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pharm skin ch 12 > ch 12 > Flashcards

ch 12 Flashcards

1
Q

__ is used short term to relieve discomfort from dermatitis (rashes) associated with allergic reactions, posion ivy, hives, and insect bites. They relieve itching by the use of products local anesthetics, drying agents (calamine), anti-inflammatory agents (corticosteroids) applied topically for systemic effect. Anithistamines administered PO for systemic effect

A

Antipruritics

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2
Q

__ is used topically to soothe, soften, protect, and seal wetness in minor dermatological conditions, such as diaper rash, irritation, abrasions, and minor burns. the purpose is to moisten the skin and its acheived by a lipid barrier that does not let moisture out of the skin

A

Emollients (protectants)

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3
Q

__ (for example salicylic acid , are used to control conditions of abnormal scaling of the skin, such as dandriff, seborrhea, and psoriasis, or to promote peeling of the skin in conditions such as acne, hard corns, calluses, and warts.
Antifungals are also used at times for seborrheic dermatits and dandruff.

A

Keratolytic.

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4
Q

___ for an example nystatin, are useful in the treatment of fungal inf (candidiasis) such as thrush, diaper rash, and vaginitis. Other antifungals like (Lotrimin) is used for fungal inf such as athletes foot, body ring worm, and jock itch.

A

antifungals

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5
Q

Bacteriostatic

A

is a biological or chemical agent that stops bacteria from reproducing, while not necessarily killing them otherwise. Depending on their application, bacteriostatic antibiotics, disinfectants, antiseptics and preservatives can be distinguished.

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6
Q 
Antipruritics-
SE: skin irritation/rash
stiing/burning sensation.
allergic reaction
seizures and irregular heart rhythm prob with topical anesthetics when used on broken skin or in lrg amts
A

sedation from antihistamines PO or paradoxical agitation in children.
non sedating antihistamines may be effective as sedating antihistamines in tx for pruritus.

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7
Q 
antipruritic precautions or contradictions
delayed healing-on open wounds for corticosteroids
prolonged use (esp corticosteroids) Hypersensitivity (severe allergic) reaction to the active drug or any component of the formulation.
A

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8
Q

Corticosteroids SE: Epidermal thinning, with frequent skin tears, increased risk of inf and frequent bruising.
increased fragility of cutaneous blood vessels irritation,itching,burning, or stinging
ulceration, especially with occulsive dressings.
activation of latent inf and slow healing
hyperglycemia, glycosuria, and cushings syndrome with prolonged use of very high potency products.

A

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9
Q

corticosteroid precautions or contradictions
skin infections, bacterial or fungal, and cutaneous (skin) or systemic viral infections- open wounds
Abrupt discontinuation of very high potency productions used for a long period of time,
Hypersensitivity (severe allergic) reaction to the active drug or any component of the formulation.

A

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10
Q

Keratolytic SE: Severe skin irritation, pruritus, or stinging
irritation to eyes or mucous membranes, photosensitivity, systemic effects in allergic individuals or with multiple applications and prolonged use.

A

precautions or contradictions:
Open areas of the skin, hypersensitivity (severe allergic) reaction to the active drug or any component of the formulation.

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11
Q

Scabicides and pediculicides SE: rare when applied topically according to directions, may include slight local irritation, rash, or conjunctivitis, dermatits with frequent application
excessive or prolonged use or with oral ingestion or inhalation of vapors, CNS sx or hepatic or renal toxicity may occur.

A

Anemia and seizures have been reported, esp with the use of lindane. lindane should be used only in pt who cannot tolerate or have failed first line tx for lice with safer meds.

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12
Q

Scabicides and pediculicides precautions or contradictions: Acutely inflamed, raw, or weeping surfaces. Should be avoided during pregnancy and lactation with infants, children, older adults, those who weigh less than 110 lb or those with uncontrolled seizure disorders.

A

Permethrin is a safer alternative than lindane for scabies.

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13
Q

local antiinfectives SE: although rare, may include contact dermatitis, itching, burning, and irritation.

A

Local antiinfective contradictions: applies to the use of vaginal preparations during pregnancy. Use only under medical supervision. Some products can cause fetal abnormalities.

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14
Q

Aniseptics SE of chlorhexidine includes: dermatitis and irritation, photosensitivity (increased reaction such as burn from brief sun exposure.) allergic reactions esp in genital area.

A

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15
Q

antiseptic: SE of povidone-iodine betadine

skin irritation or burns, allergic reactions

A

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16
Q

antiseptic contradictions for chlorhexidine is pregnancy category B, not for frequent use for total body bathing, not for use in eyes and ears.

A

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17
Q

Antiseptic: precautions for povidone-iodine include: not for those allergic to iodine, not for use of open wounds, not for use in newborns (risk for iodine absorption)

A

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18
Q

Burn medicstion SE Pain,burning,and itching. allergic reactions, staining of skin temporarily.

A

precautions: apply to newborns or pts with impaired kidney or liver function (cumulative effects), history of allergy, esp to sulfa drugs, do not use silver sulfadizine with collagenase or trypsin-containing enzymatic debriding agents-silver will inactivate these enzymes

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19
Q

Agents to treat acne SE for bezoyl peroxide is skin irriation, mild stinging, redness, dry skin

A

precautions: pregnancy-breastfeeding, use in pt with skin diseases (dermatitis, eczema, sunburn, etc) may increase risk of skin irritation. Benzoic acid or paraben hypersensitivity. Avoid exposure to the eyes or mucous membranes, can cause severe irritation.

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20
Q

factors that influence the absorption of topical meds is: condition and location of the skin, heat and moisture. is skin is thick and callused then the absorption will be lower. if the skin is moist and macerated (raw) or warm the absorption will be more rapid.

A

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21
Q

Enzyme preparations- Collagenase (santyl) is a topical enzyme ointment used for chemical debridement of dermal ulcers and burns

A

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22
Q

antipruritics- benzocaine, dibucaine, antihistamine, diphenhydramine, corticosteroids, very high potency of bethamethasone, hydrocortisone.

A

Benzocaine-cause hypersensitivity reaction
dibucaine-potential for hypersensitivity
diphenhydramine(benadryl) not as effective as oral.
bethamethasone-duration is max 2-4 weeks. dont discontue abruptly if used for long period of time- avoid occulsive dressings.

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23
Q

Emollients and protectants: ammonium lactate, vit a & d, zinc oxide,

A

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24
Q

Keratolytics: coal tar, salicylic acid, sulfur.

A

ENZYME PREPARATIONS: collagenase.

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25
Q

Scabicides and pediculicides: Scabicides (permethrin 5% or lindane lotion) Pediculicides (pernethrin 1 % and lindane shampoo, pyrethrins are considered safer for pediculosis- repeat 7-10 days is needed.

A

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26
Q

antifungal-nystatin(candidiasis),Lotrimin(athletes foot), lotrisone and mycolog II

A

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27
Q

antivirals-acyclovir(herpes simplex)- Zovirax cream is for cold sores only, Valacyclovir, famciclorvir, docosanol (abreva) is the only OTC to shorten healing time and duration of cold sores

A

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28
Q

antibacterial agents- Mupirocin (bactroban)- the ointment is used to treat impetigo caused by staphylcococcus aureus and certain strep.- Mupirocin nasal ointment is for MRSA

A

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29
Q

Antiseptics- chlorohexidine and povidone- iodine.

A

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30
Q

Burn meds- silvadene and mafenide(sulfamylon)

A

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31
Q

Acne meds- clindamycin, erythromycin, sulfur, salicyclic acid, benzolyl peroxidem tetracycline, accutane to treat type 4 stge acne

A

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32
Q

client instructions for topical meds: even though its not a pill or may not require rx does not mean they cannot harm you if over used. never take by mouth, keep out of reach of childrens, be sure labels are not obscured and are read completely, avoid application to broken skin unless instructed otherwise, discontinuing at once with any side effects seek med advice. Avoid self medication without medical advice.

A

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33
Q

common SE of topical meds

A 
itching,
    burning,
    irritation,
    redness, and.
    dryness.
34
Q

acne is staged 1-4

A
  • type 1(non inflammatory commodomes and papules) can use: nonprescription methods such as (sulfur, salicylic acid, and benzoyl peroxide.
  • type 2 commodomes and papuled)can use: prescribed topical antibiotics such as (tetrocycline and erythromycin)
  • type 3(large imflamed papules and cysts) can use: oral antibiotics (tetracyclines or erythromycin) and can be prescribed with topicals.
  • type 4 (mini commodomes with deep lesions and pitting scars) doesn’t respond to topical therapy; rather systemic hormones like birth control or retinoids (accutane).
35
Q

accutane is absolutely contraindicated in pregnancy

A
  • extreme high risk of birth defects
  • should not be initiated in females of childbearing potential (regardless if they’re sexually active or not until 2 urine or serum pregnancy tests are confirmed of the guardian signs the consent)
  • monthly pregnancy tests
  • you must use 2 forms of birth control atleast one month before, during, and for one month after discontinuation.
36
Q

side effects and contraindications of benzoyl peroxide can include

A

S&S:

  • skin irritation
  • mild stinging
  • redness and dry skin

Contraindications:

  • pregnancy and breast feeding
  • if they have skin diseases (dermatitis, eczema, sunburn, etc.)
  • benzoic acid or paraben hypersensitivity
  • avoid exposure to the eyes or mucus membranes, can cause severe irritation,
37
Q

side effects of accutane

A

S&S

  • **-mucotaneous effects (inflammation of lips, dry skin, dry mouth, nose-bleed, peeling, itching, photo sensitivity)
  • alterations in lipid profiles; decrease in hemoglobin/hematocrit
  • **-musculoskeletal pain, back pain, arthralgia, myalgia
  • GI effects (anorexia, colitis, increased appetite, nausea/vomiting, thirst)
  • **-CNS effects (dizziness, drowsiness, fatigue, headache, lethargy, malaise, weakness)
  • **-depression, emotional lability, psychosis, aggression, violent behavior (rarely, suicidal ideation)
  • decreased tolerance to contact lenses
38
Q

contraindications of accutane

A
  • pregnancy and breastfeeding
  • use in children under 12 years old
  • retinoid (vitamin A/paraben hypersensitivity)
  • prolonged exposure to sunlight
  • driving or operating machinery at night due to decreased night vision and other visual disturbances
  • use cautiously in patients with psychiatric disorders
  • osteoporosis or other bone disorders.
39
Q

topical skin preparations can be classified into 9 categories according to their action:

A
  • antipruritics relieve itching
  • corticosteroids treat dermatological disorders associated with allergic reactions
  • emollients and protectants soothe irritation
  • keratolytic agents loosen epithelial scales
  • enzymatic agents promote the removal of necrotic or fibrous tissue
  • scabicides and pediculicides treat scabies or lice
  • local anti-infectives prevent and treat fungal, bacterial, and viral infections
  • burn medications to prevent or treat infections
  • agents that treat acne
40
Q

sometimes the phycisian will order that the skin be premoistened or plastic wrap be applied over the ointment to aid in absorption.

A

know

41
Q

Collagenase should only be used on wounds associated with necrotic material.

A

If a topical antibiotic is to be applied to an infected site, the antibiotic is applied before collagenase.
– avoid using detergents, povidone-iodine, and heavy metal (mercury, silver) containing agents, which will inhibit the enzymatic activity of collagenase.

42
Q

one application of scabicides is usually enough but sometimes two applications separates from the 1st by 1 or 2 weeks to eliminate any remaining scabies.

A

you should repeat pediculicides after 7-10 days.

43
Q

nothing by mouth for at least an hour after a nystatin treatment

A

know

44
Q

all oral antivirals need to be started within 72 hours of rash onset and are most effective if started within the first 48 hours of onset.

A

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45
Q

chlorhexidine and povidone-iodine are the 2 maor antiseptics

A

used for surgical scrubs and as bacteriostatic skin cleansers.

46
Q

silvadene(sulfadiazine) and sulfamylon(mafenide) are the most common used agents for second and third degree burns.

A

apply with sterile glove hand

47
Q

degrees of burns

A

-1st degree: superficial (sunburn)
-2nd degree: partial thickness (blisters)
-3rd degree: full thickness (eschar)
escharotomy

48
Q

Sunscreens

A

only broad spectrum sunscreens both (UVA and UVB) with spf greater than or equal to 30 cna claim to reduce the risk of skin cancer and early skin aging if used correctly with other skin care measures.

49
Q

apply sunscreen 15 to 30 minutes prior to sun exposure, limiting sun exposure (especially 10am and 4pm), wearing sun protective clothing, use water resistant sunscreens when swimming or sweating, and reapplying at least every 2 hours (even on cloudy days)

A

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50
Q

end chapter questions

A
  • safest treatment of scabies: Lindane
  • topical skin prep to protect skin and soothe: Emollient
  • which antipruritic would most likely cause hypersensitivity: Benzocaine
  • which preparation is best for diaper rash: Protectant
  • a patient using burn meds should: use aseptic technique
  • what antibacterial cream is for impetigo: Bactroban
  • patient w/mild acne would use: benzoyl peroxide
51
Q

antipruritics are short term (most of them relieve itching)

A

most all end with -caine’s

52
Q

dont cover the area with antipruritics and don’t use over a week.

A

emollients are drug of choice for eczema

53
Q

scabies can tunnel and easily transmitted

A

scabicides have to be applied exactly how the directions say and left on 8-14 hours.

54
Q

shampoo is the drug of choice for lice

A

start antivirals within 48-72 hours

55
Q

bacteriostatic: slows
bacteriocidal: kills

A

promitherin left on 8-14 hours

56
Q

antivirals are MOST EFFECTIVE in the first 40 hrs

A

if after that then we can use antiimflamatorys

57
Q

antiseptics inhibit growth of bacteria

A

meds-chlorohexidine and povidone iodine

58
Q

chlorohexidine is category B for pregnancy. not for use frequently or eyes and ears.

A

know

59
Q

iodine is not for use in newborn

A

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60
Q

promethrin head to toe=left on for 8/12 hr

A

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61
Q

pyrithrin RID- head lice only

A

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62
Q

nystatin NPO for atleast an hour

A

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63
Q

paradex- oral rinse for gingivitis.

A

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64
Q

dont use silver sulfa with collagen or tripsin containing enzyme debriding agents will inactivate effects of silver

A

apply with sterile gloved hands- pain burning itching.

65
Q

sunscreen is considered a medication.

A

skin cancer is most common cancer- SPF recommended is 30 or greater.

66
Q

sunscreen applied every 2 hours or after excessive swearing for swimming. AVOID tanning beds

A

know

pharm skin ch 12 (1 decks)

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