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Clinical Pharmacology > Acne & Psoriasis > Flashcards

Acne & Psoriasis Flashcards

1
Q

Acne Vulgaris - Treatment

A 
Cleaning and removal of oils
Mild: Topical; 6-8 weeks to show effect --> continue treatment after lesions are gone; 2X weekly for 6-12 weeks.
Tretinoin or Adapelen
Benzoyl peroxide + topical antibiotics (Clindamycin)
Azelaic acid (15% gel)
Moderate: Same as mild + PO
Tetracycline
Severe:
Isotretinoin
Other
Hormonal therapy: contraceptives
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2
Q

Tretinoin/Adapelene - MoA

A

Retinoic acid. Prevents comedones and decreases inflammation

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3
Q

Tretinoin - Adverse effects

A

Stinging, dryness, skin irritation, itching

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4
Q

Tretinoin - Contraindication

A

Acute dermatitis

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5
Q

Tretinoin - Dose

A

0,05% topical cream, apply once daily

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6
Q

Benzoyl peroxide - MoA

A

Prevents comedones and decreases bacterial counts

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7
Q

Benzoyl peroxide - Adverse effects

A

Dry skin, skin irritation, contact dermatitis

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8
Q

Benzoyl peroxide - Interactions

A

Benzyl peroxide may decrease the conc of tretinoin

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9
Q

Benzoyl peroxide - Contraindication

A

Acute dermatitis

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10
Q

Benzoyl peroxide - Dose

A

5% gel, apply once daily, wash the skin after 2-12 hours depending on the irritation

Epiduo:
Benzyl peroxide 2,5% + Adapelen 0,1% Gel

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11
Q

Clindamycin - MoA

A

Protein synthesis inhibitor

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12
Q

Clindamycin - Adverse effects

A

Local skin irritation and burning if contact with mucosa or cracked skin.

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13
Q

Clindamycin - Contraindication

A

Acute dermatitis

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14
Q

Tetracycline - MoA

A

Protein synthesis inhibitor

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15
Q

Tetracycline - Adverse effects

A 
Discoloration of teeth and hypoplasia of enamel in pregnant women and children <8y
Nephrotoxicity
Hepatotoxicity
Photosensitivity
Vaginal/oral candidiasis
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16
Q

Tetracycline - Interactions

A

Ca, Al, Fe reduced bioavailability

Aminoglycosides potentiate nephrotoxicity

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17
Q

Tetracycline - contraindication

A

Pregnancy

Children <8y

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18
Q

Tetracycline - Dose

A

250-500 mg bid, 1 h before or 2 h after meal.

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19
Q

Clindamycin - Dose

A

10mg/mL, liniment. Apply thin later twice daily. continue treatment max 3 months.

20
Q

Isotretinoin - MoA

A

Synthetic retinoid.

21
Q

Isotretinoin - Adverse effects

A

Teratogenicity, depression, dry skin, chelitis, hypertriglyceridemia

22
Q

Isotretinoin - Interactions

A

Tetracycline –> risk for increased ICP

23
Q

Isotretinoin - Contraindication

A

Pregnancy, renal and liver failure

24
Q

Isotretinoin - Dose

A

0,5 mg/kg once daily doe 5 months PO

25
Q

Acne Rosacea - Treatment

A

Mild: Topical
Metronidazole (0,75% gel) or Ivermectin (10 mg/g cream)
Severe: Oral
Doxycycline
Very severe:
Isotretinoin
Cosmetic procedures: rhinophymectomy, Laser/intense pulse light

Symptoms resolve after 4-6 weeks of therapy

26
Q

Metronidazole - MoA

A

Antiparasitic drug, inhibits pyruvate ferredoxin oxidoreductase

27
Q

Metronidazole - Adverse effects

A

Nausea, Vomiting, Metallic taste, Transient leukopenia, Thrombocytopenia

28
Q

Metronidazole - Interactions

A

Increases effect of warfarin

Ethanol: disulfiram-like reaction

29
Q

Metronidazole - Contraindication

A

First trimester pregnancy

30
Q

Metronidazole - Dose

A

0,75% gel. Apply thin layer 1-2 X daily for 1 month

31
Q

Doxycycline - Dose

A

40 mg PO daily for 2-3 months

32
Q

Psoriasis - Diagnosis

A

Well-marginated erythematous plaque with silvery-white surface scale. Traumatized areas –> Koebner/isomorphic phenomenon
Fingernail involvement: punctate pitting, nail thickening
Psoriatic arthritis –> sausage digits
Auspitz sign
Skin biopsy

33
Q

Psoriasis - Treatment

A

Avoid excess drying or irritation of skin, maintain adequate cutaneous hydration.
Exfoliation/Peeling
Localized plaque-type:
Betamethasone, may combine with Calcipotriene
Widespread:
UV light with oral/topical psoralen (PUVA):
Methotrexate

34
Q

Betamethasone - MoA

A

High potency glucocorticoid

35
Q

Betamethasone - Dose

A

1mg/mL liniment. Apply 1-2 X daily for 2-4 weeks, then max 2 X per week.

36
Q

Calcipotriene - MoA

A

Vitamin D analogue

37
Q

Calcipotriene - Adverse effects

A

Burning, itching, skin irritation

38
Q

Calcipotriene - Contraindication

A

Hypercalcemia, Vit D toxicity

39
Q

Methotrexate - MoA

A

Inhibits folate reductase

40
Q

Methotrexate - Adverse effects

A

GI, hematologic, hepatic and pulmonary reactions. Elevated liver enzymes

41
Q

Methotrexate - interactions

A

Increased effect with trimethoprim

Probenecid decreases renal excretion of methotrexate

42
Q

Methotrexate - Contraindication

43
Q

Methotrexate - Dose

A

7,5 mg PO single dose once a week

44
Q

Acne Vulgaris- Differential Diagnosis

A

Acne Rosacea
Perioral/Periocular dermatitis
Folliculitis

45
Q

Acne Rosacea - Differential Diagnosis

A

Acne Vulgaris
Perioral/Periocular dermatitis
Malar rash of systemic lupus
Seborrheic dermatitis

46
Q

Psoriasis - Differential Diagnosis

A

Eczema/dermatitis
Secondary syphilis
Tinae corporis

Clinical Pharmacology (14 decks)

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