Basic Principles of Topical Therapy

Question 1

most accessible organ of the human body

Answer 1

skin

Question 2

Therapeutic efficacy depends on

Answer 2

inherent potency

ability to penetrate the skin

Question 3

peak absorption rates of the topical drugs

Answer 3

12-24 hrs

Question 4

rate limiting barrier to percutaneous drug delivery

Answer 4

Stratum corneum

Question 5

Thinner areas of the body

Answer 5

mucous membrane 
scrotum 
eyelids
face
chest and back
upper arms and legs

Question 6

thicker areas

Answer 6

lower arms and legs
dorsa of hands and feets
palmar and plantar skin
nails

Question 7

advantages of occlusion

Answer 7

inc hydration and temp
limit the rub off and wash off of the drug
enhance drug penetration

Question 8

adverse effects

Answer 8

induce local skin atrophy
suppression of the HPA axis
promote infection, folliculitis or millaria
hastens absorption into both the skin and blood stream ( inc. systemic complications)

Question 9

Occlusion techniques

Answer 9

hydrate skin for 5 mins

application of airtight dressings

Question 10

The patient’s conformance with the provder’s recommendation with respect to timing, dosage and frequency of medication-taking during the prescribed length of time.

Answer 10

Medical adherence

Question 11

Patient’s passive following provider’s orders

Answer 11

compliance

Question 12

Duration of the time the patient takes medication, from initiation to discontinuation of therapy

Answer 12

persistence

Question 13

miscellaneous factors of topical therapy

Answer 13

vigorous rubbing or massaging
persence of air follicles
thinner stratum corneum
reducing the particle size

Question 14

inactive part of a topical preparation that brings a drug into contact with the skin

Answer 14

Vehicles

Question 15

Generally used in intertriginious areas

absorb moisture and decrease friction

Answer 15

Powder

Question 16

Adverse effects of powders

Answer 16

caking 
crusting 
irritation 
granuloma formation 
may be inhaled by the user

Question 17

semisolid preparations that spread easily
capable of providing occlusion, hydration and lubrication
inc potency due to occlusion

Answer 17

ointments and creams

Question 18

Hydrocarbon bases and absorption bases

Answer 18

ointments

Question 19

water in oil and oil in water emulsion bases

Answer 19

creams

Question 20

two phase systems involving one or more immiscible liquids dispersed

Answer 20

emulsions

Question 21

also called as oleaginous bases
referred to as emollients because they prevent the evaporation of moisture from the skin
composed of a mixture of hydrocarbons of varying molecular weights with petrolatum

Answer 21

hydrocarbon bases

Question 22

hydrophilic substances that allow for the absorption of water-soluble drugs
mix with water to form emulsions
do not contain water

Answer 22

absorption bases

Question 23

contain less than 25% water, with oil being the dispersion medium
two phases may separate unless shaken

Answer 23

water in oil emulsions

Question 24

contain greater than 31% water

aqueous phase may comprise up to 80% of the formulation

Answer 24

oil in water emulsions

Question 25

preservatives that inhibit the growth of molds

Answer 25

parabens

Question 26

an agent which draws moisture into the skin such as glycerin, propylene glycol or polyethylene glycol to prevent the drying up of creams

Answer 26

humectant

Question 27

consists of PEGS, water soluble, not decompose, not support the growth of molds

Answer 27

water soluble bases

Question 28

made from water-soluble bases ( water + PEG+ PPG+ carbopol) | organic macromolecules uniformly distributed in a lattice throughout the liquid

Answer 28

gels

Question 29

sutable for facial hairs

Answer 29

gels

Question 30

incorporation of high concentrations of powder into an ointment such as hydrocarbon base or a water in oil emulsion

Answer 30

paste

Question 31

involves the dissolution of two or more substances into homogenous clarity

Answer 31

solutions

Question 32

a hydroalcoholic solution with a concentration of alcohol or approximately 50%

Answer 32

tincture

Question 33

non aqueous solution of pyroxylin in a mixture with ether and ethanol and is applied to skin with a soft brush

Answer 33

collodion

Question 34

Non aqueous solution of drugs in oil or alcoholic solutions of soap can be used as counterirritants, astringents, antipuriticss, emollients, and analgesics

Answer 34

liniment

Question 35

a two phase system consisting of finely divided, insoluble drug dispersed into a liquid in a concentration of up to 20%

Answer 35

suspension/ lotion

Question 36

often the favorite preparation in children | leave the skin feeling cooler by evaporation of the aqueous component

Answer 36

suspension/ lotion

Question 37

more drying than ointments

Answer 37

suspension/ lotion

Question 38

major cutaneous side effects

Answer 38

``` irritation allergenicity atrophy comedogenicity formation of telangiectasias pruritus stinging pain ```

Question 39

A cutaneous side effect which is mainly due to drug concentration rather then drug penetration

Answer 39

irritation

Question 40

example immunomodulating agent

Answer 40

imiquimod

Question 41

A cutaneous side effect which is mainly due to the local penetration

Answer 41

contact allergy

Question 42

systemic toxicities

Answer 42

end organ toxicity teratogenicity carcinogenicity drug interaction

Question 43

may also serve as storage for large amounts of topical drug

Answer 43

stratum corneum

Question 44

dry skin, lichenified skin and thick scaly plaques

Answer 44

ointments and occlusion techniques

Question 45

Can act as a protective barrier to prevent the drying effect of aqueous compounds on the skin

Answer 45

ointments and occlusion techniques

Question 46

example of air tight dressings

Answer 46

vinyl gloves or plastic wrap cotton gloves or socks medicated imprignated in an airtight dressing

Question 47

occlusion can increase drug delivery

Answer 47

10-100

Question 48

golden period of ointment application

Answer 48

3 to 5 minutes after taking a bath

Question 49

wet lesions

Answer 49

creams

Question 50

less greasy, spreads easily on skin, provides a protective film of oil that remains on the skin as an emollient while slow evaporation of the water phase provide cooling effect

Answer 50

creams

Question 51

diaper rash

Answer 51

pastes

Question 52

incorporation of powders into ointments such as hydrocarbon base or water in oil emulsion

Answer 52

pastes

Question 53

Pruritus

Answer 53

suspension / lotions

Question 54

2 phase system consisting of finely divided insoluble drug dispensed into a liquid in a concentration up to 20%

Answer 54

suspension / lotions

Question 55

tender papulonodules in hair bearing areas

Answer 55

gels

Question 56

sweaty skin

Answer 56

powder

Question 57

dissolution of two or more substances into homogenous clarity

Answer 57

solutions