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clinical skills in pharm prac > C7 SKIN DISORDERS > Flashcards

C7 SKIN DISORDERS Flashcards

1
Q

what is eczema?

A

inflammatory aka dermatitis

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2
Q

symptoms of inflammation

A

redness, swelling, itch, pain, heat

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3
Q

what is atopic eczema?

A

chronic, pruritic (itchy) inflammatory skin disease

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4
Q

high to low potency

A

clobetasol
betamethasone
mometasone
desonide
hydrocortisone

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5
Q

what is the max supply for betamethasone & mometasone?

A

15g for cream/ointment/gel
or
30ml for topical solution

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6
Q

what is contact dermatitis?

A

itchy rash caused by direct contact with allergen or irritant

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7
Q

what is seborrheic dermatitis?

A

skin condition that mainly affects your scalp
SS: yellow, greasy scales over eczematous-like lesion

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8
Q

should we apply topical corticosteroids or emollients first?

A

preference: emollients before TC -> space 10 to 15 mins apart -> or can be the other way

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9
Q

indication of emollients

A

dry and scaling SD
-> more oily preparations retain moisture better in the skin

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10
Q

less to more oily

A

aqueous cream/aqurea cream - soften keratin layer & hydrates skin, helps in steroid penetration
white soft paraffin (oily) - moisturizer
emulsifying ointment (wax like texture) - moisturizer, soap substitute

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11
Q

emollient CP

A
  • applied immediately after washing/bathing to maximize effect of skin hydration
  • removed with clean spoon/spatula to reduce contamination
  • keep away from flames
    applied liberally to affected area. aqurea cream -> apply 2-3 times daily
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12
Q

indication: coal tar

A

relieve itching & inflammation in psoriasis & eczema

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13
Q

CP of coal tar

A
  • sometimes cause skin irritation, photosensitivity, acne breakouts
  • may stain skin, hair, clothes or bedding & has a strong smell
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14
Q

oral medications

A

oral histamines - hydroxyzine (for severe itch), chlorpheniramine, cetirizine given for short period of time
oral steroids may be used short term to control severe flare
oral immunosuppressant

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15
Q

hydroxyzine info

A

indi: pruritus
dose: 10-25mg TDS-QDS (usually prescribed for bedtime)
SE: dw

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16
Q

eczema: non-pharm advice

A

moisturizer/emollient is essential for tx & helps to prevent symptoms

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17
Q

what is tinea?

A

caused by fungi aka ringworm infection

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18
Q

types of tinea

A

tinea corporis = circular shape, redness

tinea versicolor (white spot) = scaly rash that appears white, pink or brown patches

19
Q

what are the imidazole antifungals?

A

ketoconazole
miconazole
clotrimazole
fluconazole (oral only)

20
Q

how to prevent relapse of tinea?

A

topical antifungal tx should be continued for 1-2 weeks after disappearance of all signs of infection

21
Q

indi of ketoconazole?

A

seborrheic dermatitis, dandruff & vinea versicolor

22
Q

tx & prevention of ketoconazole?

A

for tinea versicolor: OD 5/7, OD for 3 days before sun exposure

23
Q

dosing for clotrimazole?

A

1% cream/lotion/powder: BD (maybe used up to TDS)

24
Q

CP: topical antifungals

A
  • may cause local irritation, dermatitis or a burning sensation -> tx should be discontinued if SE are severe
  • compliance is important -> continue applying for 1-2 weeks after disappearance of all signs of infection
25
Q

fluconazole: indi, dose, SE

A
  • tinea corporis & versicolor
  • max 6 weeks orally 50mg OD
  • abdominal discomfort, d, flatulence, hd, n, rash (discontinue if occurs)
26
Q

tinea: non-pharm advice

A
  • do not share towels etc
  • while infected, use separate fresh towel to dry infected area
  • wash socks etc in hot water to prevent re-infection
  • check fam animals
  • wear sandals around showers & pools
  • allow sweaty shoes to dry out b4 wearing again
  • wash & dry skin after physical activity or if sweaty
27
Q

what is acne?

A

chronic or recurrent development of papules… aka acne vulgaris

28
Q

acne: summary

A

topical keratolytic agent: benzoyl peroxide
topical antibiotics: clindamycin
topical retinoid: adapalene
oral antibiotics: doxycycline, minocycline & erythromycin
oral retinoid: isotretinoin

29
Q

example of contra in acne?

A

oral antibiotic + oral retinoid (isotretinoin)

30
Q

acne: mild

A

topical benzoyl peroxide / topical retinoid (adapalene) / topical combi therapy

31
Q

topical combi therapy

A
  1. BP + antibio
  2. BP + retinoid
  3. all 3
32
Q

acne: moderate

A

topical combi
or
oral antibio + topical (BP + R OR + ANTI)

33
Q

acne: severe

A

oral anti + topical combi
or
oral retinoid -> isotretinoin

34
Q

benzoyl peroxide: indi, dose, SE

A

mild acne vulgaris
OD-BD
skin irritation

35
Q

CP: BP / clindamycin

A

common SE at start of tx -> consult Dr immediately if do not go away or severe
- mild stinging or burning sensation
- dryness & peeling of skin -> apply moisturizers after applying med

36
Q

what does adapalene do?

A

reduce inflammation & unclog blocked pores -> applied to whole face

37
Q

adapalene: indi, dose,

A

mild to moderate acne vulgaris, OD -> thinly in evening

38
Q

adapalene: CP

A
  • apply thinly to affected area OD, preferably at night
  • CSE: dryness & skin irritation
  • avoid exposure to UV light
  • may worsen acne initially & takes 6-8 weeks
  • avoid accumulation in angles of nose
39
Q

macrolides: CP

A
  • GI upset
  • complete course
40
Q

tetracyclines: CP

A
  • avoid lying down for at least 30mins after ingestion -> drink water to avoid irritation
  • avoid exposure to sunlight
  • space apart from antacid
  • complete course
41
Q

isotretinoin: indi, dose, SE

A

severe acne
max 150mg/kg per course daily
anaemia, dry eyes…

42
Q

isotretinoin: CP

A
  • do not take vitamin A supplements
  • teratogenic = women of child-bearing age should avoid unless use 2 contraceptive methods
  • dry eyes / lips / nasal mucosa / skin -> apply moisturising cream etc to relieve or discontinue if skin peeling is severe or d develops
  • avoid blood donation (can for at least 1 month after)
  • avoid skin resurfacing producers (laser etc)
43
Q

acne: non-pharm advice

A

keep face clean, moisturize, use makeup sparingly, keep hands off face stay out of sun, relax

clinical skills in pharm prac (7 decks)

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