Chapter 196 - Other Topical Medications Flashcards

1
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Chlorhexidine belong to?

A

Bisbiguanide

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2
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Gentian violet belong to?

A

Dye

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3
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Brilliant green belong to?

A

Dye

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4
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Hydrogen peroxide belong to?

A

Peroxide

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5
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Povidone-iodine belong to?

A

Iodophor

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6
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Clioquinol belong to?

A

Iodophor

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7
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Metronidazole belong to?

A

Imidazole

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8
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Mupirocin belong to?

A

Fermentation product of Pseudomonas fluorescens

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9
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Retapamulin belong to?

A

Pleuromutilin

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10
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Azelaic acid belong to?

A

Dicarboxylic acid

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11
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Benzoyl
peroxide belong to?

A

Peroxide

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12
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Aluminum salts belong to?

A

Astringent

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13
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Potassium
permanganate belong to?

A

Astringent

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14
Q

TABLE 196-1
Topical Antimicrobials and Astringents

What group does Silver nitrate belong to?

A

Astringent

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15
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
(1) Binds to negatively charged bacterial cell wall and cytoplasmic components leading to altered osmotic equilibrium
(2) Precipitation of cytoplasmic components

A

Chlorhexidine

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16
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Unknown

A
  1. Gentian violet
  2. Brilliant green
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17
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Oxidizes microbial molecules

A
  1. Hydrogen peroxide
  2. Benzoyl peroxide
  3. Potassium permanganate
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18
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Oxidation and release of free iodine

A

Povidone-iodine

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19
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Oxidation and release of free iodine; chelates bacterial surface and trace metals needed for bacterial growth

A

Clioquinol

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20
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Creation of reduced intermediate compounds and free radicals

A

Metronidazole

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21
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Inhibits bacterial isoleucyl-tRNA synthetase

A

Mupirocin

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22
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Inhibits 50S subunit of prokaryotic ribosome

A

Retapamulin

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23
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Possibly through inhibition of microbial respiratory chain

A

Azelaic acid

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24
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Coagulation of proteins

A

Aluminum salts

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25
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIBACTERIAL MECHANISM
Precipitation of bacterial proteins by free silver ions

A

Silver nitrate

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26
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Gram-positive, Gram-negative bacteria, enveloped viruses, and fungi

A

Chlorhexidine

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27
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Some vegetative Gram-positive bacteria (eg, Staphylococcus sp.) and yeast

A
  1. Gentian violet
  2. Brilliant green
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28
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Broad-spectrum antimicrobial

A
  1. Hydrogen peroxide
  2. Benzoyl peroxide
  3. Aluminum salts
  4. Potassium permanganate
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29
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Gram-positive, Gram-negative, enveloped viruses, fungi, sporicidal, Mycobacterium tuberculosis

A
  1. Povidone-iodine
  2. Clioquinol
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30
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Anaerobes, protozoa, and microaerophilic bacteria

A

Metronidazole

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31
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Gram-positive, some Gram-negative, spares normal flora

A

Mupirocin

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32
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Gram-positive

A

Retapamulin

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33
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Propionibacterium acnes and Staphylococcus epidermidis

A

Azelaic acid

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34
Q

TABLE 196-1
Topical Antimicrobials and Astringents

ANTIMICROBIAL SPECTRUM
Gram-positive and Gram-negative bacteria

A

Silver nitrate

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35
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Keratitis, ototoxicity

A

Chlorhexidine

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36
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Potential skin necrosis at high concentrations or when occluded; stains skin and clothing; tattooing when applied over granulation tissue; mutagenic

A

Gentian violet

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37
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Potential skin necrosis; stains skin and clothing

A

Brilliant green

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38
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Avoid in abscesses; bleaches hair

A

Hydrogen peroxide

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39
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Caution in patients with thyroid disorders; potential systemic toxicity in neonates or when applied to large body surface area; neutralized by blood, serum proteins, and sputum

A

Povidone-iodine

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40
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Possible irreversible optic atrophy and peripheral neuropathy (oral); contraindicated in children <2 years of age; contraindicated for diaper rash; stains skin yellow; neutralized by blood, serum proteins, and sputum

A

Clioquinol

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41
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Contraindicated during first trimester of pregnancy

A

Metronidazole

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42
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Potentially toxic amounts of polyethylene glycol contained in vehicle may be absorbed in patients with extensive burns or open wounds

A

Mupirocin

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43
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Allergic contact dermatitis

A

Retapamulin

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44
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Hypopigmentation

A

Azelaic acid

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45
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Bleaches dark clothing

A

Benzoyl peroxide

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46
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Do not use under impervious material to prevent evaporation

A

Aluminum salts

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47
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Skin discoloration; caustic at high concentrations or with contact of undissolved crystals

A

Potassium permanganate

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48
Q

TABLE 196-1
Topical Antimicrobials and Astringents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Black skin discoloration, caustic at high concentrations; potential methemoglobinemia

A

Silver nitrate

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49
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Antiseptic surgical hand scrub and surgical site preparation

A

Chlorhexidine

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50
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Impetiginized eczema; mycotic skin infections; oral candidiasis; superficial skin infections

A
  1. Gentian violet
  2. Brilliant green
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51
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Cleansing of wounds, suppurating ulcers, and local infections

A

Hydrogen peroxide

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52
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Antiseptic surgical hand scrub, prevention or treatment of topical site infection associated with surgery, burns, minor cuts/scrapes

A

Povidone-iodine

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53
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Approved for fungal infections; also used for pyoderma, folliculitis, and impetigo

A

Clioquinol

54
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Rosacea

A

Metronidazole

55
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Nonbullous impetigo, eradication of nasal carriage of Staphylococcus aureus

A

Mupirocin

56
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Nonbullous impetigo

A

Retapamulin

57
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Acne

A
  1. Azelaic acid
  2. Benzoyl peroxide
58
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Weeping, impetiginized skin disorders

A
  1. Aluminum salts
  2. Potassium permanganate
59
Q

TABLE 196-1
Topical Antimicrobials and Astringents

USE
Weeping, impetiginized skin disorders, cauterization of wounds, removal of granulation tissue, aseptic prophylaxis of burns

A

Silver nitrate

60
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Chlorhexidine

A

B

61
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Gentian violet

A

C

62
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Brilliant green

A

Not used in Western medicine

63
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Povidone-iodine

A

C

64
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Metronidazole

A

B

65
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Mupirocin

A

B

66
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Retapamulin

A

B

67
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Azelaic acid

A

B

68
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Benzoyl peroxide

A

C

69
Q

TABLE 196-1
Topical Antimicrobials and Astringents

PREGNANCY CATEGORY
Silver nitrate

A

C

70
Q

TABLE 196-2
Topical Antiparasitic Agents

GROUP OR COMPOSITION
Permethrin

A

Synthetic pyrethroid

71
Q

TABLE 196-2
Topical Antiparasitic Agents

GROUP OR COMPOSITION
Ivermectin

A

Avermectin

72
Q

TABLE 196-2
Topical Antiparasitic Agents

GROUP OR COMPOSITION
Synergized pyrethrins

A

Natural botanical

73
Q

TABLE 196-2
Topical Antiparasitic Agents

GROUP OR COMPOSITION
Malathion

A

Organophosphate

74
Q

TABLE 196-2
Topical Antiparasitic Agents

GROUP OR COMPOSITION
Crotamiton

A

Crotonyl-N-ethyl-o-toluidine

75
Q

TABLE 196-2
Topical Antiparasitic Agents

GROUP OR COMPOSITION
Lindane

A

Organochlorine

76
Q
A
77
Q

TABLE 196-2
Topical Antiparasitic Agents

GROUP OR COMPOSITION
Spinosad

A

Fermentation product

77
Q

TABLE 196-2
Topical Antiparasitic Agents

MECHANISM
Inhibits nerve cell sodium ion influx

A

Permethrin

78
Q

TABLE 196-2
Topical Antiparasitic Agents

MECHANISM
Binding to glutamate-and gamma-aminobutyric acid–gated chloride ion channels

A

Ivermectin

79
Q

TABLE 196-2
Topical Antiparasitic Agents

MECHANISM
Pyrethrins inhibit nerve cell sodium ion influx; piperonyl butoxide inhibits cytochrome P450

A

Synergized pyrethrins

80
Q

TABLE 196-2
Topical Antiparasitic Agents

MECHANISM
Cholinesterase inhibitor

A

Malathion

81
Q

TABLE 196-2
Topical Antiparasitic Agents

MECHANISM
Unknown

A

Crotamiton

82
Q

TABLE 196-2
Topical Antiparasitic Agents

MECHANISM
Cholinesterase inhibitor

A

Lindane

83
Q

TABLE 196-2
Topical Antiparasitic Agents

MECHANISM
Generalized CNS excitation leading to paralysis

A

Spinosad

84
Q

TABLE 196-2
Topical Antiparasitic Agents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Itching and stinging on application; contraindicated for infants <2 months of age

A

Permethrin

85
Q

TABLE 196-2
Topical Antiparasitic Agents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Skin irritation upon application

A

Ivermectin

86
Q

TABLE 196-2
Topical Antiparasitic Agents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Itching and stinging on application; ragweed or chrysanthemum allergy

A

Synergized pyrethrins

87
Q

TABLE 196-2
Topical Antiparasitic Agents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
Flammable; not approved for children <6 years of age

A

Malathion

88
Q

TABLE 196-2
Topical Antiparasitic Agents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
May cause seizures, muscle spasms, aplastic anemia; not for use in children <3 years of age, pregnant or breastfeeding women, patients with underlying neurologic disorders, or over broken skin

A

Lindane

89
Q

TABLE 196-2
Topical Antiparasitic Agents

MAJOR SIDE EFFECTS OR CONTRAINDICATIONS
No major side effects in preclinical trials

A

Spinosad

90
Q

TABLE 196-2
Topical Antiparasitic Agents

USE
Lice and scabies; used on clothing as an insect repellant

A

Permethrin

91
Q

TABLE 196-2
Topical Antiparasitic Agents

USE
Scabies, head lice, rosacea

A

Ivermectin

92
Q

TABLE 196-2
Topical Antiparasitic Agents

USE
Lice

A
  1. Synergized pyrethrins
  2. Malathion
  3. Spinosad
93
Q

TABLE 196-2
Topical Antiparasitic Agents

USE
Scabies

A

Crotamiton

94
Q

TABLE 196-2
Topical Antiparasitic Agents

USE
Lice and scabies

A

Lindane

95
Q

TABLE 196-2
Topical Antiparasitic Agents

PREGNANCY CATEGORY
Permethrin

A

B

96
Q

TABLE 196-2
Topical Antiparasitic Agents

PREGNANCY CATEGORY
Ivermectin

A

C

97
Q

TABLE 196-2
Topical Antiparasitic Agents

PREGNANCY CATEGORY
Synergized pyrethrins

A

C

98
Q

TABLE 196-2
Topical Antiparasitic Agents

PREGNANCY CATEGORY
Malathion

A

B

99
Q

TABLE 196-2
Topical Antiparasitic Agents

PREGNANCY CATEGORY
Crotamiton

A

C

100
Q

TABLE 196-2
Topical Antiparasitic Agents

PREGNANCY CATEGORY
Lindane

A

C

101
Q

TABLE 196-2
Topical Antiparasitic Agents

PREGNANCY CATEGORY
Spinosad

A

Not rated

102
Q

TABLE 196-3
Topical Antipruritics

GROUP
Diphenhydramine

A

Antihistamine

103
Q

TABLE 196-3
Topical Antipruritics

GROUP
Doxepin

A

Tricyclic antidepressant

104
Q

TABLE 196-3
Topical Antipruritics

GROUP
Menthol

A

Cyclic terpene alcohol

105
Q

TABLE 196-3
Topical Antipruritics

GROUP
Pramoxine hydrochloride

A

Surface anesthetic

106
Q

TABLE 196-3
Topical Antipruritics

MECHANISM
Local anesthesia; histamine antagonism

A

Diphenhydramine

107
Q

TABLE 196-3
Topical Antipruritics

MECHANISM
Histamine antagonism, interference with neuronal synaptic communication; decreased awareness through production of drowsiness

A

Doxepin

108
Q

TABLE 196-3
Topical Antipruritics

MECHANISM
Counter irritant. Cooling sensation in the skin via transient receptor potential melastatin 8 (TRPM8) receptors in the skin

A

Menthol

109
Q

TABLE 196-3
Topical Antipruritics

MECHANISM
Local anesthesia

A
  1. Phenol
  2. Pramoxine hydrochloride
110
Q

TABLE 196-3
Topical Antipruritics

PRECAUTIONS
Significant percutaneous absorption; potential sensitization with cross-sensitization to oral form and related compounds

A

Diphenhydramine

111
Q

TABLE 196-3
Topical Antipruritics

PRECAUTIONS
Potential contact sensitization; significant systemic absorption resulting in drowsiness and drug interactions; contraindicated in patients taking monoamine oxidase inhibitors

A

Doxepin

112
Q

TABLE 196-3
Topical Antipruritics

PRECAUTIONS
Avoid in pregnant women and infants; irritant in diaper area and skin folds

A

Phenol

113
Q

TABLE 196-3
Topical Antipruritics

PREGNANCY CATEGORY
Diphenhydramine

A

B

114
Q

TABLE 196-3
Topical Antipruritics

PREGNANCY CATEGORY
Doxepin

A

B

115
Q

TABLE 196-3
Topical Antipruritics

PREGNANCY CATEGORY
Menthol

A

C when combined with camphor (ie, Sarna)

116
Q

TABLE 196-3
Topical Antipruritics

PREGNANCY CATEGORY
Phenol

A

Should be avoided

117
Q

TABLE 196-3
Topical Antipruritics

PREGNANCY CATEGORY
Pramoxine hydrochloride

A

C

118
Q

TABLE 196-4
Topical Keratolytic Agents

DOSAGE
Alpha-Hydroxy acids

A

2% to 20% as nonpeeling agent, >20% as peeling agent

119
Q

TABLE 196-4
Topical Keratolytic Agents

DOSAGE
Propylene glycol

A

40% to 60% under occlusion at bedtime; may be combined with salicylic acid (Keralyt gel) or lactic acid (Epilyt); 2% vehicle in many preparations

120
Q

TABLE 196-4
Topical Keratolytic Agents

DOSAGE
Salicylic acid

A

Scaly dermatoses: FDA approved twice daily to 4 times daily at 1.8% to 3%; calluses, corns, and warts: FDA-approved at 12% to 40% for plaster vehicles, 12% to 17.6% in collodion-like vehicles

121
Q

TABLE 196-4
Topical Keratolytic Agents

DOSAGE
Urea

A

Twice daily to 4 times daily in 10% to 40% creams and lotions

122
Q

TABLE 196-4
Topical Keratolytic Agents

DOSAGE
Lactic acid

A

Twice daily to 4 times daily in 5% to 12% preparations

123
Q

TABLE 196-4
Topical Keratolytic Agents

INDICATIONS
Photoaging, scaling, hyperkeratosis, acne, hyperpigmentation

A

Alpha-Hydroxy acids

124
Q

TABLE 196-4
Topical Keratolytic Agents

INDICATIONS
Ichthyosis, hyperkeratosis, psoriasis

A

Propylene glycol

125
Q

TABLE 196-4
Topical Keratolytic Agents

INDICATIONS
Hyperkeratosis, scaling

A

Salicylic acid

126
Q

TABLE 196-4
Topical Keratolytic Agents

INDICATIONS
Xerosis, pruritus, hyperkeratosis, eczema, ichthyosis, psoriasis, nail avulsion

A

Urea

127
Q

TABLE 196-4
Topical Keratolytic Agents

INDICATIONS
Ichthyosis, xerosis, eczema, photoaging

A

Lactic acid

128
Q

TABLE 196-4
Topical Keratolytic Agents

PREGNANCY CATEGORY
Alpha-Hydroxy acids

A

Not contraindicated in pregnancy

129
Q

TABLE 196-4
Topical Keratolytic Agents

PREGNANCY CATEGORY
Salicylic acid

A

C

130
Q

TABLE 196-4
Topical Keratolytic Agents

PREGNANCY CATEGORY
Urea

A

C

131
Q

TABLE 196-4
Topical Keratolytic Agents

PREGNANCY CATEGORY
Lactic acid

A

Not contraindicated in pregnancy