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Pharmacology > Chapter 16: Skin disorders > Flashcards

Chapter 16: Skin disorders Flashcards

1
Q

purpose of topical corticosteroids

A

decrease inflammation, reduce itching, acute and chronic dermatitis

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2
Q

delivery types of topical corticosteroids

A

ointments, gels, aerosols, cream and lotions

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3
Q

low potency topical corticosteroids used for

A

eczema, iritant dermatitis, seborrhea, atopic dermatitis

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4
Q

high potency topical corticosteroids are used for

A

psoriasis, lichen planus, allergic contact dermatitis

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5
Q

are cream or ointments generally preferred

A

creams because they are nonocclusive and less greasy

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6
Q

when are aerosols preferred

A

weeping lesions or lesions on scalp

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7
Q

what is the drawback of lotions

A

often contain alcohol and sting

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8
Q

what is the advantage of gels

A

spread easily and can be used on scalp and hairy areas

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9
Q

most common adverse effect

of topical corticosteroids

A

cutaneous atrophy

(thinning of skin accompanied by telangiectasia)

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10
Q

other adverse effects of topical corticosteroids

A

striae, acne, hypopigmentation, alopecia, glaucoma,

adrenal suppression (may be life threatening)

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11
Q

conscientiou prescribing of topical steroids

A

drug absoprtion enhanced by increased skin temp, skin hydration, application to denuded areas

cannot be used extended periods in women who are or may become pregnant

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12
Q

what is the most commonly used topical corticosteroid

A

1% hydrocortisone

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13
Q

topical corticosteroid patient teaching

A

effects are short term, agents cannot be used frequently

symptoms may reappear after effects wear off

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14
Q

mechanism of action for topical corticosteroids

A

controls protein synthesis rate

depresses migration of polymorphonucleic leukocytes

reverses capillary permeability

reverses lysosomal stablization

prevents or controls inflammation

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15
Q

topical corticosteroid pharmacokinetics

A

absorption: no systemic absorption
distribution: 2/3 protein bound if systemically absorbed
metabolism: hepatic if absorbed
excretion: urine

half-life: 6.5 hours

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16
Q

clinical uses for topical corticosteroids

A
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17
Q

contraindication to topical corticosteroids

A

hypersensitivity

systemic fungal infection

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18
Q

dosage and application of topical corticosteroids

A

Page 295

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19
Q

topical corticosteroid patient education

A

avoid occlusive dressings

avoid with diapers (occlusive)

caution with pregnancy

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20
Q

etiologic agent of acne

A

propionibacterium acnes

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21
Q

mild acne

A

few to several papules and pustules but no nodules

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22
Q

moderate acne

A

several papules and pustules with a few nodule

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23
Q

severe acne

A

several papules, pustules, and nodules

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24
Q

drugs used to treat acne

A

keratolytics, antibiotics, vitamin A derivatives

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25
Q

names of mild keratolytics

A

benzoyl peroxide

salicylic acid

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26
Q

mild keratolytics mechanism of action

A

causes epidermis cells to shed faster to prevent pore clogging

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27
Q

how does benoyl peroxide decrease anaerobic bacteris in follicles

A

convert benzoic acid in skin and releases free-radical oxygen that oxidizes bacteria proteins

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28
Q

what can happen with high concentration formulations of benzoyl peroxide

A

hyperpigmentation and increased risk of skin irritation

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29
Q

antiobitc mechanism of action

A

decreases bacterial load and inflammation and infection that results from bacteria presence

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30
Q

Administration of antibiotics for acne

A

may be topical or oral

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31
Q

why are ABT and benzoyl peroxide often prescribed together for acne treatment

A

provides better results than either agent alone

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32
Q

side effects of ABT

A

light sensitivity, gastric upset, diarrhea

33
Q

tetracyclines after expiration date

A

become more potent

don’t use

34
Q

caution with ABT prescribing

A

children under 10

pregnant women

to avoid blue-gray discoloration of teeth

35
Q

what infection may clindamycin lead to

A

c-diff

36
Q

mechanism of action: vitamin A

A

retinoids prevent the formation of comedones by normalizing the desquamation of follicular epithelium

37
Q

major side effects of retinoids

A

excessive drying, burning, skin inflammation

38
Q

examples of retinoids

A

tretinoin (retin A), adapalene, tazoarotene

39
Q

pregnancy category of retinoids

A

tretinoin - class C

tazarotene and isotrentinion - class X

Never use in pregnant women

40
Q

treatment of urticaria

A

antihistamines

41
Q

antihistamine mechanism of action

A

act on histamine receptor to decrease release of histamine from mast cells

42
Q

first generation antihistamines

A

diphenhydramine

lead to drowsiness

43
Q

second generation antihistamines

A

loratidine, fexofenadine, cetirizine

cause very little drowsiness if used at commonly prescribed doses

44
Q

treatment of superficial bacterial infection

A

usually topical agents are sufficient

if not, oral agents are used

45
Q

impetigo characterisitics

A

lesions with a honey colored crust

highly contagious

46
Q

mupirocin

A

topical antibiotic that is effective against gram+ bacteria including MRSA

47
Q

examples of oral agents utilized when topicals are insufficient

A

dicloxacillin, erythromycin, and amoxicillin with clavulanate

48
Q

imidazole and triazole

A

antifungals that inhibit p450 system to stop conversion of lanosterol to ergosterol

(which is necessary for cell wall synthesis)

49
Q

allylamines

A

antifungals inhibits epoxidase

(which is required for ergosterol)

50
Q

griseofulvin

A

antifungal that binds to microtubules, stopping fungal mitosis

51
Q

patient education on drugs treating superficial bacterial infections

A

wash with soap and water before applying

52
Q

drugs used to treat superficial fungal infections

A

imidazole, triazoe, allylamines, griseofluvin

53
Q

treatment of tinea cruris

A

topical treatment with any antifungal agentunless it has spread to lower thighs and buttocks, then use itraconazole or terbinafine

54
Q

treatment of tinea capitis

A

oral griseofulvin usually used cause topical agents do not clear infection very well

55
Q

treatment of tinea corporis

A

topically id 1-2 lesions present, otherwise orally. fluconazole once weekly x 4 weeks

56
Q

treatment of tinea pedis

A

topical agent in most cases but highly kerototic lesion may require oral therapy

57
Q

treatment of onchyomycosis and candiasis

A

Page 299

58
Q

Topical conditions that are viral

A

shingles

chicken pox

herpes simplex

herpes zoster

59
Q

antiviral agents mechanism of action

A

inhibits DNA synthesis to decrease viral replication

60
Q

antiviral pharmacokinetics

A

metabolism: liver
excretion: urine

half-life: 8-10 hours

61
Q

antiviral agents drug interactions

A

probenecid will increase drug levels

risk of toxicity when adinistered with theophylline

62
Q

agents used for cleansing and disinfecting skin

A

NS, isopropyl alcohol, phenol derivatives, chlorhexidine, cationic surfactants, povidone-iodine, hydrogen peroxide

63
Q

purpose of topical cleansing/disinfecting agents

A

decrease risk of infection by decreasing bacterial load

usually for intact skin

64
Q

first degree burn

A

exhibit pain and erythema only

65
Q

second degree burn

A

exhibits blisters and pain

66
Q

third degree burns

A

full thickness that are insensate and usually require more than outpatient treatment

67
Q

treatment of 2nd degree burns

A

silver sulfadiazine and covered with guaze. CHange twice daily

68
Q

pressure ulcers

A

page 302

69
Q

topical drugs used for reatment of psoriasis

A

corticosteroids

vitamin D analogues

emollients

keratolytics

tazarotene

calcineurin inhibitors

page 303

70
Q

oral drugs for treatment of psoriasis

A

cyclosporin A

methotrexate

acitretin

fumaric acid esters

page 303-304

71
Q

IV/injectable meds for psoriasis

A

page 304-305

72
Q

drugs to treat seborrhea

A

mild strength corticosteroids

shampoos containing selenium

mineral oil pretreatment for debridement

73
Q

example of drugs used to treat seborrhea

A

page 305-306

74
Q

mechanism of action for topical anethestics

A

blocks sodium channels, slowing conduction along nerves and disrupting the action potential

75
Q

examples of topical anesthetics

A

lidocaine

benzocaine

prilocaine

76
Q

application of topical anesthetics

A

only to intact skin

77
Q

pregnancy, pediatric, geriatric implications

A

page 308

78
Q
A

Pharmacology (28 decks)

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