ch 88 highlights Flashcards
impetigo is caused by
staph
strep
treat impetigo with
mupirocin
altabax
mupirocin comes in
ointment
cream - more expensive
treat inoculation of MRSA
intranasal mupirocin (same as the treatment of impetigo)
drugs for hair loss
Minoxidil ( topical)
Finasteride (BPH)
what formulations of Minoxidil are available and for what gender
2% solution (generic) - women
5% solution (Rogaine Extra Strength for Men)
5% foam (Rogaine mens extra strength)
apply to scalp twice a day
what was finasteride and Minoxidil originally developed for
Minoxidil - hypertension
Finasteride - BPH
Finasteride in pregnancy?
teratogen that can cause genitourinary abnormalities in males exposed to the drug in utero
Not in pregnancy
Also they should not handle the tablets that are crushed or broken
seborrheic Dermatitis and Dandruff is caused by
a microbe in the yeast family
drug for Seborrheic Dermatitis and Dandruff
Ketoconazole
2% foam (Extina) - applied BID for 4 weeks
2% gel (Xolegel) - applied daily for 2 weeks
1% and 2% shampoos (Nizoral) - periodic maintenance also with Head and Shoulders - pyrithione zinc
or selenium sulfide (Selsun Blue and Head and Shoulders intensive)
Botox should be avoided in people ages
65 and older because it is unlikely to help:
in older people, the major cause of lines and wrinkles is loss of elasticity in the skin - cannot be reversed by neuromuscular blockade
over time, with botox, some patients develop
antibodies against botulinum toxin type A which produces a reduction in the botox benefits
Botox and uses
There is botox and botox cosmetic which is the same
Also used for strabismus, hyperhidrosis, migraine headache prophylaxis
med for unwanted facial hair
Eflornithine (Vaniqua) - benefits developed slowly over 4-8 weeks. It slows hair growth, causes it to be finer and lighter and decrease. Does not eliminate it and effects are not permanent. Requires continuous treatment
adverse effects of Botox injections
headache, facial pain, swelling, bruising reduced by applying ice to the site and avoiding alcohol, vit E and ASA and other NSAIDS for the week before treatment
Best protection from venereal warts is
prevention HPV vaccine (Gardasil 9)
how is genital warts removed
topical drugs
cryotherapy
electrodessication
laser surgery
conventional surgery
drugs that are provider applied for venereal warts
Podophyllin Trichloroaceitic acid (TCA) Bichloroaceitic acid (BCA)
drugs for home application for venereal warts
podofilox
imiquimod
kunecatechins
can you use Podofilox in pregnancy
no
1st line for eczema
moisturizers and topical glucocorticoids
topical immunosuppressants for eczema
tacrolimus (Protopic) and pimecrolimus(Elidel) (second line)
what ointment is approved for use in young children for atopic dermatitis (eczema)
Crisaborole 2% ointment (Eucrisa)
ages for Tacrolimus (Protopic)
older than 2 years old
Tacrolimus does not cause ______ like glucocorticoids
thinning of skin
organic sunscreen is known as ____screens
chemical
inorganic sunscreens is known as ____screens
physical
Organic sunscreen does what
absorb UV radiation and then dissipate it as heat
Inorganic sunscreen does what
scatter UV radiation
Organic screens absorb ____, but only 6 absorb ___
UVB, UVA
only two agents are employed as physical screens
titanium dioxide and zinc oxide
broad spectrum sunscreen
protect against UVA and UVB
all sunscreens protect against
UVB
iPLEDGE
Prescribers must register with iPLEDGE and agree to follow key points to prescribe Isotretinoin (Accutane)
Isotretinoin (Accutane) is a derivative of
Vit A
adverse effects of Accutane
Not for pregnancy
dryness or itching of skin, nose, mouth
Skin may become sensitized to UV light,
pancreatitis
hearing impairment
decreased bone mineral density
depression with SI
what hormonal agents approved for acne treatment have increased risk of blood clots
Beyaz and Yaz
what contraceptives ae approved for acne in women
Estrostep
ortho-tri-cyclen
beyaz
yaz
guidelines to prescribe contraceptives for acne
must be 15years old who want contraception, have reached menarche and not responded to topical drugs. may take 6 mos or more to improve
diuretic for acne treatment
Spironolactone (Aldactone)
risk for using spironolactone for acne
hyper k
dont use steroids on
groin
face
effects of topical glucosteroids
thinning of skin
does the concentration of topical glucocorticoids tell you the potency?
no
oral abx used to treat moderate to severe acne
Doxycycline and Minocycline
use of abx for acne
benefits develop slowly
give 3 months then d/c and switch to topical
Keratolytic agents - what do they do
promote shedding of the outermost layer of epidermal skin cells
keratolytic drugs used to treat acne
benzoyl peroxide
Azelaic acid is used for
rosacea
salicylic acid is used for
acne
ointment are not good for
weeping oozing skin or areas that sweat alot
lotions and gels
hairy, oily, large areas
may decrease oilyness
gels are better for
face and they dry clear
steroids cant be covered bc
it increases absorption so you can have systemic effects
benzoly peroxide cannot be used in what population
asthmatics
combining dapsone with benzoyl peroxide
can turn the skin yellow or orange
organic sunscreen that provides full range UV protection
Avobenzone
most effective at treating recent hair loss
Minoxidil
If topical glucocorticoids fail to treat eczema without causing skin atrophy and hypopigmentation
topical immunosuppressants may be used
Botox wears off in
3-6 mos
for salicylic acid peeling and drying are
not desired effects
symptom of systemic tox for salicylic acid
tinnitis
SPF 15 blocks ___ of UVB
93% (highly protective for SPF of 15 or higher)
Triamcinolone acetonide is a
glucocorticoid
Tretinoin is a
Retinoid
Tretinoin and sun
makes more susceptible to sunburn
Before applying Retin-A
Wash skin
towel dry
allow to dry 15-30 min
apply once daily
Trentinoin and wrinkles
used for fine wrinkles
not course or sun damage
6 mos to start to see results
While taking accutane - drug interaction
no tetracycline
no acohol
pregnancy tests and Accutane
2 preg tests to start therapy
1 preg test to refill
initial treatment severe acne
Doxycycline and Retin -A
high permeable area
axilla face eyelids neck perineum genitalia
low permeable area
palms
soles
inflamed skin increases or decreases absorption
increases
will an occlusive dressing decrease or increase absorption
increase
long term topical glucocorticoids can cause
atrophy of dermis and epidermis
thinning of skin
long term induce acne and hypertrichosis (excessive hair)
salicylic acid adverse effects
tinnitus
hyperpnea
psychologic disturbances
microbe involved in acne
propionibacterium acnes
antiacne drugs and kids
not for younger than 12
Atralin - which is a tretinoin gel for 10 and older
dont give BC to kiddies
what preferred for pregnant in antiacne
Benzoyl peroxide and topical salicylic acid
excretion of systemic sulfonamides in breast milk can cause
kernicterus in breastfed neonates
what meds can increase side effects of Accutane
Tetracyclines
Vit A
abx of choice for acne
alternatives are
Doxycycline and minocycline
tetracycline and erythromycin
with Salicylic acid monitor for
s/s
Salicylism
hyperpnea, tinnitis, n/v
mental status changes
what part of Birth control is helpful in acne
estrogen
how long does it take for birth control to help with acne
6 months
organic sunscreens ____ UV radiation and then dissipate it as heat
inorganic screens ___ UV radiation
absorb
scatter
only 2 agents are employed as physical screens
titanium dioxide
zinc oxide
Products that protects against UVA and UVB are labeled
broad spectrum
Sunscreens only retain SPF after ___ min of water exposure
40 unless labeled for 80
avoid sun exposure between what hours
10am-4pm
sunscreen containing PABA should be applied how far in advance
2 hours
first line for dermatitis (exzema)
moisturizers and topical glucocorticoids
topical immunosuppressants approved for dermatitis eczema) - second line for those who dont respond to the glucocorticoids
Tacrolimus
pimecrolimus
tacrolimus for dermatitis doesnt cause
what does it cause
thinning of skin, well tolerated but in children increases risk for varicella zoster
cancer risk
phsophodiesterase 4 for dermatitis
novel agent inhibits PDE4 can be used in younger children - burning and stinging at site side effect
impetigo pathogens
S. aureus
Strep pyogenes
impetigo is treated with
mupirocin topical
which drug formulation is the highest absorption
ointment
which drug formulation can be used for oily hairy skin
lotion
which drug formulation is good for face
gel
which drug formulation is good for dry and sensitive skin
cream
St Johs with Dig will
decrease dig level
SSRI, MAO, TCA and St johns
worry about
serotonin syndrome
if someone needs to be treated for osteoporosis with a familial history of breast cancer - what drug
Evesta
