3
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Bacitracin + Polymyxin + NEOMYCIN

BPN

A

USA triple antibiotic =

NEOSPORIN

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4
Q

broad category

may be applied topically, but have

SYSTEMIC EFFECTS (enter skin)

usually through lymphatic transport when applied topically

A

Anti-BIOTICS

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5
Q

Steroid Class? / Allergy Group?

Triamcinolone Acetonide

0.025%

0.1% - Cream/lotion vs OINTMENT

0.5%

A

“Ace-Bounce”

ALL Allergy group B -

6-5v4-3

6

5 v 4

3

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6
Q

Moisturizer for SENSITIVE skin

Moisturizers hold water in the outermost layer of skin

temporary barrior, usually contain combo of humectants + Emollients

A

SHOULD NOT CONTAIN

ACIDS / Fragrances + Dyes

SHOULD contain

Soothing agents = Aloe / Chamomile

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7
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Hydrogen Peroxide 3-6%

  • DO NOT ADVICE*
  • less preferable than GENTLE HAND WASHING*, can induce scarring / delay healing

Phenol & Related Phenolics

Thymol / tricolsan* - rmoved

many of these products had endocrine effects or allergenic

A

ANTISEPTICS

not generally adviced to use tho

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8
Q

salty ikky sweat, ikky=eccy

SALTY sweat glands

About 99% water, pH of 5

Concentrated in Palms & Soles

Functions as heat control for humans and MOST animals (not in hooved animals)

<1/10000 of total surface area

A

ECCRINE

Sweat Glands

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9
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Silver Sulfadiazine

sulfa drug to prevent infection in BURNS

Benzoyl Peroxide +/- Clinda or Erythromycin

treat ACNE, gram POSITIVE propionibacterium acne

A

TOPICAL ANTIBIOTICS

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10
Q

REMOVE SKIN/HAIR

Thioglycolate breaksdown Di-sulfide bonds in keratin

Hair is weakened, making it easier to slough off

A

DEPILATORIES

THIOGLYCOLATE

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11
Q

1 of 3 active ingredients in SUNSCREENS

NEWER agens mainly in Europe / Australia / Japan

not in USA

Designed to improve UVA BLOCKING

longer wave length ~320-400nm

does not protect SUNBURN, but does prevent long term skin dmg –> photodermatitus / melanoma

A

UV-Absorbing

COLLOIDAL SOLIDS

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12
Q

Outer most layer of the skin

A

Stratum Corneum

Barrier layer, comprimised primarily of keratin protein

10um in thickness

MOSTLY DEAD TISSUE

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13
Q

What type of steroid?

Utilized for thin-skinned / sensitive areas

especially areas under occlusion

armpit / groin / buttock / breast folds

A

Weaker TOPICAL Steroids

7-6-5

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14
Q

Type of Semi-Solid - topical dosage form

Hydrocarbon-based, with dissolved or suspended drugs

addition of high melting waxes to liquid mineral oil or petrolatum

addition of polyetheline into mineral oil

A

OINTMENTS

Adv: excellent moisturizing materials, adhesive, hard to remove, good vehicles for dry skin

DisAdv: greasy, may stain, not good solvents -> lessen drug availability

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15
Q

Functions of the skin

4.2 - 5.6 pH

of acid mantle is low enough to be BACTERIOSTATIC

A

MICROBIAL BARRIER

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16
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Bacitracin + Polymyxin + GRAMICIDIN

BPG

A

Canadian TRIPLE ANTIBIOTIC

  • polysporin complete*
  • has gramicidin instead of neomycin*
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17
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Sodium Chloride

HIGH concentrations >> 0.9% are damaging to living cells

Sodium + Calcium Hypochlorite

chlorine Bleach, useful as a DISINFECTANT, no longer used as a topical antiseptic

A

FIRST IS ANTISEPTIC

second was antiseptic, now just a disinfectant (non-living surfaces)

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18
Q

SEBUM / COMEDO

A

SOAP + WATER

removes sebum+acne ,

prevents formation of COMEDO

Comedo = black/whiteheads, pores that are blocked by sebum

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19
Q

Main Drugs that use TRANSFERMAL DELIVERY

for SYSTEMIC EFFECTS

A

Patches

NICOTINE / NITROGLYCERIN

Clonidine / ESTRADIOL

/ Scopalomine / FENTANYL

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20
Q

How are SEMISOLID dosage forms PREPARED?

A
  • FUSION METHOD -
    • Heat to >70*C, emulsify @ HIGH temps
      • Congeal upon cooling
    • Creams = water phase is SLIGHTLY hotter than oil
  • COLD INCORPORATION
    • levigate drug INTO prepared ointment/cream base
  • Importance of GEOMETRIC PROPORTIONS
  • Neutrolization of carbopol genls
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21
Q

Steroid Class? / Allergy Group?

Betamethasone DiPropionate

0.05% - diprosone vs Dermovate

A

C

only (di)PROPIONATE that HAS an allergy CLASS

3 / 1

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22
Q

Steroid Class? / Allergy Group?

Fluocinonide 0.5%

Halcinonide 0.5%

Amcinonide 0.5%

Desoximetasone 0.25%

no allergy group

A

2 - B

ALL Class 2 are allergy group B

ALL 0.5%

except for the non-allerrgy group desoximetasone = 0.25%

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23
Q

Moisturizer for MATURE / OLD skin

Moisturizers hold water in the outermost layer of skin

temporary barrior, usually contain combo of humectants + Emollients

A

typically Water in Oil = W/o

with PETROLATUM BASE, just like VERY DRY SKIN

but also have ANTIOXIDANTS to combat

wrinkles / prevent flaking + scaling

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24
Q

Steroid Class? / Allergy Group?

Fluocinolone Acetonide 0.01-0.2%

Triamcinolone Acetonide OINTMENT 0.1%

Fluradrenolide 0.05%

no allergy group

A

4 - B

4 is a MIX of B & D

Triamcinolone Cream/Lotion = 5, Triamcinolone OINTMENT = 4

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25
Q

Steroid Class? / Allergy Group?

Clobetasol Propionate 0.05%

Betamethasone Dipropionate 0.05%

Halobetasol proprionate 0.05%

Diflorasone Diacetate 0.05%

A

1 - D

All 1’s are D’s, MOST POTENT

up to 600x stronger thatn group 7 (hydrocortisone)

except for the 2 withought allergy groups

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26
Q

DRUG used to stop hair loss and promote hair growth

side effect = initial hair loss

stimulates hair follicle activity, could lead to the shedding of OLD hairs. before NEW HAIR can grow

A

MINOXIDIL

rogaine

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27
Q

Main drugs that use TRANSDERMAL DELIVERY for

LOCAL EFFECTS

extending beyond the skin

A

Muscle/Joint Pain Relief:

Menthol / methyl salicylate

Camphor / capsaicin

Local analgesics

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28
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Mupirocin

A

RX ONLY

Topical ANTIBIOTIC

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29
Q

Steroid Class? / Allergy Group?

Betamethasone Dipropionate 0.05%

A

3 - C

Group 3 are allergy class B D or C

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30
Q

ADVANTAGES

of percutaneous drug delivery

A

AVOIDS 1st Pass Metabolism

Avoids stability/BV issues of oral drugs

Prolonged therapy + Reduces Dose

Controlled / Convenient -> Compliance

Nocturnal Treatment

Accomodates for drug w/ short half life

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31
Q

How do drugs move through the skin?

D-Ni-P

A

Passive-Non-Ionic Diffusion

Diffusion - follows a conc gradient from high-> low

Passive - not active, NO energy

Non-Ionic - ONLY uncharged molecules can cross membranes

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32
Q

Absorbs or reflects some of the sun’s

UV radiation on the skin, protects against sunburn

mainly against UV-B spectrum = effective spectrum

A

SUNSCREEN

aka sunblock / sun tan lotion / sunburn cream / block out

type of LOTION / SPRAY / GEL / other

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33
Q

What type of steroid?

Used on the face / eyelids / diaper area / perianal skin

interigo of groin / body folds

A

Weaker Steroids

7-6-5?

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34
Q

Steroid Class? / Allergy Group?

Triamcinolone Acetonide Lotion/Cream 0.1%

Fluocinolone Acetonide 0.025%

Desonide OINTMENT 0.05%

Hydrocortisone Valerate 0.2%

Fluticasone propionate 0.05%

does not have an allergy class

A

5 - B + 1 D (Valerate)

All B except valerate (D)

mainly the same drugs, just greater strength vs class 6

Desonide OINTMENT = 6 ,desonide cream/lotion = 5

Triamcinolone Cream/Lotion = 5, Triamcinolone OINTMENT = 4

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35
Q

Moisturizer for NORMAL skin

Moisturizers hold water in the outermost layer of skin

temporary barrior, usually contain combo of humectants + Emollients

A

Oil in Water = O/W Emulsions

light-weight oily component such as cetyl alcohol o rcyclomethicone

36
Q

Therapeutic Effect on the STRATUM CORNEUM (SC)

Removal of Thickened SC

lysis of covalent bonds of keratim protein

disintegration / SLOUGHING of DEAD SKIN

A

KERATOLYTICS

37
Q

Steroid Class? / Allergy Group?

Mometasone Furoate

0.1% Cream/lotion vs Ointment

A

infuruoateD

D

4 / 3

38
Q

Functions of the skin

Helps keep body at 37*C = 98.6*F

Vessels DILATE to cool

CONTRACT to CONSERVE

MOST HEAT IS LOSS @ THE HEAD

A

THERMAL BARRIER

Temperature regulating

39
Q

Physical factors

that affect the DEVELOPMENT of

transdermal drug delivery systems

A

PROMPT onset

Adequate rate of delivery + duration

Controlled delivery, to lessen variability

lessen environmental effect

Efficient use of drug by body

40
Q

Steroid Class? / Allergy Group?

Hydrocortisone Valerate 0.2%

Hydrocortisone Butyrate 0.1%

Mometasone Furoate 0.1%

A

4 - D

4 is a MIX of B & D

valerate is higher strength vs the class 5, still D allergy

41
Q

Steroid Class? / Allergy Group?

Desonide 0.05%

Cream/Lotion vs Ointment

42
Q

Type of Semi-Solid - topical dosage form

white semisolids, emulsions

only O/W, not w/o

prepared by fusion,

Higher concentration of INTERNAL PHASE –> MORE VISCOUS

A

CREAMS

Adv: water washable / soluble, volatile components evaporate, vanishing cream

43
Q

UVA vs UVB

A

UVA does NOT cause sunburn

Causes longer term skin damage

Photodermatitus + Melanoma

PPD = persistent pigment darkening

rating measures UVA exposure protection from TANNING

44
Q

Hydrocortisone creams & ointments

Class? / Allergy Group?

Treatment of rash / eczema / dermatitis

weakest topical steroid, poor lipid permeability for mucous membranes

THE REFERENCE

A

A-7

least potent

45
Q

SPF

A

Sun Protection Factor

Measures the effectiveness of a product at blocking

UVB

SPF 15 = user wearing product can

Expose skin 15x as long as unprotected expsure

TIME BASED / COMPLEXTION OF SKIN

46
Q

Classified as a COSMETIC

most are alcohol-based liquid products, some gel formulations

Contain perfume fragrances / natural essential oils inteded to MASK the odor of perspiration

corn starch + baking soda also recommended

A

DEODORANTS

in comparison to antipersperants**, deodorants DO NOT have Al or Zr

47
Q

Broad Category

System that retain their shape until acted upon, in which they deform and deformations are permenant

Toothpaste / Ointments / Pastes / Creams (O/W)

Gels / Rigid Foams

A

type of topical/cutaneous dosage forms

SEMISOLIDS

48
Q

Steroid Class? / Allergy Group?

Fluocinolone ACEtonide

0.01%

0.025% Cream

0.01-0.2% Ointment?

FluocinoNIDE

A

“Ace-Bounce”

B - 6-5-4-2

6

5

4

2

49
Q

Type of Semi-Solid - topical dosage form

Emulsification of AIR or other gasses in a LIQUID PHASE

some can be “quick-breaking” –> become liquid or powder RAPIDLY

A

RIGID FOAMS

aerosol shaving creams / medicated foams

50
Q

What type of steroid?

used for Psoriasis / severe Poison Ivy Exposure

lichen planus / discoid lupus / chapped feet

alopecia areata / nummular eczema

A

STRONG STEROIDS

1-2-3

51
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Bacitracin + Polymyxin

A

BP

Polysporin

topical ANTIBIOTIC

52
Q

Steroid Class? / Allergy Group?

HyDrocortisone VALERATE

0.2% Cream vs Ointment

HyDrocortisone Butyrate

A

hyDrocortisone, except for the OG one that is A

D

5 v 4

4

53
Q

oily hairy bum, SEBum

Secrete SEBUM, oily skin lubricant

Maintains acid pH = 5 at skin surface = acid mantle

Comprises only 1/1000 of the total SURFACE AREA

A

SEBACEOUS GLANDS

associated with HAIR FOLLICLES

54
Q

Inner-most layer of sikin

A

DERMIS

Primarily collagen / reticulum / elastin proteins

Semi-gel matrix of mucopolysaccharide ground substance

network of NERVES / Micro-circulation

Lymphatic circulation

55
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Lower Aliphatic Alcohols

Ethanol 70-90% / isopropanol 70-80% - MORE EFFECTIVE

Quartenary Amonium surfactants

BAC / CTAB / CPC / BZT

A

Types of topical ANTISEPTICS

56
Q

Keratolytics

for ACNE

A

Sulfur + Salicylic acid

ROSORCINOL

used in 5-10% in ointments for chronic skin diseases such as:

Psoriasis / Hidradenitis supporativa / ECZEMA

57
Q

1 of 3 active ingredients in SUNSCREENS

Listings vary by GEOPOLITICAL region

More effective for blocking UVB

UVB = shorter wavelength, blocks the outer skin

from SUNBURN

A

UV-Absorbing Dissolved Substances

58
Q

Transepidermal Route

Primary Route of Percutaneous Absorption

A

High skin permeability = good LIPID & Water Solubility

Lipid Zone - slowest, rate limiting

Stratum corneum, packed with KERATIN

drugs must transverse through lipid channels

Aqueous Zone

Pass through epidermis –> circulatory system

must diffuse through the largely aqeuous epidermal region = 99% of cross section

59
Q

BIOLOGICAL Factors

that affect the DEVELOPMENT of

transdermal drug delivery systems

A

May see local irritation from device

Allergic skin RXNS

METABOLISM of drug in skin

Variability in system ELIMINATION

Vasoconstriction activity, further delays absorption

60
Q

Favorable DRUG CHARACTERISTICS

for percutaneous drug delivery systems

A

POTENT, IV dose <10mg qd

Adequate Solubility in mineral oil & water, logP ~ 1

low MW, <800 amu

low melting point

PK/Pkdynamics properties well known

61
Q

Moisturizer for DRY skin

Moisturizers hold water in the outermost layer of skin

temporary barrior, usually contain combo of humectants + Emollients

A

typically WATER IN OIL = W/O

have antioxidants / grape seed oil / dimethicone

62
Q

AyPO = AyBO

Secrete MILKY SUBSTANCE** = **B-O

contains proteins / lipoproteins / lipids

Bacterial action on the secretions –> body odor

Located in axillae = armpits / anogenital regions** / **nipples

A

APOCRINE

SWEAT GLANDS

63
Q

broad category

topical products applied to the skin to

kill harmful microorganisms

  • NOT absorbed through the skin*
  • can also be used as disinfectants*
A

Anti-SEPTICS

broad category

64
Q

Steroid Class? / Allergy Group?

Triamcinolone Acetonide 0.025%

Fluocinolone Acetonide 0.01%

Desonide CREAM/LOTION 0.05%

Aclometasone Dipropionate 0.05%

does not have an allergy class

A

6 - B

all class 6’s are allergy group B

these are all the LOWER STRENGTH VERSIONS

same drugs/allergy group as group 5, just lower % strength

65
Q

Steroid Class? / Allergy Group?

Mometasone Furoate 0.1%

A

3 - D

3 is a mix of BDC

66
Q

Keratolytics

Salicylic Acid

Allantoin, Lactic Acid, Urea

A

REMOVE EXCESS DEAD SKIN ON SURACE

used to remove warts and other skin lesions

Soften keratin, improve natural moisturization

relieve dry skin

Sulfur added -> secondary treatment for dandrugg / seborrheic dermatitis

67
Q

Broad Category

agents applied to NON-LIVING SURFACES

to kill microrganisms that would be harmful to living tissue

can also be an antiseptic

A

DISINFECTANT

68
Q

Steroid Class? / Allergy Group?

Triamcinolone Acetonide 0.5%

Fluticasone propionate 0.005%

not in an allergy class

A

3 - B

Group 3 is one of each B / D / C

69
Q

Type of Semi-Solid - topical dosage form

Clear - Whitish, but TRANSLUCENT

semisolid system w/ cross-linked polymer w/ concentration <10%, generally 0.5% to 2%

natural gums

A

GELS

JELLIES

70
Q

Therapeutic Effect on the STRATUM CORNEUM (SC)

MOISTURIZING ABILITY

re-hydrate tissue, apply water-impermeable film

containign fatty acids + fatty acid esters

A

EMOLLIENCY

71
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

IODINE

Povidine Triiodine = Betadine, SAFER & MORE PREFERRED. delays release of iodine that promotes wound healing

Alcoholic solution** = tincture of iodine, NO LONGER RECOMMENDED for minor wounds due to **inducing scarring / delaying healing**

A

ANTISEPTIC

72
Q

Type of Semi-Solid - topical dosage form

  • like ointments* w/ HIGH concentration of *INSOLUBLE solids*
    ex. Starch / ZnO / Talc

protective barrier / water impereable film

less greasy

film/ opaque

73
Q

Types of Drug Delivery systems to deliver:

LOCAL/Topical ANESTHETICS

A

used to numb body parts

to REDUCE PAIN & relieve ITCHING

Creams / Ointments

Aerosols / Sprays

Lotions / Gels

74
Q

Percutaneous Absorption

ISSUES

A

NOT a frequently used route

Drug absorbed slowly

Incomplete absorption

Inefficient route

Variation in delivery

75
Q

Patient Counseling for Topical Steroids

A

Important to counsel, excessive use –> dangerous side effects

Patient allergic to one steroid in a Group A-D are allergic to ALL OTHER STEROIDS IN THAT SAME GROUP (A-D)

if allergic:

recommend SUBSTITUTE in SAME CLASS

76
Q

Middle layer of tissue

A

Stratum Germinativum

Viable Epidermis

Living tissue, germative layer produces more stratum germinativum

100um in thickness

77
Q

Antiperspirant

or

Antiperspirant / Deodorant combintation

A

CLASSIFIED AS** **DRUGS

Al / Zr Salts

do chemical reversible DAMAGE to glands

Aluminum based complexes react w/ electrolytes in sweat to form a gel-plug in the duct of the sweat gland

78
Q

Topical Steroids

Goal is to select the:

Least Potent (Class 1) steroid that will do that job

in the allergy Group (a-d) which the patient is not sensitive

A

Classified by US FDA into SEVEN CLASSES

based on POTENCY compared to Hydrocortisone = REFERENCE

1 = MOST POTENT, 7 = least potent

Also classified into FOUR GROUPS based on ALLERGY

A / B / C / D

steroids in SAME GROUP = CROSS REACTIVE, can be reactive to more than 1 group

79
Q

Steroids WITHOUT Allergy Groups

Alclometasone Diproprionate 0.05%

Fluticasone Propionate 0.05% + 0.005%

Fluranderenolide 0.05%

Desoximetasone 0.25%

Halobetasol Proprionate

Diflorasone Diacetate

A

almost all PROP-ionates do NOT have allergy groups, exception is BETAmethasone 0.05/0.05 = class C

6

5/3

4

2

1/1

80
Q

Functions of the skin

Prmarily to UV RADIATION of the sun

Role of Melanocytes to produce MELANIN to

LESSEN Burning

A

RADIATION BARRIER

81
Q

Moisturizer for OILY skin

Moisturizers hold water in the outermost layer of skin

temporary barrior, usually contain combo of humectants + Emollients

A

typically OIL IN WATER = O/W

Need to be NON-COMODOGENIC = will NOT clog pores

help prevent acne recurrence

82
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Boric Acid

for opthalmics, also effective against yeast

Chlorhexidine Digluconate

cationic surfactants –> surgical swags / mouthwash

A

ANTISEPTIC

83
Q

Moisturizer for VERY DRY skin

Moisturizers hold water in the outermost layer of skin

temporary barrior, usually contain combo of humectants + Emollients

A

typically w/o

WATER IN OIL w/ PETROLATUM BASE

84
Q

1 of 3 active ingredients in SUNSCREENS

Metals

85
Q

Topical Antiseptic, Antibiotics, or Disinfectant?

Manuka Honey

Natural source of methylglyoxal, which has AB properties

Polyhexanide

PHMB

Octenidine Dihydrochloride

cationic surfactant with broader spectrum of AB action

A

ANTI SEPTIC

86
Q

Containment of body fluids & Tissues

Barrier function

Receptor of external stimuli

Regulate body temperature

Synthesis and metabolism function

disposes of biochemical wastes

Sexual Attraction / Blood Pressure regulation

A

Skin functions

87
Q

Functions of the skin

need to partition across the

STRATUM CORNEUM

via pore routes, need HIGH LIPID SOLUBILITY

and sufficient water solubility

A

CHEMICAL BARRIER

Ceutics2 - Midterm 1 (7 decks)

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